Post-Laser Treatment Changes in Floaters After Retinal Tear

After retinal tear laser repair?

Hello, Doctor.
I have high myopia of approximately -1900 diopters and have had issues with floaters for some time.
Recently, I experienced a traumatic impact to my left eye, which caused a significant increase in the floaters.
I immediately went to the emergency department at Chang Gung Memorial Hospital in Kaohsiung, but the examination showed no retinal tears.
The next day, I noticed a change in the appearance of the floaters, seeing black spots in the sky, and they seemed to coalesce into a mass.
I then visited a general clinic for further confirmation, and again, no tears were found.
Three days later, I went to Kaohsiung Medical University for a detailed examination, where a retinal tear was finally discovered, and I underwent laser repair immediately.
I have the following questions:
1.
After the initial impact, the doctor indicated that the detached portion would not recover and advised me to get used to it.
Is there truly no way for it to improve? The number of floaters in my impacted left eye significantly affects my vision.
2.
After the laser repair, I noticed that in dim lighting at home, I was less aware of the floaters, but when I went outside in daylight, they became more apparent.
However, post-laser, I can now see the floaters even in dim yellow light at home, and there seems to be a particularly dark floater moving in front of my vision.
Is this normal?
3.
Is it common for floaters to increase after laser treatment, or should I expect them to gradually improve over time?
I apologize for the lengthy message, and thank you for your understanding.

Mr. Lu, 30~39 year old female. Ask Date: 2017/01/05

Dr. He Jianxian reply Ophthalmology

1.
Floaters caused by vitreous detachment cannot be reversed.
2.
Under normal circumstances, this phenomenon should not occur, and I cannot explain it.
3.
Laser treatment generally does not affect the condition of floaters.

Reply Date: 2017/01/05

More Info

After undergoing laser treatment for a retinal tear, it is not uncommon for patients to experience changes in their perception of floaters, especially if they have a pre-existing condition like myopia (high nearsightedness). Your concerns regarding the changes in floaters after the laser procedure are valid and warrant a detailed explanation.

1. Understanding Floaters and Retinal Detachment: Floaters are small spots or strands that drift through your field of vision. They are caused by tiny pieces of gel or cells inside the vitreous, the clear gel-like substance that fills the eye. In individuals with high myopia, the risk of retinal tears and detachment increases due to the elongation of the eyeball, which can lead to changes in the vitreous gel. When you experienced trauma to your eye, it is possible that the impact caused further changes in the vitreous, leading to an increase in floaters.
2. Post-Treatment Changes: After laser treatment for a retinal tear, it is not unusual for patients to notice an increase in floaters or changes in their appearance. This can be attributed to the laser's effect on the vitreous gel and the surrounding tissues. The laser creates a scar that helps to seal the tear, but it can also lead to further changes in the vitreous, which may result in more noticeable floaters. This phenomenon can be temporary, and many patients report that their floaters become less bothersome over time as they adapt to the changes in their vision.

3. Adaptation Period: The adaptation period after a retinal laser procedure can vary from person to person. While some may find that their floaters diminish in visibility, others may continue to notice them, especially in certain lighting conditions. The fact that you are seeing floaters more prominently in dim light is not unusual, as contrast can make them more noticeable. It is essential to give your eyes time to adjust after the procedure.

4. Consultation and Follow-Up: It is crucial to maintain regular follow-up appointments with your ophthalmologist after such procedures. They can monitor your condition and ensure that there are no complications, such as further retinal detachment or other issues. If you notice any sudden changes in your vision, such as an increase in floaters, flashes of light, or a shadow in your peripheral vision, you should seek immediate medical attention.

5. Long-Term Outlook: In many cases, floaters can become less bothersome over time as your brain learns to ignore them. However, if they significantly impact your quality of life or vision, discussing potential treatments with your eye care provider is essential. Options may include vitrectomy, a surgical procedure to remove the vitreous gel, but this is typically reserved for severe cases due to the associated risks.

In summary, while it is concerning to experience changes in floaters after laser treatment for a retinal tear, it is often a part of the healing and adaptation process. Regular follow-ups with your eye care provider are essential to monitor your condition and address any concerns you may have. If the floaters continue to be bothersome or if you experience any new symptoms, do not hesitate to reach out for further evaluation and guidance.

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