Post-Retinal Surgery: Addressing Eye Pain and Vision Changes

Q: Post-Retinal Surgery: Addressing Eye Pain and Vision Changes

Hello, Hong： 1. The chances are probably slim, but it still requires attention. 2. Closing the eyes when sneezing is likely a reflex action; I think there isn't much difference when blowing the nose. 3. Sudden blurriness that recovers could be an issue with fo

Post-retinal surgery

Hello, Doctor.
Three weeks ago, I underwent retinal laser treatment on my right eye.
Last week, I blew my nose too hard and felt significant pain in my right eye, but the pain subsided after about a minute.
However, I experienced pain when I tried to hold my eye open (it was like this all day).
After that day, I didn't feel any pain, but the next evening, I suddenly noticed blurriness in my right eye for about five seconds, which then went away.
Concerned, I tested my right eye by looking at a straight line and found it to be straight without any issues.
However, I noticed that the brightness of objects viewed with my left eye seems different from that of my right eye; the left eye appears brighter, but I'm not sure if it was like this before.
I found online that many people experience a difference in brightness between their eyes, but since I had pain from blowing my nose, I'm worried if there's any connection between the two issues.

1.
After undergoing retinal laser treatment, is there a possibility of developing a new tear just from blowing my nose too hard, even though I wasn't engaging in any vigorous activities? How much force should I control, considering I was keeping my eyes closed?
2.
Does closing my eyes while sneezing or blowing my nose, which may slightly vibrate the retina, have any mitigating effect?
3.
What could be the possible causes of sudden blurriness? It's been a week since that incident, and I haven't experienced any particular issues since then.
4.
Occasionally, in complete darkness while sleeping, I perceive a faint brightness at the lower edge of my eyes, which seems to appear and disappear quickly.
I only noticed this after the incident of blowing my nose.
What could be the reason for this?

Hong, 20~29 year old female. Ask Date: 2021/08/23

Dr. Gao Pilin reply Ophthalmology

Hello, Hong: 1.
The chances are probably slim, but it still requires attention.
2.
Closing the eyes when sneezing is likely a reflex action; I think there isn't much difference when blowing the nose.
3.
Sudden blurriness that recovers could be an issue with focal adjustment.
It may also be caused by secretions or vitreous opacities drifting to the center and obstructing vision.
4.
It might be photopsia, which is a physiological phenomenon.

Reply Date: 2021/08/23

More Info

After undergoing retinal laser surgery, it is not uncommon to experience various sensations and changes in vision, including pain, discomfort, and differences in brightness between the eyes. Your concerns are valid, and I will address each of your questions based on medical knowledge and experience.

1. Risk of Retinal Tear from Sneezing or Blowing Your Nose: After retinal surgery, especially laser treatment, the retina is more vulnerable to stress. While it is generally safe to sneeze or blow your nose, excessive force can potentially lead to complications, including the risk of creating a new retinal tear. However, if you were careful and closed your eyes while sneezing, the risk is significantly reduced. It is essential to maintain gentle pressure and avoid straining. If you experience any sudden changes in vision or increased pain, it is advisable to consult your ophthalmologist.

2. Impact of Sneezing on the Retina: Sneezing or blowing your nose can create pressure changes in the head and eyes. Closing your eyes during these actions can help minimize the impact on the retina, as it reduces the strain on the eye muscles and the retina itself. However, if you feel discomfort or pain during these actions, it may indicate that your eye is still sensitive post-surgery. If the pain persists or worsens, it would be prudent to seek medical advice.

3. Causes of Sudden Blurriness: Sudden blurriness can arise from various factors, including changes in intraocular pressure, fluid shifts in the eye, or even temporary changes in the retina's response to light. Given that you had recent surgery, your eye may still be adjusting, and transient blurriness can occur as part of the healing process. If the blurriness lasts for more than a few seconds or is accompanied by other symptoms (like flashes of light or a curtain-like shadow), you should contact your eye doctor immediately.

4. Seeing Flickering Lights in Darkness: The perception of flickering or bright spots in your vision, especially in a dark environment, can be related to several factors. It may be a phenomenon known as "phosphene," which occurs when the retina is stimulated in a way that causes visual sensations without light actually entering the eye. This can happen due to pressure changes or even as a residual effect of your recent surgery. If this sensation becomes frequent or bothersome, it would be wise to discuss it with your ophthalmologist to rule out any underlying issues.

In summary, while some discomfort and visual changes can be expected after retinal surgery, it is crucial to monitor your symptoms closely. If you experience persistent pain, significant changes in vision, or any new symptoms, do not hesitate to reach out to your eye care provider. Regular follow-ups and open communication with your doctor are essential for ensuring a smooth recovery and addressing any concerns you may have.

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