Patient Education
Laser Retinopexy
In-office · about 10–20 minutes
Laser retinopexy seals a retinal tear before it can progress to a retinal detachment. The laser places a ring of tiny, controlled burns around the tear; as those spots heal over the following one to two weeks, they weld the retina to the wall of the eye and wall the tear off, so fluid cannot get underneath and lift the retina away.
Laser retinopexy seals a retinal tear before it can progress to a retinal detachment. The laser places a ring of tiny, controlled burns around the tear; as those spots heal over the following one to two weeks, they weld the retina to the wall of the eye and wall the tear off, so fluid cannot get underneath and lift the retina away. It is one of the highest-value procedures in retina — a short office visit that prevents an operation.
What It Treats
- Retinal tears
- Retinal holes and lattice degeneration
- Flashes and floaters with a tear
- Small, localized retinal detachments
What to Expect
Before
Your eye is fully dilated, which takes about thirty minutes, and numbed with drops. If the tear sits far forward in the eye where treatment is more uncomfortable, a small anesthetic injection around the eye may be used.
During
Treatment is given either at a slit lamp with a contact lens resting on your numbed eye, or lying back while the doctor wears a headset laser. You will see very bright flashes of light, and you may feel pinching or a dull ache, particularly for tears far in the periphery. Most treatments place a few hundred spots over several minutes.
After
Your vision will be dim and spotty from the bright light for twenty minutes to an hour — this is an afterimage, not damage. A dull ache or mild headache for a few hours afterward is common and usually settles with acetaminophen.
Recovery & Restrictions
- Bring a driver. Between dilation and the afterimages, you should not drive home.
- The laser scars take one to two weeks to reach full strength. Many surgeons advise avoiding heavy lifting and high-impact activity during that window.
- The laser seals the tear — it does not remove floaters. Floaters from the vitreous separation that caused the tear usually persist and fade slowly over months.
- A follow-up exam in one to two weeks confirms the seal and checks the rest of the retina for new tears.
- Treatment protects the tear that was treated, not the whole retina. New flashes, a fresh shower of floaters, or a curtain or shadow in your vision means you need to be seen the same day.
Risks & Side Effects
Detachment despite treatment
A small number of tears go on to detach anyway, either because fluid was already tracking under the retina or because the seal was incomplete. This is why the follow-up exam matters.
New tears elsewhere
The same vitreous separation that caused the first tear can cause another in the following weeks. A new tear is not a failure of the laser — it is a new problem in a different spot.
Discomfort during treatment
Treating far-forward tears can be genuinely uncomfortable. Tell your doctor if it is too much; more anesthetic can be given.
Macular pucker or swelling
Uncommonly, laser treatment contributes to scar tissue on the macula or to macular swelling, which may need further treatment.
Small blind spots
Each laser spot creates a tiny permanent scar. Because tears are usually far from the center of vision, these are not noticeable — but treatment close to the macula is approached much more cautiously.
Every procedure carries risk, and this list is not exhaustive. Your doctor will discuss the risks that apply to your eye and your circumstances before you decide.