The use of laser photocoagulation, a procedure where a laser is used to cauterize or destroy abnormal blood vessels leaking into the eye, is relatively safe but does carry some risks. The most common complaint from patients who have it is loss of vision, which can manifest in several ways. Scarring from the laser may cause a blind spot, or nerves can be damaged, which impairs their sensitivity to light. Sometimes, central or peripheral vision is mildly affected or the patient loses some of his or her ability to focus or see at night. In rare cases, more severe issues can result from the treatment, including burns to the fovea of the eye, hemorrhaging, and retinal detachment.
Vision loss is the main risk of laser photocoagulation. It is often mild, but a certain amount is usually to be expected with the procedure. This can seem somewhat ironic, as the procedure is normally performed to decrease the chances of vision loss due to other conditions like diabetic retinopathy. Typically, the vision loss from the procedure is less than what would occur without it, however, so it is often the better option.
Laser photocoagulation can cause a number of different vision problems. As it burns the targeted blood vessels, it can also leave a scar on the macula. This scar can form a blind spot, known as a scotoma, in the patient’s vision.
Nerves can also be damaged during laser photocoagulation. When this occurs, they may not react as effectively to light as they should, leading to reduced vision. Some people may experience vision loss in their central line of sight, while others may notice it in their peripheral, or side, vision. It may become more difficult for them to see in dim light, reducing their night vision. Certain patients also lose some of their ability to focus on objects they are looking at.
While they do not happen often, significant complications of laser photocoagulation can occur. When they do, patients may suffer from extensive vision loss. The laser may burn a section of the macula known as the fovea, which does not contain any blood vessels. Occasionally, the procedure can actually cause bleeding within the eye, a condition called a vitreous hemorrhage. It is also possible for laser photocoagulation to cause the retina at the back of the eye to detach.