Eye Pressure and Visual Disturbances After Surgery

Q: Eye Pressure and Visual Disturbances After Surgery

Hello： <br>1. <br>It is possible that you are experiencing floaters, a common eye condition caused by the presence of protein or cellular debris in the vitreous humor, which creates shadows that are projected onto the retina as light passes through the vitreous. <br>Symptoms of f

Intraocular pressure when looking out with the eyes?

Happy New Year, Doctor! I would like to ask:
1.
Recently, I have noticed that when I focus intently on a specific spot, I can see very fine particles, somewhat similar to a pixelated effect (I've thought for a long time about how to describe this, haha).
It does not affect my overall vision.
After undergoing scleral buckle surgery on my left eye at the end of December last year, a fundus examination showed no significant issues.
This phenomenon seems to occur less when looking at my phone or television.
What could be the reason for this?
2.
After the scleral buckle surgery on my left eye at the end of December, I was initially prescribed a glaucoma medication (Brimonidine) to control my intraocular pressure.
When the medication ran out, I went to a small clinic for a check-up (because sometimes I feel a pressure sensation in my eyes) and found that the intraocular pressure in both eyes was 24-25 mmHg.
I was given more glaucoma medication.
If my right eye's fundus examinations have always been normal, why is the intraocular pressure elevated? Additionally, I am currently using Ivermeq eye drops in the morning and evening, and I apply Lumify eye drops at night, but it seems that after using Lumify, my eyes are quite red in the morning, although I do not experience any other discomfort.
Could this be a side effect of the medication? How long should I continue using the glaucoma medication to stabilize my intraocular pressure? Thank you, Doctor, for your patient answers, and I appreciate your hard work! 😊

Xiao Le, 20~29 year old female. Ask Date: 2024/02/10

Dr. Gao Pilin reply Ophthalmology

Hello:
1.
It is possible that you are experiencing floaters, a common eye condition caused by the presence of protein or cellular debris in the vitreous humor, which creates shadows that are projected onto the retina as light passes through the vitreous.
Symptoms of floaters typically include small black dots, tiny insects, or lines that appear to float in your field of vision.
These floaters are usually more noticeable against a white or bright background.
If you have undergone scleral buckling surgery, this condition may occur as a result.
2.
Regarding the issue of elevated intraocular pressure, fluctuations in eye pressure can be influenced by various factors, including daily habits, sleep, and diet.
Even if the fundus examination is normal, intraocular pressure can still vary.
It is recommended that you follow your ophthalmologist's advice, use prescribed eye drops for lowering eye pressure as directed, and regularly monitor your eye pressure to ensure it remains within the normal range.
If the eye pressure continues to rise, further evaluation and adjustment of the treatment plan may be necessary.
3.
Mild redness and swelling after using Lumigan eye drops may be one of the side effects of the medication.
This can vary based on individual reactions to the drug, as some people may be more sensitive to certain ingredients.
If the redness and swelling are not significant and do not affect your vision, you may continue using the medication; however, it is advisable to mention this situation to your doctor during your next scheduled ophthalmology follow-up.
4.
The effectiveness of intraocular pressure-lowering eye drops can vary from person to person, and some individuals may require time for stable control of their eye pressure.
Doctors typically adjust treatment plans based on the specific circumstances of the patient.
Please use the medication as advised by your doctor and discuss your treatment progress during regular eye examinations.
Wishing you a Happy New Year!

Reply Date: 2024/02/10

More Info

Happy New Year! Thank you for your questions regarding your eye health after surgery. Let's address your concerns one by one.

1. Visual Disturbances: The phenomenon you describe, where you see fine particles or a pixelated effect when focusing intently, can be attributed to several factors. After undergoing scleral buckle surgery, your eyes may still be adjusting to the changes. This adjustment period can lead to visual disturbances, especially when focusing on a single point for an extended period. These disturbances might be related to the way light is refracted through the eye or even due to the presence of floaters, which are common after eye surgeries. Floaters are tiny clumps of gel or cells inside the vitreous, the clear gel that fills the space between the lens and the retina. They can cast shadows on the retina, leading to the perception of particles or spots in your vision. Since you mentioned that this does not affect your overall vision and is less noticeable when looking at screens, it may be a benign post-surgical effect. However, if these symptoms worsen or are accompanied by flashes of light or a sudden increase in floaters, it would be wise to consult your ophthalmologist for a thorough examination.

2. Elevated Eye Pressure: Regarding your eye pressure readings of 24-25 mmHg, it’s important to understand that elevated intraocular pressure (IOP) can occur for various reasons, even if previous examinations showed normal results. After surgery, the eye may experience changes in fluid dynamics, leading to increased pressure. Factors such as inflammation, changes in the drainage system of the eye, or even the use of certain medications can contribute to elevated IOP. The fact that you were previously on a pressure-lowering medication (like Brimonidine) indicates that your eye was at risk for elevated pressure, and it’s not uncommon for patients to require ongoing treatment after surgery.

Regarding the redness you experience after using Lumigan (Bimatoprost), this can indeed be a side effect of the medication. Prostaglandin analogs, like Lumigan, can cause increased pigmentation of the iris, changes in eyelash growth, and sometimes conjunctival hyperemia (redness). If the redness is persistent or bothersome, it’s essential to discuss this with your doctor, as they may consider adjusting your treatment regimen.

As for how long you will need to continue using the eye drops, this can vary significantly from person to person. The goal is to maintain your IOP within a safe range to prevent damage to the optic nerve. Regular follow-up appointments with your ophthalmologist will help determine the effectiveness of your current treatment and whether adjustments are necessary. It’s crucial to adhere to the prescribed treatment plan and report any new symptoms or concerns promptly.

In summary, the visual disturbances you are experiencing may be a normal part of your recovery process, but ongoing monitoring is essential. Elevated eye pressure post-surgery can happen for various reasons, and managing it effectively is crucial for your long-term eye health. Always keep an open line of communication with your healthcare provider to ensure that any changes in your condition are addressed promptly. Thank you for your thoughtful questions, and I wish you the best in your recovery!

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