Laser Procedures

Laser involves the use of powerful focused light energy. It is widely used for treatment of retinal tears to seal holes to prevent retinal detachment, essentially by “spot-welding” the retina to the deeper layers in the eye. It is also used to treat the complications of diabetic retinopathy to stop bleeding of the retina. Retinal laser is also used to reduce swelling of the retina following a vascular insult such as a blocked blood vessel.

For the laser treatment you will be seated at a machine with a chin and forehead rest. A drop of local anaesthetic will be instilled to keep you comfortable. A hand-held contact lens and a small amount of jelly will be placed on the eye to help focus the laser beam. The untreated eye will be asked to watch a target to help keep the treated eye steady.

The laser works with a click and a flash of light. There will be some mild discomfort. If it is painful you may request to have a small injection of local anaesthetic for greater comfort. After the laser treatment your vision will be dazzled for about 7 days, and you may experience floaters. The speed at which your vision recovers will depend on the amount of laser treatment received. You may also notice that your night vision is reduced – this may last up to two months.

The aim of this laser is not to improve your vision. The aim is to prevent any further loss of vision. A follow-up appointment is generally arranged for 2-3 weeks after your laser.

Laser peripheral iridotomy is used to treat or prevent future angle closure glaucoma attacks. A small hole or holes are made in the iris to create a new pathway for the fluid to drain from your eye. It will hopefully also prevent scar formation between the iris and cornea which can lead to the progression of glaucoma. These holes are only the size of a pinhead and are generally concealed from view by your upper eyelid. The laser is performed on one eye at a time.

For the laser treatment you will be seated at a machine with a chin and forehead rest. A drop of local anaesthetic will be instilled to keep you comfortable. A hand-held contact lens and a small amount of jelly will be placed on the eye to help focus the laser beam. The untreated eye will be asked to watch a target to help keep the treated eye steady. Nearly all patients find the procedure comfortable and pain free.

After the laser there may be a mild ache. If this persists for more than two hours please call us. If there is a sudden loss of vision, a red sore very painful eye, swelling, vision change or nausea and vomiting, please call us. You may be asked to return for a pressure check in 30-60 minutes after your treatment. You will need some drops after the laser to help the eye heal correctly, and you will usually be asked to continue any glaucoma medication after the laser procedure.

You will be given an appointment for review in a few weeks. Please keep this appointment as the effectiveness of the laser will be evaluated.

(See Closed angle glaucoma)

Selective laser trabeculoplasty is used for patients with open angle glaucoma. The laser is used to treat the drainage system of the eye (trabecular meshwork), to improve the outflow of fluid. This type of laser will be effective in some patients but not others. Your response will be determined by the type of your glaucoma and the specific structures found in your drainage system. Your doctor cannot predict how well the laser will work before the laser surgery.

For the laser treatment you will be seated at a machine with a chin and forehead rest. A drop of local anaesthetic will be instilled to keep you comfortable. A hand-held contact lens and a small amount of jelly will be placed on the eye to help focus the laser beam. The untreated eye will be asked to watch a target to help keep the treated eye steady. Nearly all patients find the procedure comfortable and pain free.

You may need to use drops after the laser procedure to help the eye heal correctly. In most cases you will be asked to continue with your glaucoma medications after the laser surgery. It will take several weeks for the laser treatment to take full effect, and a review appointment is usually made for 4 to 6 weeks after the procedure. If lower pressure is needed, your doctor will help you decide whether additional laser treatment, medication or surgery is required.

(See Open angle glaucoma)

After modern cataract surgery with lens implant surgery, the back membrane of the natural lens is left in place to support the lens implant. The membrane may become cloudy and cause blurred vision, and sometimes the patient will see streaks or haloes around lights. These problems worsen with time. With a YAG posterior capsulotomy, a laser is used to make a small opening in the cloudy capsule, allowing light to pass through again for clear vision.

For the laser treatment you will be seated at a machine with a chin and forehead rest. A drop of local anaesthetic will be instilled to keep you comfortable. A hand-held contact lens and a small amount of jelly will be placed on the eye to help focus the laser beam. The untreated eye will be asked to watch a target to help keep the treated eye steady. Nearly all patients find the procedure comfortable and pain free.

The laser is performed on one eye at a time. Your vision should gradually improve over the next twenty four hours, but will be blurry for the first few hours while the dilating drops wear off. You may be given an eye drop after the laser to help control the pressure in your eye. If you are currently using any eye drops for glaucoma or any other eye condition, you should continue with these unless advised differently by your Doctor. It is not unusual to see floaters across your vision for the next week or two. If you see a shower of floaters, flashing lights or a veil across your vision please call us. You may feel a gritty sensation in the eye which will settle on its own. If you use any lubricating drops in your eyes, you can continue with these. There is usually no need to change your glasses script after this procedure.
There is no need to limit your activity after laser treatment.

(See Cataract surgery)