Focal laser for diabetic maculopathy
Information for patients from Ophthalmology
You have been referred for laser treatment for a condition called diabetic maculopathy. This leaflet will explain the following.
What diabetic maculopathy is.
What the symptoms and treatment options are.
Whether there are any alternatives.
What risks are involved in this procedure.
What happens before, during, and after the treatment.
Who to contact if you need further support, or if you have any concerns.
We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to a member of your healthcare team.
What is the macula?
The diagram below shows the retina, which is the inner part of the eye. It is responsible for picking up light and converting it into signals, for your brain to interpret as an image.
In the centre of the retina is a special area called the macula.
The macula is broken down into the fovea, parafovea, and perifovea. Each of these areas has a specific role and structure, that affect how we see.
The fovea, at the very centre, gives your sharpest vision.
Surrounding the fovea is the parafovea. This supports fine detail, but is a bit less precise.
The perifovea is the outer part of the macula. It marks where vision begins to lose some sharpness.
We split the macula into three different zones, as each zone plays a unique part in how you see. This helps us spot and treat different eye conditions more accurately, and target treatment if needed.
What causes diabetic maculopathy?
Diabetic maculopathy is damage to the macula, the part of the eye responsible for sharp central vision.
One cause of macular damage is from diabetic macular oedema. This is where blood vessels near to the macula leak fluid or protein within the macula, causing the retina to thicken.
What are the symptoms of diabetic maculopathy?
If you have diabetic maculopathy you will experience blurring of your central vision. You may notice this when you have trouble with reading or recognising faces in the centre of your vision.
What is the treatment for diabetic maculopathy?
If you have macular changes, we will apply gentle laser burns close to the central part of your retina to seal the areas of leakage. The retina is the part of the eye that you use for seeing clearly.
The laser burns the retina in small amounts. The eye can heal from these burns.
The laser cannot be given directly to the very centre of the vision (the fovea), as the area is very fine and complex.
We may apply laser burns in a grid pattern over the area or we aim the laser directly at the leaking areas.
Are there any alternatives?
Laser treatment is currently the best option for non-central diabetic maculopathy.
We treat central diabetic maculopathy involving macular oedema above a certain level at the fovea (see diagram) with intravitreal injections.
Your treatment plan may need a combination of both. Your ophthalmologist will discuss your needs with you.
What are the risks of laser treatment for maculopathy?
Some people may notice temporary visual changes after laser treatment. These changes include seeing patterns, spots, or areas of altered vision. These effects usually improve with time.
Rarely, laser scars or changes near the centre of vision may cause a lasting change in vision. This can include a reduction in central vision or small blind spots.
During treatment, it is important that you keep your head still and follow the instructions given by the Eye Care team. If we cannot perform the treatment safely, we may stop or postpone the procedure.
How successful is laser treatment?
The Early Treatment Diabetic Retinopathy Study (ETDRS) showed that focal / grid laser treatment reduced the risk of moderate vision loss by about 50% over 3 years, compared with no treatment. However, the benefit varies from person to person. Treatment cannot guarantee that vision will remain stable or improve.
Current UK NICE guidance supports the use of macular laser in selected patients. Particularly for non-centre-involving diabetic macular oedema.
Laser treatment for diabetic macular oedema (DMO) aims to reduce further damage to the macula and help preserve your vision. In many cases, treatment can help maintain the level of vision needed for activities such as reading and driving. However, this is not guaranteed. The outcome varies depending on how bad your condition is and how your eye responds to treatment.
Why might laser treatment not work for me?
In some cases, the damage to the retina is too advanced for laser treatment to work well. Laser treatment cannot restore vision that has already been permanently lost. However, when appropriate, it may help slow further damage and keep your remaining vision. Your doctor will discuss whether laser treatment is likely to benefit you.
If your diabetic eye disease is very aggressive:
the changes may progress too quickly for laser treatment to fully control them; or
the underlaying structure of your eye becomes too damaged due to lack of oxygen. Oxygen feeds the cells and nerves that help you see, this is called ischaemic maculopathy.
Keeping your blood glucose and blood pressure at the best possible levels is very important. Good control of these can help to:
slow down further damage to the retina; and
reduce the risk of your vision getting worse over time.
Please see your GP or diabetes physician regularly to monitor this.
How long will I be at the hospital?
The procedure is performed in the Ophthalmology department as an outpatient. You will not need to stay in hospital overnight. The procedure usually takes about 30 minutes.
How do I prepare for my procedure?
Do not drive to and from your appointment, as you will be having dilating drops in your eye. These drops will blur your vision for up to 6 hours after your treatment. Arrange for a responsible adult to take you home after your treatment.
Diabetic patients. Make sure you have enough food and medication for your visit.
Please take all your normal medications before your treatment.
You may eat and drink as normal, unless you have been told not to.
Can I drive myself home from hospital?
No.
Do not drive yourself home or use a mobility scooter after your appointment, as you will be having dilating drops in the eye. These drops will blur your vision for up to 6 hours after the treatment. The laser treatment itself will make you feel “dazzled”, so it will be unsafe to drive.
Please arrange for someone to collect you after your treatment and take you home, or make other suitable transport arrangements. If you need help getting home, please speak to a member of staff.
What do I need to bring with me to the hospital?
Please make sure you bring food, drink, and any medication you need to take whilst away from home. This is in case your appointment runs longer than expected.
You may need a vision test, so please bring your distance glasses with you. If you wear contact lenses, please be prepared to remove them for your appointment.
Some people find it helpful to bring sunglasses to wear after their treatment. Sunglasses can help shield you from any glare, and provide comfort for your journey home.
What happens when I arrive at the hospital?
Your appointment letter will tell you the date and the time of your procedure. Please check-in at the main Outpatients reception desk, unless your appointment letter tells you otherwise.
The procedure is carried out in the Ophthalmology Outpatients department by a member of the medical staff.
After you have checked-in, take a seat in the department's waiting area. The team will call your name when they are ready to see you.
Before your procedure begins, the ophthalmologist will explain the process to you in detail. You will have a chance to ask any questions and raise any concerns.
If you are happy to proceed, you will be asked to sign a consent form. Please remember that you may withdraw your consent for treatment at any time. If you tell the clinician to stop during treatment, they can stop when it is safe to do so.
Why do I need to sign a consent form?
All patients must give permission before they receive any type of:
medical treatment
test, or
examination.
Consent is usually given when you sign the consent form before your treatment. We may ask you to give your consent verbally (spoken rather than written consent).
You must give your consent voluntarily.
The hospital must give you all the information you need to make a decision about your treatment. This is so you can give us informed consent. Please speak to staff if:
staff have not given you this information; or
they have but you still have questions.
You must be capable of giving consent. This means you understand the information given to you, and can make an informed decision.
When we ask you to give consent, please use this time to ask any questions you may still have. For more information, please go to the NHS Consent for Treatment web page. Remember, you can withdraw your consent for treatment at any time.
What happens before and during the laser treatment?
Before your treatment, we will give you dilating drops in one or both eyes to enlarge your pupils. These drops may sting for around 30 seconds. Your vision may become blurred for several hours afterwards. This is normal and should not be painful.
We will also give you anaesthetic drops to numb your eye and keep you comfortable during the procedure.
During the treatment, we will ask you sit at the laser machine, similar to sitting for a routine eye examination. Your chin and forehead will rest on a support to help keep your head steady.
Your doctor will place a special contact lens on the surface of your eye. This helps focus the laser beam and keeps your eye open during treatment.
Your doctor will guide you on where to look and may ask you to focus on specific targets. As they apply the laser, you will see bright flashes of light. You will hear a gentle buzzing or clicking sound from the laser machine each time your doctor activates the laser. This is a normal part of the treatment.
Will the procedure hurt?
You may feel some discomfort during the treatment. It is not usually painful, but you may feel a sharp pricking sensation when we treat certain areas of your eye.
What happens after the treatment?
Immediately after the laser treatment, your eye may feel dazzled or sensitive to light. This is a common and temporary effect, and for most patients it settles within a short time. Wearing sunglasses can help make you more comfortable.
Your vision may also appear slightly darker or blurred after the treatment. In most cases, this improves within 24 to 48 hours, although this can vary between patients.
Do not drive or operate machinery for 24 hours after treatment.
How do I look after my eyes at home?
There is no specific aftercare advice for this treatment. If needed, your doctor will advise you of any extra drops you need to use, or care you need to take.
Continue to use your usual eye drops as normal.
Will I need a follow up appointment?
Yes. You will have a follow-up appointment 3 to 4 months after your procedure, or sooner if you are having other treatments. At this appointment the doctor will check that your eye is responding to the treatment.
What should I do if I feel unwell at home?
If you feel unwell at home, please contact the Urgent Eye Clinic at the William Harvey Hospital on 01233 616232.
Summary
For most patients, the potential benefits of laser treatment in helping to protect vision and reduce the risk of further sight loss are greater than the possible risks. Your eye specialist will discuss these with you to make sure the treatment is appropriate for you.
The aim of laser treatment is to stabilise the changes caused in your eyes by your diabetes.
The main aim of laser treatment is to help preserve your current vision and reduce the risk of further sight loss. It does not usually improve vision that has already been lost, although some patients may notice an improvement after treatment. Individual outcomes vary and cannot be guaranteed.
Further information and support
NHS England. Your guide to diabetic retinopathy. Updated 23rd June 2025.
Diabetes UK. Diabetic retinopathy: diabetes and eye problems.
RNIB. Diabetes related eye conditions including diabetic retinopathy.
[Web sites last accessed 9 July 2026]
For in-person help and advice:
Ask your doctor or nurse.
Ask your ophthalmologist to put you in contact with our Eye Clinic Liaison Officer (ECLO). The ECLO works in contact with Kent Association for the Blind (KAB).
References
[Web sites last accessed 9 July 2026]
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