Retinal Laser Therapy

Retinal laser therapy is a procedure in which a precisely aimed beam of light energy is used to treat damaged or abnormal tissue at the back of the eye, known as the retina (the light-sensitive layer that sends visual signals to the brain).

During the procedure, the laser creates tiny, controlled burns on targeted areas of the retina. These burns seal leaking blood vessels, destroy abnormal new vessels before they can bleed, or create a barrier that helps keep the retina attached to the back of the eye. The treatment does not involve any cuts to the eye.

Retinal laser therapy is used when conditions affecting the retina or its blood vessels threaten vision or have already caused some vision loss. An eye specialist will recommend it after examining the retina closely, usually with imaging tests.

• Diabetic retinopathy (damage to the retina's blood vessels caused by long-term high blood sugar) — the laser can seal leaking vessels or shrink abnormal ones.
• Retinal tears or small holes — the laser welds the retina back to the tissue beneath it before a full detachment develops.
• Retinal vein occlusion (a blocked vein in the retina that causes fluid and blood to leak into the retinal tissue).
• Macular edema (swelling in the macula, the central part of the retina responsible for sharp, detailed vision) when caused by leaking vessels.
• Lattice degeneration (areas of thinning at the edges of the retina) that carry a high risk of tearing.
• Certain rare benign retinal tumors or vascular lesions (abnormal blood vessel growths) at the back of the eye.

Retinal laser therapy is not suitable in every situation. Your doctor will decide whether it is the right choice based on the severity and location of the problem.

• Advanced retinal detachment (separation of the retina from the back of the eye) — surgery is usually needed instead.
• Very dense bleeding inside the eye (vitreous hemorrhage) that blocks the laser from reaching the retina.
• Certain types of macular degeneration where laser can worsen central vision.
• Eyes with very cloudy corneas or lenses that prevent a clear laser path.

Retinal laser therapy is generally considered a low-risk outpatient procedure, but like any medical treatment it carries some possible side effects and complications.

• Temporary blurred vision or light sensitivity for a few hours to days after treatment.
• Mild discomfort or a dull ache in or around the eye during and shortly after the procedure.
• Small permanent blind spots (scotomas) in the treated area — usually at the edges of vision and often not noticed in daily life.
• Reduced night vision or peripheral (side) vision, particularly after extensive treatment for diabetic retinopathy.
• Accidental damage to the macula (central vision area) if a laser pulse lands slightly off-target — rare with modern equipment.
• Swelling inside the eye that temporarily worsens vision.
• In rare cases, new or worsening retinal detachment following treatment.
• Very rarely, bleeding inside the eye triggered by the laser.

Preparation for retinal laser therapy is usually straightforward. Because the procedure is performed under local anesthetic eye drops rather than general anesthesia (full sleep), fasting is usually not required — but confirm with your care team, as practice can vary between hospitals.

Your doctor will review all medications you take. Blood thinners may need to be paused before the procedure, but only on medical advice. If you use eye drops regularly, ask whether to continue them on the day. Smoking and alcohol are best avoided for at least several days beforehand, as they can affect how blood vessels respond to treatment.

Before the session, the eye team will typically run one or more of the following tests to map the retina precisely:

• Fundus photography — detailed photographs of the inside of the eye.
• Fluorescein angiography (FA) — a dye is injected into a vein in the arm; as it travels to the eye's blood vessels, a camera photographs any leaks or abnormal vessels.
• Optical coherence tomography (OCT) — a scan that produces a cross-sectional image of the retina's layers, showing swelling or fluid.
• Visual field testing — to record your baseline side vision before treatment begins.

On the day of the procedure, here is what typically happens, step by step. The number of sessions needed varies — some conditions require only one, others need several visits.

• 1. Anesthetic eye drops are applied to numb the surface of the eye. An injection of local anesthetic around the eye may be given for longer or more intensive sessions.
• 2. Dilating eye drops are used to widen the pupil so the doctor can see the entire retina clearly.
• 3. You sit at a slit lamp (a microscope with a bright light) or lie back in a treatment chair, depending on the equipment used.
• 4. A special contact lens is placed on the eye to focus the laser beam and keep the eye still.
• 5. The doctor aims the laser at the targeted areas of the retina. You may see flashes of bright light and feel a mild stinging or pressure with each pulse.
• 6. Once all target areas are treated, the contact lens is removed, and the eye is rinsed gently.
• 7. The pupil remains dilated for several hours, so you will not be able to drive yourself home — arrange transport in advance.

Retinal laser therapy is an outpatient procedure, meaning most patients go home the same day. Recovery is generally quicker than after eye surgery, but vision changes in the first day or two are normal and expected.

• Vision will likely be blurred for several hours after the procedure due to the dilating drops — this is normal and clears on its own.
• Sunglasses are recommended outdoors for the rest of the day, as the dilated pupil makes the eye very sensitive to bright light.
• Avoid rubbing the eye; the surface may feel gritty or irritated for a short while.
• Anti-inflammatory eye drops or lubricating drops are commonly prescribed for use in the days following treatment.
• Strenuous physical activity, heavy lifting, and contact sports are usually restricted for at least one to two weeks — your doctor will give specific guidance.
• Do not drive until your vision has fully returned to normal and you have been cleared by your doctor.
• A follow-up appointment is usually scheduled within a few weeks to photograph the retina and check that the laser has had the intended effect. Further sessions may be planned at that visit.
• If you have diabetes, keeping blood sugar well controlled after the procedure supports the healing of the retina.
• Seek urgent medical attention if you notice a sudden increase in floaters (small dark shapes drifting across your vision), new flashes of light, a shadow or curtain over your vision, or significant pain — these could be signs of a complication.