Post-Retinal Laser Treatment: Increased Visual Disparity

After retinal laser treatment, the disparity between the two eyes has increased?

Hello, doctor.

1.
I received my glasses on July 8, 2022, with myopia and astigmatism measurements of -5.25/1.50 for the left eye and -6.25/0.75 for the right eye, with corrected vision of 1.02 in both eyes.

2.
In May 2023, I accidentally hit my eye (the exact time is uncertain, but I recall it was around my appointment).

3.
On May 8, 2023, I visited the doctor for a stye in my left eye, and my vision was measured at 0.9 for the left eye and 0.6 for the right eye (I later inquired with the doctor to obtain the vision test results).

4.
On June 27, 2023, during a retinal examination (with dilation), a tear was found in my right eye, and I underwent laser treatment.
I was also prescribed a medication: Hucare Vision - suspension eye drops.
It was at this time that I noticed significant blurriness in my right eye.

5.
On July 12, 2023, I returned for a check-up due to discomfort in my eyes.
The doctor did not find any issues and mentioned that my recovery was satisfactory, without prescribing any additional medication.

6.
On August 8, 2023, during a post-operative follow-up, the doctor again found no issues and stated that my recovery was going well.
However, I reported to the doctor that my right eye was noticeably blurry before and after the surgery, and my prescription has since increased by -0.50 for the left eye and -1.25 for the right eye.
I am uncertain about the cause, so the doctor prescribed another medication: Methacholine Sulfate and Neostigmine eye drops.
I would like to ask the following questions:
1.
Is it normal for vision recovery after surgery to take time, or is it possible that the vision may be fixed and I will only need to increase the prescription? (I do not experience blurriness when looking at things up close, but I do when looking at things far away.)
2.
If I want to determine whether there are other factors contributing to the rapid deterioration of my vision, what tests would be advisable? Thank you.

Ming, 20~29 year old female. Ask Date: 2023/08/11

Dr. He Jianxian reply Ophthalmology

Dear Miss Ming,
1.
Generally, retinal laser treatment does not cause changes in refractive error; any changes in refractive error may be due to other reasons.
2.
It is recommended that you monitor your refractive error for a period of time to see if it continues to increase.
Director He Jianxian, Ophthalmology, Nantou Hospital

Reply Date: 2023/08/11

More Info

Post-retinal laser treatment, particularly after experiencing complications such as retinal tears or detachments, can lead to various visual changes, including increased visual disparity between the eyes. Your situation involves a series of events that may have contributed to your current visual status, and understanding these can help clarify your concerns.

1. Recovery Time and Visual Acuity: After undergoing retinal laser treatment, it is common for patients to experience fluctuations in their vision as the eye heals. The healing process can take weeks to months, and during this time, visual acuity may improve or change. It is important to note that while some patients regain their pre-treatment vision, others may experience residual visual deficits. In your case, the increase in prescription strength for both eyes suggests that your vision has not returned to its previous level of clarity. This could be due to several factors, including the initial trauma to the eye, the presence of any underlying conditions, or the effects of the laser treatment itself. If your vision remains stable but not at the desired level, it may indicate that the changes are more permanent, and further corrective measures, such as glasses or contact lenses, may be necessary.

2. Investigating Underlying Issues: To determine if there are other factors contributing to the rapid increase in your prescription or the disparity in vision between your eyes, several diagnostic tests can be performed. These may include:
- Comprehensive Eye Examination: This includes checking visual acuity, refraction, and assessing the overall health of the eye.

- Optical Coherence Tomography (OCT): This imaging test provides detailed images of the retina and can help identify any structural changes or damage that may not be visible during a standard examination.

- Visual Field Testing: This assesses your peripheral vision and can help detect any issues with the optic nerve or retinal function.

- Fundus Photography: This captures images of the interior surface of the eye, allowing for a detailed examination of the retina and any potential abnormalities.

- Electroretinography (ERG): This test measures the electrical responses of the retina's light-sensitive cells and can help evaluate retinal function.

In summary, while some visual changes post-laser treatment may resolve over time, others could be indicative of more persistent issues. It is crucial to maintain open communication with your ophthalmologist, who can guide you through the recovery process and recommend appropriate follow-up care or additional testing as needed. If you experience any new symptoms, such as flashes of light, increased floaters, or significant changes in vision, it is essential to seek immediate medical attention. Your eye health is paramount, and timely intervention can help preserve your vision.

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