Persistent Flashes After Retinal Detachment Surgery

After retinal detachment surgery, there is continuous flashing?

Dear Dr.
He,
I experienced a failed cataract surgery on my right eye, which resulted in the intraocular lens dislocating and subsequently led to a retinal detachment.
At that time, I was working abroad and delayed returning to Taiwan for emergency care for a few days.
After surgery in early May, I had to undergo another procedure in early June due to traction from a proliferative membrane.
Prior to the June surgery, I noticed flashes of light, and post-surgery, due to intraocular hemorrhage, I was advised not to lie flat and maintained a reclined position during recovery.
The flashes of light have not improved since then; initially, they were localized to the upper right corner but have now extended to the central area.
When I view objects with my right eye alone, they appear distorted, and the flashes are also affecting my left eye's vision.
Dr.
He, do you have any insights into the possible causes of these flashes? During my follow-up appointment last week, my attending physician mentioned that he was uncertain about the origin of these flashes.
I have begun to speculate whether this could be due to silicone oil migrating between the retina and the choroid, as the June surgery also addressed a retinal tear and the issue of silicone oil being beneath the retina.
Is it possible that this phenomenon can only be resolved through another ophthalmic surgery? I initially thought I could tolerate the flashes, but they have become nearly constant, causing me significant anxiety, and I am concerned about the possibility of another retinal detachment.
I have noticed that the upper right corner sometimes appears gray unless I intentionally look with one eye for a while, which helps somewhat.
I greatly appreciate your clarification on this matter.
Thank you.
Sincerely,
Lin

Lin, 40~49 year old female. Ask Date: 2019/07/10

Dr. He Jianxian reply Ophthalmology

I'm sorry, but I am not sure about the cause of your flashes.
I recommend that you continue to follow up with your original clinic.
If there are any issues, your attending physician should inform you.

Reply Date: 2019/07/10

More Info

Dear Lin,
Thank you for reaching out with your concerns regarding the persistent flashes you are experiencing after your retinal detachment surgery. I understand how distressing this situation can be, especially given your history of complications following your cataract surgery and subsequent retinal issues.
Flashes of light, or photopsia, can occur for various reasons, particularly after retinal surgery. In your case, the flashes may be related to several factors, including the presence of vitreous traction, changes in the vitreous gel, or even residual effects from the surgeries you have undergone. After a retinal detachment, it is not uncommon for the vitreous gel to pull on the retina, which can lead to the sensation of flashes. This is often exacerbated by any inflammation or changes in the eye's internal environment, such as bleeding or the presence of silicone oil.

The fact that you are experiencing an extension of the flash phenomenon from the right upper quadrant to the central area of your vision is concerning. It suggests that there may be ongoing vitreous traction or possibly other complications that need to be addressed. The visual distortion you describe, where objects appear deformed, can also be indicative of retinal issues, including potential changes in the retinal structure or function.

Regarding your speculation about silicone oil migrating between the retina and choroid, this is a possibility, especially if there were complications during the surgery. Silicone oil is often used to tamponade the retina after detachment, but if it is not properly positioned, it can lead to various visual disturbances, including flashes and distortions.

It is crucial to follow up with your ophthalmologist regarding these symptoms. If your doctor is uncertain about the cause of the flashes, it may be beneficial to seek a second opinion or request further diagnostic imaging, such as optical coherence tomography (OCT) or ultrasound, to evaluate the state of your retina and vitreous more thoroughly. These tests can provide valuable insights into whether there are any new tears, detachments, or other issues that need to be addressed.

In terms of management, if the flashes are indeed due to vitreous traction or other mechanical factors, surgical intervention may be necessary to alleviate these symptoms. This could involve a vitrectomy, where the vitreous gel is removed to relieve traction on the retina. However, the decision for surgery should be made carefully, weighing the risks and benefits based on your specific situation.

I understand that living with persistent flashes can be anxiety-inducing, and it is essential to communicate openly with your healthcare provider about your concerns. They can help you navigate this challenging time and determine the best course of action to manage your symptoms effectively.

In summary, the flashes you are experiencing could be due to a variety of factors related to your previous surgeries and the current state of your eye. It is essential to have a thorough evaluation to determine the underlying cause and appropriate management. Please do not hesitate to reach out to your ophthalmologist for further clarification and support.

Wishing you the best in your recovery and health.

Sincerely,
Doctor Q&A Teams

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