Post-Retinal Laser Surgery Care: Common Concerns and Solutions

Q: Post-Retinal Laser Surgery Care: Common Concerns and Solutions

Hello： 1. <br>Generally, after undergoing laser treatment, there may be some ocular reactions such as crusting, redness, swelling, pain, and dryness. <br>These reactions typically resolve within a few days to weeks. <br>As for the occasional bright spots you see when you close yo

Post-retinal laser treatment issues and eye care?

Hello Doctor, I underwent retinal laser surgery at the Taoyuan General Hospital at the end of January, with both eyes treated.
My left eye had retinal thinning, and my right eye had a small tear.
After the procedure, I lay in bed for three days (my family said I felt very tired due to mental exhaustion...).
Last week, during a follow-up visit, the doctor performed a fundus examination and indicated that the laser scarring looked good, which relieved my anxiety and helped me feel less tense.
I have congenital amblyopia, and after treatment for it, I suddenly developed myopia at a rate of 100 degrees per year.
By sixth grade, I had already reached 600 degrees, and now I have high myopia (over 1000 degrees in both eyes).
I would like to ask the doctor some questions regarding the laser treatment and eye care:
1.
A few days after the laser treatment, the area around the laser changed from white to black, and when I close my eyes, I occasionally see a bright spot in that area, as if my eyelids are not fully closed.
What could be the reason for this? The doctor checked my fundus and said there was no fluid accumulation, so could it be due to the vitreous pulling on the scar tissue?
2.
During my follow-up visit last week, I mentioned that my eyes are very easily fatigued and dry, so the doctor prescribed preservative-free artificial tears and B12 eye drops (Sambucus).
He mentioned to use both together.
Is there a limit to how many times I can use the Sambucus drops in a day? I use the artificial tears whenever my eyes feel dry, especially after the laser treatment, as my eyes have been particularly dry.
Additionally, I have incense burning at home and I take correspondence courses.
Is it inappropriate to use the artificial tears frequently?
3.
Sometimes, I experience a pain in my left eye that feels similar to a migraine, and my left shoulder muscles are quite tense.
At times, my left eye doesn't hurt, but instead, I feel a clear sensation similar to applying menthol (it's hard to describe, but it feels like a cool breeze on my eye).
Could this be related to poor blood flow in my shoulder muscles? I found information suggesting that shoulder muscle tension can affect eye discomfort.

4.
The doctor suggested that I apply warm compresses to my eyes in the morning and evening to significantly improve eye fatigue and dryness.
However, I read an article stating that hot compresses should be avoided (the author seemed to use very hot temperatures).
If I use water at a normal temperature (around 35°C), should I be concerned about damaging my retina? Would using a steam eye mask be better than using a towel soaked in warm water (which cools down quickly)?
5.
After the laser treatment, I have been sleeping on my back, which causes some discomfort in my lower back.
I am afraid that sleeping on my side might put pressure on my eyeball and cause retinal issues.
Am I being overly cautious? A soft pillow shouldn't cause significant pressure on the eyeball, right? However, I also found information stating that sleeping on one's side can increase intraocular pressure, which makes me hesitant to do so.

6.
Can I engage in jogging or aerobic exercise? Is it correct to avoid heavy lifting, straining during bowel movements, and intense exercise due to my high myopia?
7.
After lunch, I take a male multivitamin (containing fish oil) and lutein (with zeaxanthin and astaxanthin), and I drink black goji berry tea (rich in anthocyanins).
Can taking these together cause any nutrient competition or absorption issues? Is it too late for me to start taking these supplements?
8.
When listening to music with headphones, does the vibration affect my retinal condition? Does letting the showerhead spray water on my eyes while bathing have any negative effects?
9.
I found a type of artificial tears made from serum.
Are these better than regular over-the-counter artificial tears? Do they provide better moisturizing effects? (Regular artificial tears seem to dry out quickly.)
10.
Currently, my prescription is -150 degrees for the left eye and -100 degrees for the right eye, with an additional -50 degrees.
I can see clearly when reading, but distant vision is somewhat blurry, though it doesn't affect my daily life.
Do I need to get a new pair of glasses with the exact prescription, or would a pair with -50 degrees suffice? I am quite worried about my vision continuing to worsen (my vision increased by over 50 degrees after the laser treatment...).

11.
Should I avoid rubbing my eyes, and should I also avoid touching my face while washing? I am hesitant to touch my eyes with my hands, even when my eyelids itch, for fear of damaging my retina.
Is it true that only significant pressure can harm the retina?
12.
I currently take breaks every half hour after using my phone or reading by closing my eyes for a few minutes.
If my eyes feel dry, I yawn or use artificial tears.
Are there any other methods to help my eyes rest?
13.
Is retinal laser treatment similar to using a staple gun to secure wallpaper that might peel or has small tears, thereby preventing severe tearing or fluid accumulation? Does my situation count as early detection and prevention, like taping windows before a storm?
14.
Does sneezing pose a risk to my retinal health? I am currently very anxious about sneezing...
Thank you, Doctor, for your patience in reading this.
Since the end of January, I felt the need to have my eyes checked, which led me to the clinic and subsequently to the laser treatment.
The pain during the procedure and the transition of my vision from black to pink and then back to color was quite shocking.
Additionally, I noticed a dark spot in my lower field of vision (which was slightly pink during bathing but now appears frosted).
I have been quite anxious, but after last week's follow-up, where the doctor said the scarring looked good, I began to relax and started taking supplements to help me continue to see the world's colors.

Jing shen you dian hao ruo de ren, 30~39 year old female. Ask Date: 2023/02/17

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
Generally, after undergoing laser treatment, there may be some ocular reactions such as crusting, redness, swelling, pain, and dryness.
These reactions typically resolve within a few days to weeks.
As for the occasional bright spots you see when you close your eyes, this may be due to debris or other substances in the vitreous humor exerting pressure or interference on the eye, leading to visual disturbances.
However, as you mentioned, you have undergone examinations, and the fundus examination did not reveal any abnormalities such as fluid accumulation, so this phenomenon may be temporary and should gradually resolve during the recovery period.
2.
There should be no adverse reactions if done four times a day or less.
3.
Your symptoms may be related to shoulder muscle stiffness.
When the shoulder muscles are tense and stiff, they can affect nearby nerves and blood vessels, which in turn can impact surrounding tissues and organs, including the eyes.
Muscle tension in the shoulders may lead to neck and back tightness, resulting in discomfort or pain in the eyes.
4.
There is no risk of retinal detachment, and a steam eye mask is a good option.
5.
Your sleeping position will not have an impact, so rest assured.
6.
Correct.
7.
It is not too late to use skincare products.
8.
Music will not have an effect, but if the water pressure is strong, try to avoid direct contact with the eyes.
9.
Such treatment is only necessary for individuals with severe dry eye syndrome; for most patients, artificial tears are sufficient.
10.
If it is convenient for your lifestyle, that is fine; there is no need for a full prescription.
11.
There is no need to worry; this level of force will not have an impact.
12.
The 20-20-20 rule for eye care suggests that for every 20 minutes of computer use, you should look away from the screen for 20 seconds and focus on something 20 feet (6 meters) away; blinking 20 times during this time would be even better.
13.
Your analogy is quite good; it is similar to that.
14.
It should not be easy to occur if the laser treatment is complete.
There is no need to worry.

Reply Date: 2023/02/17

More Info

Post-retinal laser surgery care is crucial for ensuring optimal recovery and minimizing complications. Your concerns reflect common issues faced by patients after such procedures. Let's address your questions one by one, providing clarity and guidance based on medical knowledge.

1. Visual Phenomena Post-Surgery: It’s not uncommon to experience visual disturbances after laser surgery, such as seeing bright spots or flashes. This can be attributed to the healing process of the retina and the vitreous gel pulling away from the retina. If your doctor has confirmed that there is no fluid accumulation, this is likely a normal part of your recovery.

2. Use of Artificial Tears: Artificial tears are essential for managing dryness, especially after laser surgery. You can use them as often as needed, particularly if your eyes feel dry. The preservative-free artificial tears are a good choice, as they are less likely to irritate your eyes. As for the B12 drops, follow your doctor's advice regarding frequency. Overuse of any eye drop can lead to dependency or irritation, so moderation is key.

3. Pain and Sensations in the Eye: The sensations you describe, such as pain similar to a migraine or a cooling feeling, could be related to muscle tension in your neck and shoulders, which can indeed affect your eyes. Stress and fatigue can exacerbate these symptoms. Consider relaxation techniques and proper posture to alleviate muscle tension.

4. Warm Compresses: Applying a warm compress can help relieve dryness and fatigue. Using water at around 35°C is generally safe and should not harm your retina. Steam eye masks can provide consistent warmth, but ensure they are not too hot to avoid burns.

5. Sleeping Position: It’s understandable to be cautious about your sleeping position post-surgery. While lying flat is generally safe, side sleeping should not significantly impact your eye unless you are applying excessive pressure. If you are concerned about eye pressure, consider using a supportive pillow that maintains your head in a neutral position.

6. Exercise: Light aerobic exercise like jogging is typically safe after retinal laser surgery, but you should avoid heavy lifting and high-impact activities until cleared by your doctor. These activities can increase intraocular pressure, which is a concern for those with a history of retinal issues.

7. Nutritional Supplements: The combination of vitamins and antioxidants you are taking is generally beneficial for eye health. However, it’s wise to consult with a healthcare provider to ensure there are no interactions or absorption issues. Starting these supplements is not too late, as they can support overall eye health.

8. Impact of Music and Water: Listening to music through headphones should not affect your retina. However, be cautious with water exposure; avoid letting water directly hit your eyes, especially in the shower, as it can introduce bacteria and irritants.

9. Serum-based Artificial Tears: These can be more effective for some patients as they mimic natural tears more closely. If you find that standard artificial tears are not providing sufficient relief, discussing serum tears with your doctor may be worthwhile.

10. Eyeglass Prescription: If your vision is still functional for daily activities, you may not need a new prescription immediately. However, if you notice significant changes in your vision, it’s advisable to consult with your eye care provider.

11. Avoiding Eye Rubbing: It’s crucial to avoid rubbing your eyes, as this can lead to complications, especially after surgery. Gentle cleaning with a damp cloth is safer than using your hands directly on your eyes.

12. Resting Your Eyes: The 20-20-20 rule is effective: every 20 minutes, look at something 20 feet away for 20 seconds. Additionally, practicing eye exercises and ensuring proper lighting while reading can help reduce fatigue.

13. Understanding Laser Surgery: Your analogy of using tape to secure wallpaper is apt. Laser surgery aims to stabilize the retina and prevent further complications, much like reinforcing a weak structure.

14. Sneezing Concerns: Sneezing should not pose a significant risk to your retina. However, if you feel discomfort or pressure during a sneeze, it’s wise to consult your doctor for personalized advice.

In summary, your post-operative care is essential for a successful recovery. Maintain open communication with your healthcare provider, adhere to their recommendations, and prioritize your eye health through proper care and nutrition. If you have any further concerns or experience new symptoms, do not hesitate to seek medical advice.

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