Light Flashes After Retinal Laser Treatment for Detachment

After retinal laser treatment for retinal detachment, there may be movement of light flashes?

My left eye has a refractive error of -400 diopters, and my right eye has -600 diopters.
Both eyes have floaters.
In November 2018, I was diagnosed with a hole-induced retinal detachment in my left eye (not involving the macula).
The doctor said I did not need a scleral buckle and immediately performed laser treatment.
After repeated follow-ups, there has been no recurrence of the detachment.
However, starting from February and March 2019, I began to experience flashes of light in my left eye.
Most of the time, it appears as a light spot moving from left to right above my eye.
On average, I experience this about ten times a day, rarely during the day but increasing in frequency at night, especially before sleep.
During a follow-up on May 15, 2020, the doctor said there were no issues with my fundus.
I have a few questions for the doctor:
1.
Is the sensation of this light spot caused by vitreous detachment pulling on the retina? I have had this phenomenon for over a year, and the doctor said it would gradually improve, but how much longer might that take?
2.
Is the risk of recurrence after laser treatment for retinal detachment significant? It has been a year and a half since the treatment; is there a chance of recurrence in the future? What risk factors could continue to cause detachment?
3.
Can laser treatment help the detached retina reattach? My understanding is that the laser can seal the hole to prevent fluid from entering, but the detached retina may not reattach, which could lead to further detachment.
This is my biggest concern.
Thank you!

Mr. Shi, 30~39 year old female. Ask Date: 2020/06/10

Dr. Gao Pilin reply Ophthalmology

Hello Mr.
Shi,
1.
Is the sensation of these floaters caused by vitreous detachment pulling on the retina? I have been experiencing this phenomenon for over a year.
The doctor said it will gradually improve, but how much longer might it take? It is possible, but the timing is uncertain.
2.
Is the risk of recurrence high after laser treatment for retinal detachment? It has been a year and a half since my treatment; will I experience recurrence in the future? What risk factors could continue to cause detachment? If it has been stable until now, recurrence should be unlikely.
The most common cause of detachment is trauma to the eye or vigorous shaking, so it is important to avoid these risks.
3.
Can laser treatment help reattach a detached retina? My understanding is that the laser can seal holes to prevent fluid from entering, but if the detached retina is not reattached, could this lead to further detachment? Since laser treatment has been applied to the periphery, the retina will scar and adhere tightly to the underlying choroid, making further detachment less likely.
Taiwan E-Hospital, Puzi Hospital, Ophthalmology Department: Monday, Tuesday, Thursday, Friday from 8:00 AM to 12:00 PM; Wednesday from 2:00 PM to 4:30 PM.
Online responses are for reference only; it is necessary to seek medical attention at a healthcare facility.
I hope to have the opportunity to serve you.
Best regards,
Gao Pilin

Reply Date: 2020/06/10

More Info

Understanding light flashes after retinal laser treatment for detachment can be quite complex, especially for individuals who have undergone such procedures. Your experience with light flashes, particularly after laser treatment for a retinal detachment, raises several important points that merit discussion.

1. Nature of Light Flashes: The sensation of seeing flashes of light, often described as "photopsia," can indeed be associated with vitreous detachment. When the vitreous gel that fills the eye begins to pull away from the retina, it can cause traction on the retina, leading to the perception of flashes of light. This is particularly common after laser treatment, as the eye undergoes changes during the healing process. The flashes you are experiencing, especially if they resemble a moving light or "light blob," may be a result of this vitreous traction. While your doctor has indicated that this phenomenon may improve over time, the duration can vary significantly from person to person. Some individuals may notice gradual improvement over several weeks to months, while others may experience persistent symptoms for a longer period.

2. Risk of Recurrence After Laser Treatment: The risk of recurrence of retinal detachment after laser treatment is generally low, especially if there have been no signs of detachment in follow-up examinations. However, certain factors can increase the risk of future detachments, including high myopia (nearsightedness), trauma to the eye, or the presence of additional retinal tears. Since you have a history of retinal detachment, it is crucial to remain vigilant for any new symptoms, such as an increase in flashes, new floaters, or a shadow in your vision. Regular follow-ups with your ophthalmologist are essential to monitor the health of your retina.

3. Effectiveness of Laser Treatment: Laser treatment is designed to create a scar around the retinal tear or detachment, effectively sealing it and preventing fluid from entering the subretinal space. While the laser can help stabilize the retina, it does not always guarantee that the retina will reattach completely on its own. In some cases, additional procedures may be necessary if the retina does not adhere properly. Your concern about the retina not being fully attached is valid, and it is important to communicate any ongoing symptoms to your ophthalmologist. They may recommend further imaging or treatment if they suspect that the retina is not adequately reattached.

In conclusion, while light flashes can be a common occurrence after retinal laser treatment, it is essential to keep an open line of communication with your eye care provider. They can offer personalized advice based on your specific situation and monitor your progress. If your symptoms worsen or if you experience new visual disturbances, do not hesitate to seek immediate medical attention. Your eye health is paramount, and proactive management can help prevent further complications.

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