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* Ocular Anatomy And Function

* Two Kinds Of Diabetic Retinopathy

* Laser Surgery

* Fluorescein Angiography

* Nonproliferative Diabetic Retinopathy (NPDR)

* Early Diagnosis Of Nonproliferative Diabetic Retinopathy (NPDR)

* Laser Surgery For Nonproliferative Diabetic Retinopathy (NPDR)

* Proliferative Diabetic Retinopathy (PDR)

* Laser Surgery For Proliferative Diabetic Retinopathy (PDR)

* Vitreous Hemorrhage

* Traction Retinal Detachment

* Closure Of Macular Vessels

* Preventing Diabetic Retinopathy

* Emotional Factors In Diabetes

* FAQ's About Laser Surgery

 
   
Laser Surgery.

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In some cases, laser treatment can be done to prevent or lessen severe loss of eyesight if the abnormal blood vessels are discovered early enough.

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The laser beam is a high energy light that turns to heat when it hits the parts of the retina to be treated. This heat destroys the abnormal blood vessels causing the wet macular degeneration and stops them from growing, leaking and beleeding. A scar forms as a result of the treatment

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Vision does not usually improve after laser treatment and, in some cases, may even be somewhat worse. But loss of vision following laser, though immediate, is usually less severe than the eventual loss of vision that usually occurs if laser treatment is not done. In many cases, the visual distrotion will disappear after laser treatment.

Laser treatment only works about half the time. Since macular degeneration is a condition that is caused by the aging process, laser treatment is often only a means of temporarily preventing further loss of vision, or lessening the amount of visual field loss that usually occurs if no laser is done. After laser treatment, vision may continue to worsen. But if the laser is indicated, the chances are that there will be less visual loss with laser than with no laser treatment. Without laser, loss of vision will usually continue.

Before laser treatment, people with macular degeneration often notice that they have a dark or gray spot in or near their central vision. The laser treatment will cause that spot to become completely and permanenetly black. That area of the macula is sacrificed to save the remaining portions of the macula.

The decision to use laser depends upon the appearance and location of the abnormal blood vessels, as well as how much blood is present. In addition, the general health of the macula is important. In some cases, laser treatment may not always be helpful, or even possible, and is best not done.

Even when laser treatment is considered successful, and the abnormal blood vessels have been destroyed, additional abnormal blood vessels can appear later and further damage vision. The patient who is treated with laser should continually check the vision in the treated eye and tell the doctor immediately if there are new changes, such as a return of distortion or blurriness; in some cases additional laser treatment may be helpful.

One reliable way for a person who has had laser treatment to measure changes is to learn to use the Amsler grid self test with the large "X". It may take some practice to learn to do the test without difficulty and accurately, but with this simple test, using a piece of paper and a pencile, the spot that was caused by the laser can be traced. By tracing it every day, it will be immediately evident when the spot has gotten bigger, or if a new spot has occurred somewhere else. If this happens, it usually indicates that the abnormal blood vessels have recurred. A person who has had successful laser treatment must use the Amsler grid everyday for the rest of his or her life. If there is a change, see your eye doctor promptly.

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We recommend you make copies of the Amsler grid and use your copies for drawing the spot. Use the Amsler grid recording chart to test your vision each day.

  1. Wear your reading glasses.
  2. Cover the opposite eye.
  3. Look at the center dot (the center of the crossing "X") and keep your eye focused on the center at all times
  4. While looking directly at the center and only the center, draw the area of abnormality.
  5. Use different colored pencil for each day of the week. Change the test sheets each week. At the bottom of the sheet write the date of each test with the same colored pencie for that day. In this way, each Amsler sheet of paper will show a record of your vision each day for one week.
  6. Bring your Amsler tests to your next exam.
  7. If you see that the area of abnormality is getting bigger or changing--please call right away.

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