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.
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 bleeding. A scar forms as a result of the
treatment
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 distortion 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 the spot to become completely and
permanently 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
pencil, 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.
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.
- Wear your reading glasses.
- Cover the opposite eye.
- Look at the center dot (the center of the crossing "X") and keep
your eye focused on the center at all times
- While looking directly at the center and only the center, draw the
area of abnormality.
- 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 pencil for that day. In this way, each
Amsler sheet of paper will show a record of your vision each day for one
week.
- Bring your Amsler tests to your next exam.
- If you see that the area of abnormality is getting bigger or
changing--please call right away.
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