Diabetic retinal lasers
Diabetic eye care
Regular eye exams are a must for diabetic patients. Early detection and treatment of diabetic-related eye changes are vital to prevent vision-threatening complications and blindness.
Diabetic patients can experience various changes in the eyes, such as changes in refractive error, cataracts, iridopathy, retinopathy, macular edema, and optic neuropathy. Diabetic retinopathy is the major concern that can be prevented, but if left untreated, it can lead to blindness.
Eye Care for Diabetics
The most important point is that even in advanced cases, the disease may progress a long way without symptoms; hence, regular dilated eye examinations for people with diabetes are very important.
Diabetic eye care includes complete eye examination to look for the changes in eye due to diabetes. This includes visual acuity, refraction, lensometer, dilated fundus examination and investigation to detect diabetic retinopathy.
Detection and Diagnosis
Diabetic retinopathy has been graded according to the severity of the disease. In our hospital, we have retina specialists who are well-versed in treating diabetic retinopathy and give proper care and treatment.
Diabetic patients are also more at risk for developing glaucoma, a disease of the eye. Glaucoma is a disease that affects the optic nerve due to increased eye pressure.Regular monitoring of eye pressure is essential for diabetic patients. Diabetic retinopathy patients may not have any symptoms until it reaches an advanced stage. There may be frequent changes in glass power or a decrease in vision due to cataracts. Diabetic retinopathy is diagnosed on a dilated fundus evaluation. In our hospital, all diabetic patients are evaluated by the retina specialist to detect any subtle changes in the eyes.
Treatment options for diabetics
Diet, exercise, and special medication are the best ways to control diabetes. With the latest advancement in the field of medicine, vision loss due to diabetic retinopathy could be treated with laser photocoagulation.
All diabetic patients undergo a dilated examination and further investigation if needed. Various tests that can help in the diagnosis and treatment of diabetic eye changes are available in our hospital.
Fundus photography is done to have a document and can be used for monitoring diabetic changes. Our hospital offers state-of-the-art optical coherence tomography (OCT) tests, ensuring high-quality diagnostic imaging for our patients.
This test can determine the amount of fluid collection in the retina, the extent of bleeding, or any other complications in the eye. This test gives a microscopic cross-section of the retinal layers of the eye. These tests are done in our hospital and used effectively for the treatment of patients. Other tests, like fundus fluorescein angiography, are also done in our hospital. This test can detect the exact location of bleeding and leakage in the retina so that an appropriate laser can be given to prevent further complications.
What is Retinal Laser Photocoagulation?
Ophthalmologists employ retinal laser photocoagulation to treat a variety of retina-related illnesses. The conditions include diabetic retinopathy, retinal vein blockage, retinal breaks, central serous chorioretinopathy, and choroidal neovascularization. Unlike what many patients believe, the process is not similar to surgery. During this therapy, the doctor ensures that the laser beam (focused light waves) falls on the correct location in the retina. During this process, heat energy is created, and retinal coagulation occurs, resulting in the intended treatment.
Retinal lasers
Retinal laser photocoagulation is an in-office procedure used to treat a number of retinal conditions, including retinal tears, diabetic retinopathy, macular edema and retinal vein occlusion. It is most frequently used to seal a retinal tear to prevent development of a retinal detachment, a potentially blinding condition. Retinal laser photocoagulation is also used to seal or destroy leaking blood vessels to prevent further retinal damage and preserve sight.
The laser procedure works by creating small areas of scar tissue that can seal off a tear or leaking blood vessels. It can also slow the growth of abnormal blood vessels (neovascularization) in the eye. The procedure cannot typically restore vision that is already lost, but it can reduce your risk of experiencing future vision loss.
Anti VEGF
Anti–vascular endothelial growth factor therapy, also known as anti-VEGF (/vɛdʒˈɛf/) therapy or medication, is the use of medications that block vascular endothelial growth factor. This is done in the treatment of certain cancers and in age-related macular degeneration. They can involve monoclonal antibodies such as bevacizumab, antibody derivatives such as ranibizumab (Lucentis), or orally-available small molecules that inhibit the tyrosine kinases stimulated by VEGF: sunitinib, sorafenib, axitinib, and pazopanib (some of these therapies target VEGF receptors rather than the VEGFs).
Types and benefits of Retina Laser
According to the type of retinal disorder, laser therapy is provided in different ways.
Proliferative Diabetic Retinopathy (PDR).
Proliferative diabetic retinopathy is a form of advanced or end-stage diabetic retinopathy. Due to the long duration of diabetes and uncontrolled blood sugar levels, the retinal blood vessels undergo changes which happen in stages, ultimately leading to PDR. PDR is a vision-threatening disorder. When timely treatment is not provided, it can cause complications like bleeding within the eyes from the abnormal vessels and/or can retinal detachment.
Retinal laser therapy is helpful in PDR as it decreases the risk of such complications. The doctor performs pan-retinal photocoagulation (PRP) to treat PDR.
The retina is a 360-degree structure that is responsible for vision. The central retina is called as macula and is the chief zone responsible for fine vision. During proliferative diabetic retinopathy, the doctor applies laser therapy to the poorly vascular retinal areas sparing the macula. Proliferative diabetic retinopathy therapy is provided in three to four sessions since the almost 360-degree retina is slowly covered with laser spots. The formation of abnormal blood vessels and undue complications are prevented by this procedure.
Diabetic Macular Edema (DME)
DME is abnormal fluid collection leading to swelling at the level of the macula, causing vision loss. Retinal laser photocoagulation is beneficial in some cases of DME. Here, minimal laser spots are given targeting the leaky macular blood vessels to reduce the swelling.
Retinal Vein Occlusion (RVO)
In RVO, the entire retinal vessel or a part of the retinal vessel gets blocked due to various reasons leading to abnormal blood flow to the part of the retina supplied by the vessel. Here, Retinal laser therapy is useful, similar to PRP in PDR, as explained before.
Retinal Tears, Holes and Lattice Degeneration
Retinal tears, holes, and lattice degenerations (areas of retinal thinning) affect around 10% of the general population and are more prevalent in myopes. If not treated, there is always a risk of retinal detachment from the breaks. In such circumstances, the doctor can delimit the retinal fractures with two to three rows of laser spots, resulting in dense adhesion in the surrounding retina and lowering the chance of retinal detachment. It is necessary to screen and laser such lesions prior to LASIK and cataract surgery.
Central Serous Chorioretinopathy (CSC) and Choroidal Neovascularization
Both disorders cause macular leaks, resulting in fluid collection and visual loss. Retinal laser therapy targeting the leaking areas may be effective in some circumstances, depending on the specialist's opinion.
Patient preparation
The laser operation is only conducted after topical anesthesia has been administered. To reduce pain, eye drops would be administered before the treatment. The treatment is relatively painless. During therapy, the patient may experience slight pricking sensations. Depending on the patient's illness, the complete operation could last anywhere from five to twenty minutes.
After the procedure
The patient might feel mild glare and visual discomfort for a day or two. He or She will be advised to use antibiotic and lubricant eye drops for 3 to 5 days, depending on the type and duration of the procedure. Extensive PRP in diabetic retinopathy can lead to a decrease in contrast sensitivity and colour vision.
Types and method
There are two methods by which laser therapy can be performed: Contact and Non-Contact methods. In the contact procedure, a lens with a lubricating gel will be placed over the patient’s eyes, and laser therapy would be delivered in sitting position.
In the non-contact method, the patient is made to lie down, and laser therapy is delivered. Sometimes the doctor might apply minimal pressure around the patient’s eyes with a handheld instrument.
