Diagnosis and treatment

How is it done?

You will be given drops to dilate your pupil after the doctor has explained the procedure to you. There are two ways which the laser may be performed, depending on the location of the tears in the retina.

1. An anaesthetic drop will be put in your eye. The doctor will then place a contact lens on the surface of your eye. This will focus the laser, which is then performed sitting upright on the slit-lamp. The anaesthetic “numbing” drops do not completely anaesthetise the eyeball itself, but should allow the contact lens to be placed comfortably on the surface of the eye. This is not always possible despite sufficient eye drops.
2. The laser may be delivered through a special device worn on the doctor’s head. This technique of “indirect laser” for treating retinal tears involves the use of an instrument to press on the wall of the eyeball in order to reach parts of the retina that contain the retinal tear. In this case, you will be asked to lie flat and the doctor will press on your eye using a small instrument to allow him/her to visualise the tear.

In both techniques, the doctor surrounds the hole/weak spot with laser. It is important that you keep your head still throughout the procedure. You will see a series of bright flashes.

Does it hurt?

The laser treatment itself can be associated with “stabbing”, “sharp”, and “aching” pains. Very occasionally, there can be a feeling of an “electric shocklike” feeling during the laser treatment.

Although these sensations can be worrying, they do not indicate any adverse effects inside the eye related to the laser treatment. Depending on the amount of laser performed, you may also experience a headache after the procedure. Laser treatment with the use of a contact lens can occasionally cause redness of the tissues that cover the eyeball. This settles without any treatment within five days. If we have to “indent” or press on your eye-ball the eye-ball using a small instrument then this can cause redness of the tissues
that cover the eyeball, but this also settles without any treatment within five days. 

What are the risks?

Since no incisions are made to the eye, there is no risk of infection inside the eye. Some patients experience a slight irritation after the procedure from the lens being placed on the eye; however, this usually recedes quickly. As stated before, it is important that you do not move during the procedure. If you do, there is a possibility that the laser will affect a portion of your vision that it was not intended to (i.e. your central vision).

There is also a very small possibility that the laser retinopexy does not completely seal the tear. Even after laser retinopexy, a retinal detachment can still form, though the possibility of one is greatly reduced with treatment.

What happens after the treatment?

Immediately after the laser your vision will be dazzled as a result of the bright lights. Your vision will be misty for a few hours and should return to normal by the next day. You should not drive on the day of your laser. It is important to remember that laser retinopexy will not “get rid” of any pre-existing symptoms such as floaters that you experienced before your treatment. Sometimes the floaters may increase immediately after the treatment, but these will settle after a few days. There may be light sensitivity and glare outside.

Will I need a follow-up?

Yes, you will be reviewed in the outpatient clinic approximately two weeks after your laser treatment to check that the laser has worked.

Can the retina detach after laser retinopexy?

Laser retinopexy considerably reduces the risk of retinal detachment but it can still occur despite laser retinopexy. You should seek help immediately if you notice: 

• New floaters (Any floaters in the vision that were present before the laser will still be there afterwards but with time will become less noticeable)
• Flashing lights in the eye
• A change in vision (like a curtain coming across).