What eye tests should be done before Photorefractive Keratectomy (PRK) laser treatment in one eye?

From the Guidelines

Before undergoing PRP laser treatment for one eye, a comprehensive dilated eye examination, including visual acuity testing, intraocular pressure measurement, and a thorough fundus examination, should be performed to establish a baseline and identify any potential contraindications to the procedure. This examination is crucial in determining the appropriate laser parameters and identifying areas that require treatment 1. The following essential eye tests should be included:

• Visual acuity testing with current correction at distance and near
• Refraction when indicated
• Visual fields by confrontation
• External examination, including eyelid position and character, lashes, lacrimal apparatus and tear function, globe position, and pertinent skin and facial features
• Pupillary function, including size and response to light, and relative afferent pupillary defect
• Ocular alignment and motility, including cover/uncover test, alternate cover test, ductions and versions
• Slit-lamp biomicroscopic examination, including eyelid margins and lashes, tear film, conjunctiva, sclera, cornea, anterior chamber, and assessment of central and peripheral anterior chamber depth, iris, lens, and anterior vitreous
• Intraocular pressure measurement, preferably using a contact applanation method, such as a Goldmann tonometer
• Fundus examination, including mid and posterior vitreous, retina, vasculature, and optic nerve Additionally, Optical Coherence Tomography (OCT) should be conducted to evaluate retinal thickness and detect any macular edema, and fluorescein angiography should be performed to identify areas of retinal ischemia and neovascularization that require treatment 1. These tests will help the ophthalmologist determine the appropriate laser parameters, identify areas requiring treatment, establish a baseline for future comparison, and ensure there are no contraindications to the procedure. Patients should be informed that pupil dilation will be necessary, so arranging transportation home after the tests is advisable.

From the Research

Pre-PRP Laser Eye Test

Before undergoing PRP (Panretinal Photocoagulation) laser treatment, the eye test should include:

• A comprehensive eye examination to assess the severity of diabetic retinopathy and detect any other potential eye problems 2
• Best-corrected visual acuity (BCVA) test to measure the sharpness of vision 2
• Fundus examination to evaluate the retina and detect any signs of diabetic retinopathy 3, 4
• Optical coherence tomography (OCT) to assess the retinal thickness and detect any signs of macular edema 5
• Optical coherence tomography angiography (OCTA) to evaluate the macular vascular density and detect any signs of ischemia 5
• Non-stereo photographic screening to detect any fibrovascular lesions after treatment 6

Key Considerations

• The eye test should be performed by an experienced ophthalmologist or optometrist 2, 3
• The test results should be carefully evaluated to determine the best course of treatment for the patient 4, 5
• The patient should be informed about the potential risks and benefits of PRP laser treatment and the importance of follow-up care 2, 6

Additional Tests

• Static and kinetic perimetry to assess the visual field and detect any signs of peripheral field loss 4
• Microperimetry to assess the retinal sensitivity and detect any signs of macular damage 4
• Fluorescein angiography to evaluate the retinal vasculature and detect any signs of ischemia 4