Post-Laser Retinal Repair: Discomfort and Complications

Discomfort after retinal laser treatment?

Dear Director Gao,
Half a month ago, I visited the clinic due to floaters in my vision.
The doctor informed me that there was a tear in the retina located just below my left eye, and performed laser treatment on the same day.
Since then, I have experienced a persistent foreign body sensation at the site of the laser treatment, especially when lying flat while sleeping, as if my eyeball is going to fall backward.
There is a constant feeling of pressure inside my lower eye socket, as if something is lodged there.
I also occasionally feel as though my eye is sinking downwards.
Sometimes, the movement of my left eyeball seems less responsive than before, feeling somewhat stiff.
After a week of these symptoms, I began to feel a dull sensation in the bridge of my nose on the left side and around my left ear.
Upon examination by an otolaryngologist, it was found that there was abnormal function of the left Eustachian tube.
An endoscopic examination revealed no tumors, but medication treatment is necessary.
These discomforting symptoms were completely absent before the laser treatment on my left eye, but suddenly appeared afterward, which has caused me considerable concern.
I would like to ask Director Gao:
1.
During retinal laser repair, is there a possibility that the laser could inadvertently misfire, causing damage to the eye muscles, nerves, or ligaments, leading to abnormal eye movement or a downward displacement of the eyeball, which could then compress the Eustachian tube?
2.
If there was no actual hole in the retina but laser treatment was performed, could this result in any complications?
Thank you very much for taking the time to respond to my questions despite your busy schedule.
I greatly appreciate it!

Ms. Su, 30~39 year old female. Ask Date: 2018/01/26

Dr. Gao Pilin reply Ophthalmology

Hello Ms.
Su,
1.
The retinal laser treatment directs the beam straight to the retina, so it should not affect the area you mentioned.
2.
Retinal laser treatment uses heat to cauterize the retina, creating scar tissue that helps the retina adhere strongly.
However, a side effect is that some local tissue may be damaged.
Typically, the laser is applied to the peripheral areas, which does not affect vision but may cause minor peripheral visual field defects that are usually imperceptible.
Taiwan E-Hospital, Puzi Hospital Ophthalmology Department:
Monday to Friday, 8:00 AM to 12:00 PM
Wednesday, 1:00 PM to 4:30 PM
Online responses can only serve as a reference; it is necessary to seek medical attention at a healthcare facility.
I hope to have the opportunity to assist you.
Best regards,
Gao Pilin

Reply Date: 2018/01/26

More Info

Hello! Thank you for your detailed questions regarding your post-laser retinal repair experience. It’s understandable to have concerns after undergoing such a procedure, especially when experiencing discomfort and unusual sensations. Let’s address your questions one by one.

1. Laser Treatment and Potential Damage: The laser used in retinal repair is designed to target specific areas of the retina with precision. While it is theoretically possible for the laser to cause unintended damage if misaligned, this is quite rare. The laser is typically focused on the retinal tear or hole, and the surrounding structures, including the muscles and nerves that control eye movement, are usually not affected. However, post-operative discomfort can arise from inflammation or irritation in the eye, which may lead to sensations such as pressure or heaviness. If you feel that your eye movements are not as fluid as before, it could be due to inflammation or muscle fatigue rather than direct damage from the laser.

2. Consequences of Unnecessary Laser Treatment: If the retina is intact and laser treatment is applied, it can lead to unnecessary scarring or changes in the retinal structure. However, most retinal specialists will only perform laser treatment when there is a clear indication of a retinal tear or risk of detachment. If laser treatment is performed without a clear need, potential side effects could include visual disturbances or changes in peripheral vision. It’s crucial to have a thorough evaluation before any procedure to ensure that it is necessary.

Regarding your symptoms of pressure and discomfort, these can be common after retinal laser surgery. The sensation of something being in your eye or a feeling of heaviness can be attributed to several factors, including:
- Inflammation: Post-operative inflammation can lead to discomfort and a sensation of pressure. This is often managed with anti-inflammatory eye drops as prescribed by your doctor.

- Dry Eye: After surgery, some patients experience dry eye symptoms, which can contribute to discomfort. Using lubricating eye drops can help alleviate this sensation.

- Eustachian Tube Dysfunction: The pressure you feel in your nose and ear could be related to Eustachian tube dysfunction, which can occur due to changes in pressure or inflammation. This is not directly caused by the laser treatment but may be coincidental.

It’s essential to communicate these symptoms to your ophthalmologist, as they can provide a more tailored assessment and treatment plan. If your symptoms persist or worsen, further evaluation may be necessary to rule out complications such as retinal detachment or other issues.

In summary, while discomfort after retinal laser surgery can be concerning, it is often manageable and may resolve with time and appropriate care. Ensure you follow up with your eye care provider to monitor your recovery and address any ongoing symptoms. They can provide reassurance and adjust your treatment plan as needed. Thank you for reaching out, and I hope you find relief soon!

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