About Dr Brian Ang

Diabetic Retinopathy Laser Complications

In general, laser treatment for diabetic retinopathy is usually safe and straightforward. However, complications can and do occur after laser treatment. Some of the complications may have a long-term impact on your visual function, so it is important that you know about the potential risks of laser.

In general, these retinal laser procedures are performed because the potential benefit of reducing serious vision loss and possible blindness from diabetic retinopathy (from macular edema, vitreous hemorrhage and retinal detachment) far outweigh the risks of the laser treatment itself.

(Image adapted from the internet)

Left: normal vision. Right: how your vision may be affected if you have diabetic retinopathy.

Short-term retinopathy laser complications

Most people will experience some transient and temporary short-term effects after retinal laser. These generally do not cause any long-term visual problems if they are monitored and treated appropriately.

These short-term effects include:
      – Temporary blurring of the vision
      – Increased light sensitivity (photophobia)
      – Inflammation in the eye (uveitis)
      – Raised eye pressure (potentially giving rise to glaucoma)

Long-term retinopathy laser complications

However, it is the longer-term effects that are more significant. There is a potential to affect your vision permanently, so you have to be aware of these risks before you proceed with laser treatment.

Focal / grid retinal laser: Focal or grid retinal laser is used mainly for the treatment of diabetic macular edema, which affects your central vision. The main concern with this laser treatment is inadvertent laser damage to the fovea. The fovea is the center of the macula and is the part that allows you to see the finest detail clearly. If your fovea is lasered, you may lose this important central part of your vision permanently. This complication is fortunately very rare.

To prevent this from happening, make sure you always follow the instructions given by your ophthalmologist and NEVER ever look at the red aiming beam during retinopathy laser treatment. If you have diabetic macular edema, your ophthalmologist will usually only laser up to within 200 micrometers of the fovea.

Pan-retinal photocoagulation (PRP): PRP is the main laser treatment for proliferative diabetic retinopathy, where abnormal new vessels have started growing in the eye. These new vessels increase the risk of bleeding in the eye and tractional retinal detachment.

With PRP laser treatment, it is your peripheral visual field that is at risk rather than the central vision. This is because PRP laser treatment is essentially destructive, and involves coagulating large areas of the peripheral retina.

As a result, you are likely to permanently lose your peripheral (side) vision after laser. Your color vision and night vision are also likely to be affected. You may also notice that your central vision is not as good as what it used to be. Due to all this, your ability to drive safely may be compromised. You may no longer fulfil the legal vision requirements for driving. Click here to download the US state driving requirements

So you are effectively losing (or sacrificing) some peripheral sight (example on your right) as a trade-off against more severe visual loss that will occur if you remain untreated. Panretinal laser treatment will not improve your vision, but is aimed at preventing future sight loss.

(Image adapted from the internet)

It is therefore very important that before you undergo any laser treatment for diabetic retinopathy, you should make sure to discuss fully with your ophthalmologist about retinopathy laser complications and the possible implications they may have on your vision and your day-to-day lifestyle.


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