Laser in Diabetic Retinopathy

Laser in Diabetic Retinopathy

    1.       Diabetes affects the eyes of 20% of all those affected by it. Although it is said that it takes 10 years for diabetes to affect the eye, one  may not be sure as to when   the  diabetes  first started.

    2.       Diabetes  affects the blood vessels of the retina  making  them leaky  i.e. they start leaking fluid or blood and  some  abnormal weak  blood  vessels may also form which are prone to  rupture  & bleed inside the eye. 

    3.       Laser is a strong, focused beam of light of single  colour. It directly or indirectly destroys the leaking blood vessels  and prevents the formation of abnormal blood vessels.

    4.       Laser is not helpful in every stage of diabetic  retinopathy (D.R).  Very early cases of D.R don't need laser treatment, while advanced cases may not be helped by doing the laser. 

    5.       Laser  treatment of retina is done in different 1-4  stages (sittings) at some intervals so that the eye can withstand the strong effect of laser beams.

    6.       There  is no proven role of any oral drugs or bodily injections  in cure of D.R., however, certain new anticancer (actually Anti-VEGF e.g. Avastin, Lucentis) injections are now given inside the eye in certain stages of DR under sterile conditions in the operation theatre. These may have to be commonly repeated.

    7.       Laser also cannot `cure' the disease but helps to control  the process to prevent further visual loss and prevent major bleeding inside the eye. 

    8.       All patients may not respond well to laser treatment as it may still fail to stop the progression of disease in-spite of multiple sittings of laser treatment.

    9.       Full effect of laser generally takes 2-3 months to come.

  10.       Some patients may experience some blurring of vision espe­cially increase in inability to read after laser treatment  espe­cially  if  central  part  of the retina  (i.e. macula)  is  already involved  or damaged.  This decrease may be  temporary  for 2-3 months or may improve  slightly or not at all in next few weeks.

   11.       Side effects of laser treatment include difficulty in  night vision, slight initial increase in impairment of vision,  failure to control the disease, etc.

  12.       Laser treatment is generally a painless procedure with  each sitting  lasting for about 10-20 minutes.

  13.       No bandaging is done after laser treatment and patient  can resume his normal activities from the same day itself.  Eye drops need to be put for about 10-14 days after laser treatment.

  14.       Postoperatively, if patient is prone to bleeding inside  the eye, he should avoid doing excessive physical jerking. 

Regular  follow-up every 3-6 months throughout the lifetime  is  must even  after  laser.  Repeat  Angiography (FA)  &  laser are  often required.

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