Post-Laser Eye Treatment: Addressing Floaters and Concerns

Q: Post-Laser Eye Treatment: Addressing Floaters and Concerns

Hello, concerned individual： 1. It is difficult to determine; you should consult your attending physician regarding the situation at that time. 2. Yes. 3. The four inflammatory cells are not floaters; they are inflammatory cells. It should be due to vitreo

Retinal laser issues?

Good evening, Dr.
Gao.
I would like to ask you about something that has been really troubling me.
I know that most people do not develop floaters after laser treatment, but in my case, the day after the procedure [I remember very clearly] I woke up to suddenly find an overwhelming number of floaters [they were large and exaggerated, appearing in all directions].
I have seen many doctors, more than a hundred times [during my military service, I almost went to the military hospital every week], but I really do not understand why this happens to me and not to others.
Currently, my thoughts are that [the laser energy was too strong, causing inflammation in the vitreous] or [the laser affected the vitreous].
I would like to ask Dr.
Gao:
1.
If the shadows are indeed due to vitreous degeneration, it seems unlikely that they would appear the morning after the laser treatment, especially in such large numbers.
Is this line of thinking correct?
2.
Is there a fixed recommended value for the energy output of the lasers you use?
3.
How can one distinguish between inflammatory floaters and degenerative floaters? [Since mine appeared the next day, there are really so many of them; when I look at the screen, those floaters cover more than half of it, which is really distressing.]
4.
If they are indeed inflammatory floaters, will they eventually be absorbed? [It has been six years, and it seems like there are even more now...
but they seem to have faded a bit.]
5.
In retinal laser treatment, is it possible for the laser to affect the vitreous, causing degeneration or inflammation, or is it completely impossible for the laser to reach the vitreous?
6.
I previously experienced a sudden appearance of a very, very dark shadow, similar to floaters but much darker, which later disappeared the same day.
If it was bleeding, is it possible for it to be absorbed so quickly, or could it be that it drifted out of my line of sight, which is why I didn’t see it afterward?
Thank you, Dr.
Gao.

Danxin de ren, 30~39 year old female. Ask Date: 2021/07/26

Dr. Gao Pilin reply Ophthalmology

Hello, concerned individual: 1.
It is difficult to determine; you should consult your attending physician regarding the situation at that time.
2.
Yes.
3.
The four inflammatory cells are not floaters; they are inflammatory cells.
It should be due to vitreous degeneration.
5.
It should not be a concern.
6.
Without examination, it is impossible to determine.
However, minor bleeding will resolve quickly, while significant bleeding will not.
Online responses can only serve as a reference; if necessary, it is still important to seek medical attention at a healthcare facility.
Gao Pi-Lin.

Reply Date: 2021/07/26

More Info

Dear Weibor,
Thank you for reaching out with your concerns regarding your post-LASIK experience and the symptoms you are experiencing. It's understandable to feel anxious about changes in your vision, especially after undergoing a significant procedure like LASIK. Let's address your questions and concerns systematically.

1. Post-LASIK Vision Changes: It is not uncommon for patients to experience fluctuations in their vision after LASIK surgery. These fluctuations can be due to several factors, including dry eyes, which is a common side effect of LASIK. The corneal reshaping can also lead to temporary changes in how light is focused on the retina, resulting in blurred vision, especially when looking at objects up close. If you are experiencing persistent blurriness, particularly after focusing on near objects, it may indicate that your eyes are still adjusting to the changes made during surgery.

2. Corneal Irregularities: The symptoms you describe, such as feeling that your vision is "foggy" or "cloudy," could also be related to corneal irregularities. If the cornea did not heal uniformly, it could lead to visual distortions. This is sometimes referred to as "higher-order aberrations," which can be assessed through a wavefront analysis by your eye care professional.

3. Floaters and Visual Disturbances: The sudden appearance of floaters, especially in large quantities, can be alarming. Floaters are typically caused by changes in the vitreous gel that fills the eye, which can occur naturally with age or due to other factors. However, the timing of your floaters' appearance—immediately after LASIK—raises questions. While LASIK primarily affects the cornea, there is a possibility that the procedure could have triggered changes in the vitreous, especially if there was any manipulation of the eye during surgery.
4. Inflammation vs. Degeneration: Distinguishing between inflammatory floaters and those caused by vitreous degeneration can be challenging. Inflammatory floaters may be associated with symptoms like redness, pain, or light sensitivity, while degenerative floaters are usually not accompanied by these symptoms. If your floaters persist or worsen, it is essential to consult with a retina specialist who can perform a thorough examination to rule out any underlying issues, such as retinal tears or detachments.

5. Laser Energy and Safety: LASIK procedures are performed with precise laser technology that is designed to minimize damage to surrounding tissues. The energy levels used are carefully calibrated to reshape the cornea without affecting the vitreous body. However, individual anatomical variations can lead to different experiences post-surgery.
6. Retinal Health: Your concern about the sudden appearance of a large dark shadow in your vision is valid. Such occurrences can sometimes be related to vitreous hemorrhage or other retinal issues. If the shadow disappeared quickly, it may have been a transient event, but it is crucial to have any sudden changes in vision evaluated promptly to rule out serious conditions.

7. Management and Follow-Up: Given your ongoing symptoms, I recommend scheduling a follow-up appointment with your ophthalmologist or a retinal specialist. They can perform a comprehensive examination, including a dilated fundus exam, to assess the health of your retina and vitreous. If necessary, they may recommend imaging studies to get a clearer picture of your eye health.

In conclusion, while some post-LASIK symptoms can be expected, persistent issues warrant further investigation. It's essential to communicate openly with your eye care provider about your concerns and symptoms. They can provide tailored advice and treatment options based on your specific situation. Remember, your vision is invaluable, and proactive management is key to maintaining eye health.

Best regards,
Doctor Q&A Teams

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