Post-Laser Treatment Eye Complications: Glaucoma or Anemia Effects?

Three months after laser surgery for retinal tear, suspected glaucoma was found during the examination?

Three months ago, I suddenly experienced a large number of floaters and went to the hospital for an examination, where a retinal tear was found in the upper right quadrant of my right eye.
I underwent laser treatment that same day.
After two weeks and three months, follow-up examinations indicated good recovery.
However, three weeks after the laser treatment, one night while watching TV, I suddenly noticed a wave-like interference pattern in the upper left quadrant of my left eye, and the screen appeared slightly dim.
Upon closer inspection of the subtitles, I felt that some letters were disappearing.
This episode lasted for about five minutes before returning to normal.
The next day, I went to another large hospital for an examination (as I felt something was off after a week at the original hospital).
I underwent tonometry, slit-lamp microscopy, ultrasound examination, and indirect ophthalmoscopy, all of which returned normal results.
The doctor suspected anemia (which I do have) as a cause of insufficient blood supply.
Three weeks later, I had a visual field test, which revealed a visual field defect in the upper right quadrant of my right eye, while my left eye showed no abnormalities.
Currently, the doctor has prescribed Azarga eye drops to lower intraocular pressure (I have -5.25 diopters of myopia in both eyes, and there is no family history of glaucoma).

1.
Given that I previously had a retinal tear in the upper right quadrant of my right eye treated with laser, could the visual field defect be a complication from the laser treatment, or is it indicative of glaucoma?
2.
Regarding the wave-like interference and dimming of the screen in my left eye, could this be a transient phenomenon due to retinal blood supply insufficiency caused by anemia? What potential impacts could this have?

Ms. Hsu, 30~39 year old female. Ask Date: 2024/04/07

Dr. He Jianxian reply Ophthalmology

Dear Ms.
Hsu,
1.
The location of the laser treatment is usually at the periphery and does not significantly affect visual field testing.
Since the laser was applied to the upper right corner, any potential visual field loss would likely occur in the lower left quadrant, so your condition raises concerns for glaucoma.
2.
If your vision returns to normal as it usually does, there typically won't be significant long-term effects.
Sincerely,
Director He Jianxian, Ophthalmology, Nantou Hospital

Reply Date: 2024/04/07

More Info

Post-laser treatment complications can be concerning, especially when they involve changes in vision or symptoms that suggest underlying issues. Based on your description, let's address your questions regarding the potential complications following your laser treatment for retinal issues and the symptoms you are experiencing.

1. Complications from Laser Treatment and Visual Field Loss: The laser treatment you underwent for a retinal tear is generally considered safe and effective. However, complications can occur, including the possibility of new retinal tears or detachment, especially if there were pre-existing vulnerabilities in the retina. The visual field loss you are experiencing in the right eye could be related to the previous retinal tear and the laser treatment, but it is essential to differentiate this from glaucoma. Glaucoma can cause peripheral vision loss and is characterized by increased intraocular pressure (IOP). Since you mentioned that your eye pressure was measured and found to be normal, it may reduce the likelihood of glaucoma being the primary cause of your visual field loss. However, the use of Azarga (a combination of brimonidine and timolol) suggests that your doctor is being cautious and monitoring for any potential increases in eye pressure that could lead to glaucoma.

2. Visual Disturbances in the Left Eye: The phenomenon you described in your left eye, where you saw a "wave-like interference" and experienced temporary dimming and disappearing text, could indeed be related to transient ischemic episodes due to your anemia. Anemia can lead to reduced oxygen delivery to the retina, which may cause temporary visual disturbances. These symptoms, if they are transient and resolve quickly, may not indicate permanent damage, but they warrant careful monitoring. If these episodes recur or worsen, it would be prudent to consult with a neurologist or an ophthalmologist specializing in retinal conditions to rule out any serious underlying issues.

Additional Considerations:
- Monitoring and Follow-Up: Given your history of retinal issues and current symptoms, regular follow-up appointments with your ophthalmologist are crucial. They can monitor your eye health, check for any changes in your retina, and assess your visual fields over time.

- Managing Anemia: Since your doctor suspects that anemia may be contributing to your symptoms, addressing this underlying condition is essential. Ensure you are following up with your primary care physician or a hematologist to manage your anemia effectively. This may involve dietary changes, supplements, or other treatments depending on the cause of your anemia.

- Visual Rehabilitation: If you continue to experience visual disturbances, consider discussing visual rehabilitation options with your eye care provider. They can provide strategies to cope with visual field loss and improve your overall visual function.

- Lifestyle Adjustments: In the meantime, ensure you are taking care of your overall health, including proper nutrition, hydration, and managing any other health conditions that may affect your vision.

In conclusion, while the symptoms you are experiencing could be related to your previous laser treatment, they may also be influenced by your anemia. Continuous monitoring and proactive management of both your eye health and anemia are essential to ensure the best possible outcomes. Always communicate any new or worsening symptoms to your healthcare providers promptly.

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