Laser Lasik Eye Treatment

Lasers? On your eyes? It sounds more dangerous than it is. Here's the scoop on laser eye treatment surgery.

You take pretty good care of yourself. You eat right and get some exercise, check your blood glucose, and see your doctor regularly. You know you should have your eyes examined every year, too, but you've been avoiding it. Having an eye exam is right up there with a trip to the dentist: You hope everything will be okay but worry that it won't be.

And what if there is something wrong? You've heard that diabetic eye disease is treated with a laser, but what exactly is laser eye treatment and how does it feel?

There's good news for you. Not only are laser eye treatments very good at preventing vision loss, they're also pretty easy to take.

What is Diabetic Eye Disease?

Before you get laser eye treatment, it helps to know what diabetic eye disease (retinopathy) is and why it's important that you do something about it.

High blood glucose levels associated with poorly controlled diabetes can damage the retina, the thin sheet of tissue in the back of the eye that is like film in a camera. The retina senses light and sends signals to the brain. It has its own blood supply. The smallest of the retinal vessels, the capillaries, can be damaged by high blood glucose levels.

There are two major causes of diabetic vision loss. In diabetic macular edema, the capillaries in the central part of the retina--the macula--become leaky. Fluid that leaks out of the capillaries makes the retina swell, blurring your vision.

In proliferative diabetic retinopathy, abnormal new blood vessels grow from the front surface of the retina. These fragile vessels have thin walls, and they bleed easily. They can also trigger the growth of scar tissue. Scar tissue shrinks as it forms, and if it develops in the eye, it can cause the retina to detach from its normal position.

Laser Eye Treatment Procedure

When you're about to have a lasik laser eye treatment, you'll first be asked to sign a consent form stating that you understand why the treatment is being done and what the potential side effects and complications are. Don't be alarmed at being asked to sign the consent form--laser treatment for diabetic eye disease is very safe, with few side effects but do feel free to ask any questions you have before signing it. Potential side effects depend on the procedure you are having and the health of your eye, so be sure to go over them with your doctor.

There are many different kinds of lasers. The ones used for treating diabetic eye disease produce a beam of light that generates heat when it is absorbed by tissue. It can be tightly controlled to get the exact amount of heat needed.

You'll be seated at the laser, which looks like the microscope your ophthalmologist (eye doctor) uses to examine your eyes. The ophthalmologist will put a drop of numbing liquid in the eye to be treated. A special contact lens that is coated with a thick, clear fluid will then be placed on the eye--the fluid forms a cushion between the lens and your eye. It will feel strange, but not uncomfortable. A drop or two of the fluid may run down your cheek.

The room lights will be turned out, and a white light will shine into your eye to let the ophthalmologist see every detail. You'll be told where to look. Don't worry about keeping the eye open; the contact lens will do that for you. You'll be aware of the laser-aiming beam, a small red or green spot that moves around in your field of vision.

What To Expect

Each time the laser is activated, you will hear a click or beep, and there will be a brief flash of bright light. The laser is usually activated for one-tenth of a second or less. Treating diabetic macular edema doesn't require many applications of the laser, usually less than 200. Treating proliferative retinopathy requires more, often 1,000 or more.

Eye Surgery Painful?

It's natural to be worried about pain, but there is actually very little cause for concern. There is never any pain when macular edema is treated because the retina has no nerve endings that sense pain. Treatment for proliferative retinopathy, however, sometimes stimulates pain nerves that run behind the retina. When this happens you can feel sharp pain for a brief moment, but it's usually not intense enough to be a problem. Some ophthalmologists prevent this pain by injecting a small amount of local anesthetic behind the eye before starting treatment. Be sure to let your ophthalmologist know if you do feel significant pain, because he or she has many ways to reduce or eliminate it.

How long does laser eye surgery take?

The treatment usually takes only five to 20 minutes, depending on how many laser applications are needed. If you received a local anesthetic, a patch will be put on the eye, but otherwise a patch is usually not necessary. You won't be able to see well out of the treated eye for an hour or so because of the bright flashes of the laser and the contact lens you wore during the treatment, but these effects wear off very quickly. By the next day your vision should be almost back to the way it was before the treatment. You'll get sympathy from family and friends, but you'll know that it really wasn't such a difficult experience after all.
The Benefits

Laser treatment for diabetic macular edema reduces the risk of moderate vision loss by at least 50 percent. With proliferative diabetic retinopathy, the risk of severe vision loss is cut by about 90 percent. In both cases, the treatment is most effective if you get it early in the course of the eye disease, while your vision is still completely normal. That's why annual dilated eye exams are so important for people with diabetes.

Now you know how little reason there is to be worried about having a laser eye treatment. So go ahead--pick up the phone and make an appointment for that eye exam!

Last updated Jan 4/07