Patients with CSME are generally recommended to undergo focal laser photocoagulation. This entails a fluorescein angiogram to guide treatment and utilization of a laser to help “dry up” the localized swelling (macular edema). Ophthalmologists apply laser treatment to the macula of the eye, avoiding the fovea where central acuity resides, in a grid-pattern or directly to leaking microaneurysms.

  
     
 
The risk of visual loss is reduced by more than 50% for patients with CSME who undergo focal laser photocoagulation. Even patients with 20/20 vision who meet guidelines for treatment should be considered for laser therapy to prevent eventual visual loss. It is important to realize that laser treatment does not usually improve vision, but is aimed at prevention of further visual loss. Most patients with CSME require 3 to 4 different focal laser sessions, two to four months apart, to resolve the swelling.  
 
     
  Patients with PDR should receive scatter laser photocoagulation (laser treatment of the ischemic peripheral retina) as soon as possible following diagnosis of the condition. This treatment is also known as pan-retinal laser photocoagulation. By causing regression of the neovascular tissues, the risk of severe vision loss is substantially reduced.  
     
 
Scatter laser photocoagulation (also known as PRP, or pan-retinal photocoagulation) is an in-office or out-patient procedure done with or without an anesthetic injection adjacent to the eye. Many patients will experience mild discomfort with the laser treatment, although this can be resolved with an anesthetic block. The laser treatment usually takes less than 30 to 45 minutes per session. A complete laser treatment, however, may require up to 3 or 4 different sessions, with a total of one to two thousand laser applications spots.  
 
     
 
In some patients with PDR, the vitreous hemorrhage prevents the ophthalmologist from performing the laser treatment. Simply put, the blood is in the way of the laser beam. If the vitreous hemorrhage fails to clear within a few weeks or months, a vitrectomy surgery may be performed to mechanically clear the hemorrhage and laser photocoagulation is then applied, either at the time of the vitrectomy or shortly thereafter. Patients who have tractional retinal detachment are usually scheduled for vitrectomy surgery promptly.  
 
 

 

 
 
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