Retinal Laser Treatment: Addressing Post-Procedure Vision Issues - Ophthalmology

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Retinal laser therapy


Hello, Doctor.
Five years ago, I underwent retinal laser treatment at an ophthalmology clinic, and since then, I have developed severe and dense shadows in my vision.
I have consulted many doctors, and they have said that the retinal laser treatment is not related to these shadows.
However, I only started experiencing these significant shadows after the laser procedure, with about one-third of my visual field affected.
I would like to ask the doctor:
1.
Is it possible for retinal laser treatment to cause vitreous inflammation? Could these shadows be a result of inflammation caused by the thermal energy from the laser? Have you encountered similar cases before?
2.
Can the inflammatory substances and the vitreous degeneration (liquefaction) that cause floaters be differentiated using instruments? Can doctors determine whether these shadows are due to inflammation or normal degeneration?
3.
If it is inflammation, is there a possibility that it could be absorbed, or could it fade? (It has been five years, and there has been no improvement; in fact, it has worsened.) Thank you, doctor.
I really appreciate your help.

Ming, 30~39 year old female. Ask Date: 2021/05/24

Dr. Gao Pilin reply Ophthalmology


Hello, Ming: Please refer to https://bit.ly/2SivZjQ1.
1.
Never encountered it before.
2.
Unable to distinguish.
3.
Inflammation may cause a fading effect; the dark shadow could be due to vitreous opacities.
Therefore, it is likely not inflammation.
Online responses can only serve as a reference; if necessary, it is important to seek medical attention at a healthcare facility.
I hope to have the opportunity to assist you.
Gao Pilin

Reply Date: 2021/05/24

More Info


Dear Weibor,
Thank you for reaching out with your concerns regarding the post-operative symptoms following your LASIK surgery. It’s understandable to feel anxious about changes in vision, especially after undergoing a procedure aimed at improving it. Let's address your questions and provide some insights based on medical knowledge.

1. Post-LASIK Vision Changes: The symptoms you describe, such as blurred vision when looking at near objects and the sensation of a "foggy" appearance, could be indicative of several factors. One possibility is that you may be experiencing a condition known as "overcorrection," where the LASIK procedure has resulted in a slight degree of hyperopia (farsightedness) instead of the intended correction. This can lead to difficulties in focusing on nearby objects, especially after prolonged use. It’s essential to have a follow-up examination with your ophthalmologist to assess your current refractive status and determine if any corrective measures, such as glasses for reading, are necessary.

2. Corneal Irregularities: You mentioned concerns about corneal irregularities or folds at the surgical site. While LASIK is generally safe, complications can arise, including irregular astigmatism due to corneal flap issues. If the cornea is not healing properly, it may lead to visual disturbances. Your surgeon can perform a topography test to evaluate the corneal surface and determine if any irregularities are present.

3. Healing Process: The healing process after LASIK can vary significantly from person to person. While many patients experience improved vision shortly after surgery, others may take longer to stabilize. It's not uncommon for vision to fluctuate during the first few months post-surgery. If your symptoms persist or worsen, it’s crucial to consult your surgeon for a thorough evaluation.

4. Management Options: In terms of managing your symptoms, your doctor may recommend the use of artificial tears to alleviate dryness, which can contribute to blurred vision. If overcorrection is confirmed, options may include corrective lenses or, in some cases, enhancement surgery. Discussing these options with your surgeon will provide clarity on the best course of action.

5. Long-Term Outlook: As for the long-term outlook, many patients see significant improvement in their vision over time. However, if you continue to experience issues, it’s essential to maintain open communication with your eye care provider. They can monitor your condition and suggest further interventions if necessary.

In conclusion, while your symptoms are concerning, they are not uncommon in the post-operative period following LASIK. The best course of action is to have a detailed discussion with your ophthalmologist, who can provide personalized recommendations based on your specific situation. Remember, your vision is precious, and addressing these concerns promptly will help ensure the best possible outcome.

Best regards,
Doctor Q&A Teams

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