Barrage Laser - Treatment, Side Effect, Uses, Recovery Time

Barrage laser is a laser procedure to strengthen the weak regions of the retina. It is performed as a preventive treatment for conditions like retinal detachment. It may also help treat retinal tears found during a regular eye examination.

An argon laser beam is used in this procedure. It can help you avoid complications that may further require the need of surgical treatment. A person’s retina may weaken due to significant conditions such as myopia (nearsightedness).

Barrage laser is also sometimes referred to as barrage laser photocoagulation. Initially, problems such as eye floaters, shadows in vision, and blurred vision may appear.

Anatomy and Physiology of Eye

The anatomy of the eye is complex compared to other body organs. It includes the following key parts that work together to provide us with a clear vision:

1. Cornea: A clear layer in front of the iris made up of collagen and water. The tears help lubricate the cornea and protect the eye.

2. Iris: The coloured part of the eye that controls the pupil’s opening. The colour of the iris may vary depending on your eye colour and may be brown, dark brown, hazel, grey, etc.

3. Pupil: The black hole at the centre of the iris. With expansion and contraction, it regulates how much light goes into the eye.

4. Lens: A small clear disk right behind the pupil. It focuses the light at the back of the eye.

5. Retina: A collection of cells that makes a wall called the retina at the back of the eye. It receives the light and sends electrical impulses from the optic nerve to the brain.

6. Macula: The central area of the retina, which allows one to see finer details and colour.

7. Optic Nerve: The nerve behind the eye carries electrical impulses from the retina to the brain to help you see images.
   

8. Vitreous: Clear, jelly-like fluid that fills the entire eye to help maintain its shape.
   

Barrage laser treatment is performed to improve and prevent the development of eye-related conditions. Some of these conditions can be:

1. Retinal Detachment

2. Macular Degeneration

3. Lattice Degeneration

4. Peripheral Retinal Holes/Tears

5. Diabetic Retinopathy

6. Glaucoma

7. Retinopathy of Prematurity

8. Retinal Vein Occlusions

9. Wet Age-Related Macular Degeneration (ARMD)

Who Needs Barrage Laser Treatment?

People who are diabetics or facing difficulties in vision, like blurred or spotty vision. As part of a regular eye examination, the doctor may look for any signs of vision problem diagnosis.

The doctor generally recommends a barrage laser treatment to patients with macular oedema or retinal tears or weakened retina that can result in vision loss.

Barrage laser is an outpatient procedure, which means the patient does not need to be admitted to a hospital. It is performed after applying topical anaesthetics through eye drops or ointments. It can be done with the patient sitting or lying down.

The retinal barrage laser procedure generally takes 30 to 45 minutes, depending on the patient's health condition and the case's complexity. An ophthalmologist performs this procedure along with other professional medical staff.

The whole procedure can be understood with the help of the step-by-step process:

1. The doctor will first test the patient’s vision and eye condition.

2. Then, the doctor will mark the affected eye.

3. Two drops of Midriatyl 1% eye drop are put in the eye to dilate the pupil.

4. The patient will be required to wait for about 20 minutes to allow the eye drops to work.

5. Now, two drops of Pantocain 2% eye drop is put in the eye to anaesthetise it.

6. A special contact lens will be placed at the cornea with the help of an ointment.

7. Laser beam is shot at the eye. Slight and occasional stings can be experienced along with flashes of light.

8. The patient must remain still before the slit lamp during the procedure.

9. A steroid eye drop will be prescribed for after-care.

A barrage laser treatment requires no hospitalisation. However, there are certain things to remember before undergoing the barrage laser procedure:

Before Barrage Laser Treatment

1. The doctor may advise an eye test before the procedure, as it will help them determine the exact problem.

2. The patient must provide information about his/her complete medical history, current medications and any allergies he/she has. This will help the doctor plan the whole procedure and avoid the risk of complications.

3. The doctor may prescribe eye drops to prevent swelling and infection during and after the surgery.

4. The doctor will briefly explain the procedure, estimated cost, and insurance formalities.

On the Day of Barrage Laser Treatment

1. The patient must reach the hospital before the scheduled time. It is important to take a family member or friend to take the patient home after the procedure.

2. The staff will ask the patient to sign the consent formalities.

3. The patient must not wear make-up, face lotion or contact lenses on the day of the treatment.

4. All the jewellery should be removed before the procedure.

5. After monitoring the patient’s vitals, the team will shift the patient to the OT room.

After a retinal barrage laser, recovery time is usually about one to four weeks, depending from patient to patient. Still, the eyes remain sensitive and need proper hygiene and care.

Once the procedure is complete, the patient must take the following precautions:

The Recovery Process in the Hospital

1. After the procedure, the patient will be shifted to the recovery room for about 30 minutes for monitoring.

2. The patient can go home the same day after monitoring.

3. The doctor will prescribe special eye drops for about four weeks after the surgery.

4. The patient will be restricted regarding driving immediately after the surgery. Thus, the patient must ask a friend or family member to take them home.

5. The eye shield can be removed the next day after the surgery but may be needed to be worn while sleeping.

Recovery Process/Expectations After Hospital Discharge

The recovery process after reaching home is easy. However, some patients may experience soreness, swelling and pain. The following things can be done to take care at home:

1. Follow the Doctor’s Advice: All the instructions provided by the doctor for the recovery process should be followed.

2. Wear Dark Sunglasses: The patient must wear sunglasses outdoors to protect the eyes from sunlight.

3. Pain Relievers: The doctor prescribes medications like eye drops or pain relievers.

4. Avoid Jerky Head Movements: Avoid sudden or jerky head movements, heavy weight lifting or strenuous exercising.

5. Avoid Driving: Driving is advised only after the vision becomes completely clear.

6. Beware of Soap: Wash the face carefully to avoid soap entering the eyes.

Note: It is crucial to follow all the doctor's instructions to avoid the risk of complications after the procedure.

First Follow-up Appointment

1. Follow-up with the doctor will be scheduled on day 1, day 7 and day 30 from the day of the procedure.

2. During the visit, the doctor may change the medicinal treatment per the eye test results and the patient's recovery speed.

3. Depending on the condition and the doctor’s advice, the patient may need to return for follow-up treatments.

Apart from being a preventive treatment for retinal detachment, and other vision loss progressive problems, a barrage laser treatment offers the following benefits:

1. Quick Recovery: Being a laser procedure, it is time saving and also offers a quick recovery.

2. Non-invasive: Laser beam does not require big incisions to treat the affected area. Scissors, forceps or any needles are not required for the procedure.

3. Vision Improvement: The procedure improves vision by removing the existing retinal dysfunctions.

4. Better Retinal Health: It prevents the risk of retinal damage, which could lead to total blindness. It also helps preserve the health of the retina in the long run.

Like every surgery, a barrage laser treatment also involves risks and possible complications. Some of the barrage laser side effects can be:

1. Eye bleeding

2. Light sensitivty

3. Blurred vision

4. Decreased peripheral vision

5. Reduced night vision

6. Blind spot

7. Retinal damage due to scar formation by treatment

8. Loss of vision

When is Consultation with the Doctor Needed?

The patient must observe their eye for vision chanegs or symptoms of other retinar disorders for the following days of the barrage laser treatment. Immediate consultation with a doctor is necessary in case of vision difficulties.

After the barrage laser for retina, some of the common symptoms that one is likely to feel include:

1. Flashing lights

2. Floaters (spots before your eyes)

3. Loss of peripheral vision

4. Blurry/weak vision

5. Mild headache

These symptoms are temporary, and normal vision will restore in a month when the eyes have completely healed. However, the patient should pay close attention to the precautions after the barrage laser procedure.

Apart from the risks and complications involved barrage laser in eye treatment, there can be possible risks of delayed treatment as well.

One of the biggest risk of a delayed barrage laser treatment is loss of vision due to retinal detachment. In retinal detachment, the retina gets separated from the layer underneath, which can lead to complete loss of vision.

Therefore, if the patient is experiencing any pain in the eye, redness, swelling or blurry vision, immediately reach out to an eye specialist who can help diagnose the disease and recommend preventative measures.

The cost of barrage laser treatment will range between ₹20,000 to ₹35,000. The cost varies based on the following factors:

1. Age of the patient

2. Other medical conditions of the patient

3. The technique and equipment used

4. Laser machine being used

5. Experience of the ophthalmologist

Problems with vision should be taken seriously and not ignored specially if it is persistent. Retinal detachment can lead to a permanent loss of vision if not treated on time. Barrage laser treatment may play a preventive role.

A barrage laser helps repair the retinal tears or holes that can help further prevent complications.