Post-Surgery Concerns: Black Spots in Vision After Retinal Detachment

Q: Post-Surgery Concerns: Black Spots in Vision After Retinal Detachment

Hello： Possible reasons for the appearance of small black spots after surgery：<br>1. <br>**Floaters**： The appearance of small black spots after retinal detachment surgery may be due to floaters. <br>This occurs because the gel-like substance in the vitreous humor changes with ag

Two and a half months post-surgery, I see small black spots in my vision?

Hello, Doctor.
My mother underwent retinal detachment surgery on April 23 of this year, utilizing scleral buckle technique.
During her follow-up appointment in May, she received additional laser treatment for reinforcement.
Unfortunately, during her recovery period, we experienced the passing of a family elder, and my mother frequently knelt and bowed at a 90-degree angle during the funeral, and due to her overwhelming sadness, she also cried frequently.

At her follow-up appointment on June 24, the gas bubble in her eye had completely absorbed, and the doctor assessed that her postoperative recovery was good, scheduling her for regular follow-ups every two months.
However, on July 1, after riding her bike outside (in the midday sun, although she wore a hat and sunglasses), she noticed small black spots in her vision and felt a sensation of dryness and discomfort in her eyes.
The next day, her vision returned to normal.

Yesterday was the anniversary of the elder's passing, and she experienced frequent tearing again, with the small black spots reappearing.
I would like to ask the doctor if this situation is a result of her eyes not being fully stable post-surgery and that it will gradually improve once stability is achieved? Or is there a possibility that there may be another tear? Thank you very much for your response!

Cai Xiaojie, 30~39 year old female. Ask Date: 2024/07/08

Dr. Gao Pilin reply Ophthalmology

Hello: Possible reasons for the appearance of small black spots after surgery:
1.
Floaters: The appearance of small black spots after retinal detachment surgery may be due to floaters.
This occurs because the gel-like substance in the vitreous humor changes with age or post-surgery, resulting in some floaters that affect vision.
Typically, these floaters will gradually decrease over time, but they may worsen due to eye strain or fatigue.
2.
New retinal issues: If the small black spots are accompanied by a sudden decrease in vision, flashes of light, or visual field loss, it could indicate new retinal problems, such as a re-detachment of the retina or the emergence of new tears.
This situation requires immediate examination by an ophthalmologist.
3.
Eye fatigue: Frequent tearing, kneeling and standing, or bowing may cause eye fatigue, leading to temporary visual disturbances.
This condition usually resolves after resting.
Recommendations for management:
1.
Maintain rest: Avoid excessive eye strain and vigorous activities, allowing ample time for the eyes to rest.
Post-surgery, the eyes need time to recover, and overexertion can impact the healing process.
2.
Regular check-ups: Continue to follow the doctor's recommendations for regular check-ups to ensure the stability of the retinal condition.
If any abnormalities arise, an immediate visit to an ophthalmologist is warranted.
3.
Monitor symptoms: If your mother experiences the small black spots again, accompanied by a significant decrease in vision or visual field loss, please seek immediate ophthalmological evaluation to rule out the possibility of new retinal tears or re-detachment.
Is it possible for new holes to appear? Although your mother is recovering well post-surgery, the retina remains relatively fragile after retinal surgery.
Frequent eye strain and vigorous activities can indeed affect recovery and increase the risk of new tears or re-detachment.
Therefore, it is advisable to avoid such actions and closely monitor any changes in vision.
In summary, your mother's condition may be due to eye fatigue causing the small black spots, which should improve with rest.
However, for safety, if symptoms persist or worsen, an early visit to an ophthalmologist is recommended to rule out other potential issues.
Wishing for a speedy recovery and healthy vision!

Reply Date: 2024/07/08

More Info

After undergoing retinal detachment surgery, it is not uncommon for patients to experience visual disturbances such as black spots or floaters. In your mother's case, the appearance of small black dots following her surgery could be attributed to several factors, including the natural healing process, changes in the vitreous gel, or even the emotional and physical stress she experienced during the mourning period.

1. Post-Surgical Changes: After retinal surgery, the eye undergoes a healing process that can lead to temporary visual disturbances. The surgery itself can cause changes in the vitreous gel, which may lead to the perception of floaters or black spots. These are often benign and may diminish over time as the eye continues to heal.

2. Vitreous Changes: The vitreous humor, the gel-like substance filling the eye, can become more liquid and may pull away from the retina, especially after surgery. This process can create floaters or shadows in the vision. If the black spots are transient and not accompanied by other symptoms like flashes of light or significant vision loss, they are likely related to these changes.

3. Eye Fatigue and Stress: The emotional stress from the recent loss in the family, combined with physical activities such as kneeling and bowing, could have contributed to eye fatigue. Stress can lead to increased awareness of visual disturbances, making them seem more pronounced. Additionally, prolonged exposure to bright sunlight, even with protective eyewear, can cause temporary discomfort and visual disturbances.

4. Monitoring Symptoms: It is essential to monitor the frequency and nature of these black spots. If they persist, change in character, or are accompanied by other symptoms such as flashes of light or a sudden increase in floaters, it would be prudent to seek immediate evaluation from an ophthalmologist. These could indicate new retinal issues, such as a new tear or detachment.

5. Follow-Up Care: Regular follow-up appointments are crucial after retinal surgery. Your mother should continue to attend her scheduled visits to ensure her retina remains stable and to address any new symptoms promptly. If the black spots continue to appear frequently, it may be necessary to conduct further examinations, such as a detailed retinal scan or ultrasound, to rule out any complications.

6. Emotional and Physical Well-being: Encourage your mother to take care of her emotional health during this time. Stress and emotional turmoil can exacerbate physical symptoms, including those related to vision. Adequate rest, hydration, and a calm environment can help her recovery.

In summary, while the appearance of black spots after retinal surgery can be concerning, they are often part of the healing process. However, vigilance is essential, and any significant changes in her vision should be evaluated by her eye care provider. Regular follow-ups and open communication with her healthcare team will ensure that any potential issues are addressed promptly, allowing for the best possible recovery.

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