Laser Photocoagulation for Age-Related Macular Degeneration (AMD)

What is laser photocoagulation for AMD?

Laser photocoagulation is a type of laser surgery for the eyes. It's done to treat age-related macular degeneration (AMD). AMD can lead to vision loss.

The retina is the layer of nerve cells in the back of your eye. It changes light into electrical signals. Your retina then sends these signals to your brain. AMD affects your macula. The macula is the sensitive, central part of your retina. This area is responsible for the detailed vision in the center of your visual field. AMD harms your macula. Blood vessels may grow under your macula. This causes blood and fluid to leak under it. This excess blood and fluid can lead to vision loss.

Before the surgery, you are given an anesthetic eye drop. An eye care provider then uses a special lens to focus an intense beam of light on the abnormal blood vessels under the macula. This creates burns in small areas of the macula. This seals off the leaky blood vessels. This can help prevent more vision loss.

Why might I need laser photocoagulation for AMD?

Laser photocoagulation is one type of treatment for AMD. AMD is a common cause of severe vision loss in older adults. In rare cases, it can result in total blindness. AMD affects the macula. So you may still have your side (peripheral) vision. But you may have a slow or sudden loss of central vision.

There are 2 types of AMD: dry and wet. Abnormal blood vessel growth only occurs in the wet type. Laser photocoagulation treatment is advised only for the wet type. Laser photocoagulation is only an optional treatment for some people with wet AMD. Your eye care provider might advise the procedure if your abnormal blood vessels are grouped tightly together. The procedure is less helpful if you have scattered vessels. It is also less helpful if they are in the central part of the macula. Your eye care provider may be more likely to advise the procedure if your vision loss comes on suddenly instead of slowly.

Laser photocoagulation doesn’t always bring back vision that you have already lost. But it may slow down the progression of damage to your central vision.

Other treatment options for AMD include medicines injected into the eye that decrease abnormal blood vessel growth. Your eye care provider may advise using injected medicines and laser photocoagulation. Talk with your provider about the risks and benefits of all your treatment options.

What are the risks of laser photocoagulation for AMD?

During laser photocoagulation, the eye care provider burns part of the macula. This sometimes causes some added vision loss. You might have a blind spot where the laser makes a scar. In some cases, this vision loss might be worse than the possible vision loss from not treating the eye. This is something to think about when deciding to have the surgery.

The procedure has some other possible risks as well. These include:

• Accidental treatment of the central macula, which causes a worse blind spot
• Bleeding into the eye
• Damage to the retina from the laser scar, right away or years later

There is also a risk that the abnormal blood vessels might grow back. If this happens, you might need to repeat the treatment.

Your risks may differ based on your age, general health, and the type of AMD you have. Ask your eye care provider which risks apply most to you.

How do I get ready for laser photocoagulation for AMD?

Ask your eye care provider what you need to do to get ready for laser photocoagulation. Ask your eye care provider if you need to stop taking any medicines before the procedure. 

Your eye care provider may want to use special tools to shine a light in your eye and check the back of your eye. You will need to have your pupils dilated (enlarged) for this eye exam. You may need other special tests to get even more information about your eye.

Before the procedure, eye drops will be used to dilate your pupil. It will stay dilated for a few hours after the procedure.

What happens during laser photocoagulation for AMD?

This is an outpatient procedure done in an eye care provider’s office. This means you will go home afterward. During a typical procedure:

• You may be given medicine to help you relax. The eye care provider will use anesthetic eye drops and shots (injections) to make sure you don’t feel anything.
• Your provider will put a special type of contact lens on the surface of the affected eye. This lens helps focus a beam of laser light on the retina using an instrument called a slit lamp.
• The eye care provider uses the laser to seal off the abnormal blood vessels under the macula.
• Your eye may be covered for a little while after the procedure.

What happens after laser photocoagulation for AMD?

Ask your eye care provider about what to expect after your surgery. You will be able to go home the same day. Plan to have someone go home with you after the procedure.

Follow your eye care provider’s instructions about eye care and medicine. Your eye may be a little sore after the procedure. But you should be able to take over-the-counter pain medicines as directed. You may need to wear an eye patch or dark glasses for a day or so. Ask your provider if you should not do certain activities as you recover.

You will need close follow-up care with your eye care provider. They will watch you for complications. The provider will continue to manage your treatment for AMD. Tell your provider right away if you have reduced vision. Or if you have more eye redness, swelling, or pain.

Your vision may be blurry after the surgery. Remember that the surgery does often cause an area of new vision loss. In the long term, it may help stop your vision from getting worse.

Next steps

Before you agree to the test or the procedure, make sure you know:

• The name of the test or procedure
• The reason you are having the test or procedure
• What results to expect and what they mean
• The risks and benefits of the test or procedure
• What the possible side effects or complications are
• When and where you are to have the test or procedure
• Who will do the test or procedure and what that person’s qualifications are
• What would happen if you did not have the test or procedure
• Any alternative tests or procedures to think about
• When and how you will get the results
• Who to call after the test or procedure if you have questions or problems
• How much you will have to pay for the test or procedure