Eyecare: just had laser treatment for lattice degeneration

In My Humble Opinion
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I’ve found it very helpful to read on the Dope about people’s experiences with IOL (intra-ocular lens replacement), so I thought I’d post about something kind of related, in case other Dopers are told they need this procedure and are curious to hear first-hand experience about what it’s like.

I expect this thread will sink like a stone as most Dopers won’t care about this topic - that’s fine, I just want to have something in the records in case anyone is searching for experiences. But if anyone does have questions, ask away.

The “laser treatment” is more formally called “photocoagulation.” I had it because of pigmented lattice degeneration in both eyes, which my ophthalmologist wanted to treat before he does IOL because I am at very high risk of retinal detachment and this will, in his opinion, help to minimize the risk. As far as I can tell from my very limited research, diabetic retinopathy is one of the most common reasons people have it.

EXTRA SHORT VERSION: No problem; if you need this procedure, don’t worry about it, it’s not particularly painful or inconvenient.

LONGER VERSION WITH PRACTICAL DETAILS: It took me a few weeks to get pre-approval from my insurance company for the treatment (the fact I’m in Indonesia and the physician is in Singapore did not help) but ultimately, it was approved. The total cost for both eyes, with all tests/medicine/doctor’s fees, was about $5500 (though I don’t know how relevant that is to other countries).

I was pretty nervous before hand, because I have a morbid imagination. I had pictured in my mind that I would feel something weird while the procedure was in progress, and would involuntarily jerk away - I have an abnormal startle response/weirdly fast reflexes, which has been noted by several physicians - and the laser would burn my optic nerve or something. (See, I TOLD you I have a morbid imagination).

I mentioned the startle reflex to the doctor (who probably thought I was nutty, but he was too kind to show it) and said “if there is any way to strap me in, please do!” He didn’t seem concerned and of course, in the event, it was fine.

The procedure took 10-15 minutes per eye. My whole visit to the doctor’s office was closer to 2-3 hours (hard to estimate precisely because he wasn’t happy with the equipment when we started at one facility, so we moved to his other office, which added time) - before the procedure is done, I had to sit and have repeated eyedrops to dilate my eyes. That adds to the total time.

I was given anaesthetic eye drops just before the procedure, so I didn’t really feel anything, though occasionally there was kind of an ache in my eye, which the doctor said was normal.

I sat up and rested my chin on a chin rest, with all the equipment in front of me. The doctor sat across from me. I had handles to grip during the procedure, which was fantastic. An assistant stayed with me and sort of held my hand, and also lightly rested her other hand on the back of my head. (This was great, from an emotional standpoint.)

The equipment comes at you (I couldn’t see it too well; it was all a blur) and then you see flashes of green light followed by red. On some level, you know there is a piece of machinery RIGHT ON YOUR EYEBALL!!! ARGHGHGH!! AND LASERS POINTING INSIDE YOUR EYE!!! but because you can’t feel much, it’s far less disturbing than it sounds.

Like I said, it is sort of achy, and a bit uncomfortable overall, but it’s not too bad. Especially if you are really motivated because you know the alternative is more and more loss of vision! When I thought to myself, “yuck, this feels kind of uncomfortable, why am I doing it?” I’d remind myself that I want to see the face of my son when he graduates from college some day, I want to see the mountains I’m hiking in, and I’d like to see the face of a grandchild if I ever have one.

I asked in advance if I needed to have someone with me to escort me home (or to the airport, in my case) afterward. They said yes, so my husband came with me, though I could have managed without him as my vision was blurry but useable. I flew home to Jakarta the same day I had the procedure. I was told I could wear my contacts the next day, though I waited a bit. I was given two kinds of eyedrops, both of which I was supposed to use 4 times a day for four days. (I kept forgetting, so it was more like 2-3 times a day, oops.)

Anyway, that’s the whole story. It didn’t improve my vision, but that was not the point - the idea was to lower the risk of retinal detachment when I have IOL. I go back to the doctor in 6 weeks to check on the healing, and have been advised that I can do the IOL 3-4 months after the laser treatment.

One weird thing (well, if you are as myopic as I am it won’t be weird - you will know what I mean) is the change in the blurry light-blobs I see at night in the dark. Those of you who are very myopic will understand - a red or green light from an air conditioner or TV in the dark will make a big blurry globe. Before the laser treatment, these blobs had developed holes and a lot of texture/variegation. Now, they are smooth!

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Moved to IMHO, our home for medical threads, from MPSIMS.

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Sorry, twickster. Since I’m not seeking medical advice or looking for opinions, just sharing a story, I thought MPSMS was the right place … but of course, anywhere is fine by me.

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I do have a question, if you don’t mind sharing. You say it hasn’t improved your vision - has it changed it at all? If someone needed new glasses, and also needed this procedure, should they get the procedure first, and wait to get an exam for the new glasses until afterwards? (They recommend you not buy new glasses just before cataract surgery, is why I ask. It might end up being a waste of money, as cataract removal sometimes changes your vision enough that you need new glasses after. No sense wasting the money to get new ones right before.)

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I’d personally say wait. Laser in this fashion won’t change your refraction per se, but if your vision is bad enough, you may have issues seeing well enough before the laser treatment to get a reliable refraction.

(IANAD/N, of course.)

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Other than the change in the “night blobs” it has had no impact that I can see, and I don’t expect it to.

Anyway, I don’t think I’d be able to judge whether it had any effect, since my vision is going downhill rapidly - I have a nuclear sclerotic cataract in my left eye and a posterior polar cataract in my right eye, both of which are making my eyesight annoyingly bad and worsening. (I’d considered IOL in the past, before my eyes got as bad as they are now, but since it wasn’t urgent and it wasn’t clear it would be covered by insurance, I didn’t get around to actually doing it. Now, however, I really cannot see very well and dealing with the cataracts is not optional. And since it is a medical necessity, IOL is covered by my insurance now - I’ve already gotten the pre-approval.)

Right now I wear the strongest available contact lenses whenever possible; I wear my old glasses when necessary but wouldn’t waste money on new ones at this point. I will probably need glasses after the IOL since I’m getting mono-ocular lenses; I’ll require reading glasses at the very least.

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Thanks to you both.

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It also depends on how bad the degeneration is. If it’s just a couple small areas that need treatment, the person may well be able to get a good refraction.

This can be especially true if allowed to move his/her head to use undamaged parts of the eye to be able to read the chart. I do refractions using frames that go on the face and require you to add/remove individual lenses, rather than the more common-these-days method of looking through a suspended eyepiece with all of the lenses built into dials. If you have the person wearing the prescription as (awkward) glasses and a chart across the room, patients have freedom to move the head side-to-side and compensate for parts of their vision that may be worse for reasons unrelated to something refraction can fix.