Retinopathy of prematurity (ROP) is a disorder of the developing retinal blood vessels of the preterm infant. New recommendations for screening and treatment of ROP have been published in the past few years. Current evidence suggests that screening infants with gestational ages of 30 6/7 weeks or less (regardless of birth weight) and birth weights of 1250 g or less is a strategy with a very small likelihood that an unscreened baby would have treatable ROP. Individual centres may choose to extend birth weight screening criteria to 1500 g. Initial screening should be performed at 31 weeks’ postmenstrual age in infants with gestational ages of 26 6/7 weeks or less at birth, and at four weeks’ chronological age in infants with gestational ages of 27 weeks or more at birth by an ophthalmologist skilled in the detection of ROP. Follow-up examinations are conducted according to the ophthalmologist’s recommendation. Infants with high-risk prethreshold ROP and threshold ROP are referred for retinal ablative therapy. Developing processes for ROP screening, documenting results and communicating results to parents as well as health professionals involved in the infant’s care are important responsibilities for all nurseries providing care for preterm infants.

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Selective Laser Trabeculoplasty, or SLT, is a form of laser surgery that is used to lower intraocular pressure in glaucoma.

It is used when eye drop medications are not lowering the eye pressure enough or are causing significant side effects. It can also be used as initial treatment in glaucoma. SLT has been in use for more than 25 years in the United States and around the world.

1. Who is a candidate for SLT?
   Patients who have primary or secondary open-angle glaucoma (the drainage system in the front part of the eye is open) and are in need of lowering of their intraocular pressure (IOP) are eligible for the procedure. Your eye doctor will make the final determination if you are a candidate.
2. How does it work?
   Laser energy is applied to the drainage tissue in the eye. This starts a chemical and biological change in the tissue that results in better drainage of fluid through the drain and out of the eye. This eventually results in lowering of IOP. It may take 1-3 months for the results to appear.
3. Why is it called Selective?
   The type of laser used has minimal heat energy absorption because it is only taken up by selected pigmented tissue in the eye. Sometimes it is referred to as a “cold laser.” Because of this, the procedure produces less scar tissue and has minimal pain.
4. What are the risks?
   One key aspect of SLT is a favorable side effect profile, even when compared with glaucoma medications. Post-operative inflammation is common but generally mild, and treated with observation or eye drops or an oral non-steroidal anti-inflammatory drug. There is an approximately 5% incidence of IOP elevation after laser, which can be managed by glaucoma medications and usually goes away after 24 hours.

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Laser photocoagulation is a proven effective treatment for preserving vision and reducing the risk of vision loss from diabetic retinopathy.  In national clinical trials of laser treatment for diabetic retinopathy conducted at multiple locations, laser photocoagulation reduced the risk of severe vision loss from diabetic retinopathy to less than 2% over a five-year period.

Two laser techniques are performed today, generally using an argon laser:

• Scatter or panretinal photocoagulation generally requires 1,200-1,800 individual laser spots, usually spread over two or three sessions. In this technique the ophthalmologist avoids the macula, the central area of the retina that is responsible for our reading vision, color vision, and other tasks requiring sharp vision. Scatter laser photocoagulation is used to treat proliferative diabetic retinopathy, a major cause of severe vision loss from diabetes.
• Focal laser surgery uses fewer spots and less intense laser power to treat diabetic macular edema. Using a technique called fluorescein angiography and other examination and photographic techniques, the ophthalmologist identifies areas that are leaking fluid into the macula area. These areas are then treated directly with a laser to prevent further leakage of fluid into the macula and to allow fluid that has already leaked to be reabsorbed.

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Macular degeneration treatment breakthroughs inspire hope that someday we may see a cure to this disease.  Promising treatments, described below, depend upon the stage of disease progression.

The treatment for early dry AMD is generally nutritional therapy, with a healthy diet high in antioxidants to support the cells of the macula.

If AMD is further advanced but still dry, supplements are prescribed, to add higher quantities of certain vitamins and minerals which may increase healthy pigments and support cell structure.

There’s no cure, but treatment for age-related macular degeneration(AMD) may slow the disease and keep you from having a severe loss of vision. Talk to your us about the best way to manage your condition.

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