Post-Laser Treatment Complications in Retinal Health

Q: Post-Laser Treatment Complications in Retinal Health

Hello, concerned individual：<br>1. <br>It is possible that the appearance of floaters coincided with the recent laser treatment, as individuals with myopia often experience floaters at an early age. <br>Vitreous liquefaction can lead to an increase in floaters; however, I cannot

Post-retinal laser treatment

Hello Doctor, I previously didn't understand my condition.
At that time, I went to see a doctor because I was experiencing some small floaters, but I was worried about misdiagnosis and consulted several doctors.
Most of them said there was nothing wrong, just that my retina was a bit thinner and that I should just monitor it.
However, when I visited a certain clinic, the doctor immediately said that there were many holes and that I needed laser treatment to repair it.
Trusting the doctor, I underwent the laser procedure right away.
Later, due to complications, I sought help from many doctors and discovered that there were actually no holes, just a thinner retina.
My complication is that after the laser treatment, I developed extremely exaggerated floaters (not exaggerating, they occupy almost half of my vision).
They are present in all directions, and despite consulting many doctors, they all said that retinal laser treatment does not cause floaters; floaters are a problem related to the vitreous.
However, I swear that these floaters definitely appeared after the laser treatment.
I have a few questions for you:
1.
Why do floaters occur after laser treatment? Could it be due to the laser energy being too strong or too much laser treatment causing vitreous opacification? After researching online, I found that vitreous liquefaction and inflammation could be involved.
Is it possible that retinal laser treatment caused inflammation leading to this?
2.
The doctor mentioned that I had a hole in the upper right area.
Does this mean that the laser was applied to the lower left area of the retina, or does the laser affect my vision in the lower left area while being positioned in the upper right?
3.
If the floaters are indeed related to the laser treatment (assuming, as the doctor said, that the laser was applied to the upper right), then if it were due to excessive energy, inflammation, or vitreous opacification, it should be localized to the upper right area of the laser treatment, not affecting the entire vitreous.
Is this line of thinking correct?
4.
Are there any tests that can thoroughly assess the issues with my eyes and explain why I have so many floaters? What is the current condition of the vitreous, and how can it be examined?
I have been affected for nearly six years and often think about ending my life.
I feel very frustrated that my eyes have been treated this way by that doctor (many doctors have told me that there was no need for laser treatment; the doctor I frequently visit even said, "Did I not tell you that you didn't need the laser and that monitoring was sufficient?").
I truly feel sorry for him...
Now, I just want to understand what is happening with my eyes.
Thank you, doctor.

Danxin de ren, 20~29 year old female. Ask Date: 2021/05/17

Dr. Gao Pilin reply Ophthalmology

Hello, concerned individual:
1.
It is possible that the appearance of floaters coincided with the recent laser treatment, as individuals with myopia often experience floaters at an early age.
Vitreous liquefaction can lead to an increase in floaters; however, I cannot definitively determine the relationship with the laser treatment.
2.
The hole in the upper right area refers to the location of the retina in the upper right quadrant, while the visual field affected is in the lower left quadrant.
3.
Correct.
4.
Floaters themselves are harmless.
If they do appear, there is no need for concern, as many people experience this condition, including myself.
It is important to face it, accept it, and then let it go; life remains full of brightness.
Taiwan E-Hospital, Puzi Hospital, Ophthalmology Department:
Monday, Tuesday, Thursday, Friday: 8:00 AM – 12:00 PM
Wednesday: 2:00 PM – 4:30 PM
Online responses can only serve as a reference.
If necessary, it is essential to seek medical attention at a healthcare facility.
I hope to have the opportunity to serve you.
Dr.
Gao Pilin

Reply Date: 2021/05/17

More Info

I'm sorry to hear about the challenges you've been facing with your eye health after undergoing laser treatment. It's understandable to feel frustrated and concerned, especially when it comes to something as vital as your vision. Let's address your questions and provide some clarity on the situation.

1. Why might laser treatment lead to floaters? Floaters, or the "little cotton-like spots" you describe, can indeed be a common occurrence after any procedure involving the retina, including laser treatments. The laser energy used during the procedure can sometimes cause changes in the vitreous gel that fills the eye. This can lead to a phenomenon known as vitreous syneresis, where the gel begins to liquefy and pull away from the retina, creating floaters. While many doctors assert that laser treatment itself does not directly cause floaters, the changes in the vitreous that may occur post-treatment can certainly lead to an increase in their visibility.

2. Understanding the laser's impact on your vision. If your doctor indicated that there was a tear or hole in the retina and subsequently performed laser treatment, the laser was likely applied to the area surrounding the identified issue. The location of the laser treatment does not necessarily correlate with where you might perceive floaters. The floaters can be a result of changes in the vitreous gel, which may not be directly related to the laser's location.

3. Your reasoning about the effects of laser treatment. Your thought process is valid. If the laser treatment was performed on the right upper area of your retina, any immediate effects, such as inflammation or changes in the vitreous, would typically manifest in that area. However, the overall health of the vitreous can be affected by various factors, including age, pre-existing conditions, and the nature of the laser treatment itself. It's possible for the entire vitreous to be affected, leading to widespread floaters, even if the laser was applied to a specific area.

4. Further examinations for understanding your eye condition. To gain a comprehensive understanding of your eye health and the reasons behind the increased floaters, several diagnostic tests can be performed. These may include:
- Optical Coherence Tomography (OCT): This imaging test provides detailed cross-sectional images of the retina and can help identify any structural changes.

- Ultrasound of the eye: This can help visualize the vitreous and detect any abnormalities that might not be visible during a standard examination.

- Visual field testing: This assesses your peripheral vision and can help determine if there are any areas of concern related to retinal health.

It's crucial to continue seeking medical advice from trusted professionals. If you feel that your concerns are not being adequately addressed, consider seeking a second opinion from a retinal specialist who can provide a more focused evaluation of your condition.

Lastly, I want to emphasize the importance of mental health in this journey. Dealing with vision problems can be incredibly challenging, and it's essential to seek support from friends, family, or mental health professionals if you're feeling overwhelmed. Your vision is important, but so is your overall well-being. Please take care of yourself, and I hope you find the answers and relief you seek regarding your eye health.

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