Vision Changes After Eye Trauma and Laser Surgery - Ophthalmology

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After experiencing eye trauma, particularly in cases involving high myopia and retinal degeneration, it is not uncommon to encounter various visual disturbances. Your description of seeing numerous small black dots and line-like objects, often referred to as "floaters," is a typical symptom following retinal injury or surgery. These floaters can result from changes in the vitreous gel of the eye, which may pull away from the retina, leading to the perception of these visual phenomena.

The presence of internal bleeding and the identification of small holes in the retina necessitated laser surgery, which is a common and effective treatment for such conditions. The laser procedure aims to seal the holes and prevent further retinal detachment, which is crucial for preserving vision. Post-surgery, it is encouraging to hear that the floaters have improved, indicating that the initial trauma's acute effects may be subsiding.

However, your report of seeing a white haze or veil over your vision, along with halos around light sources, is concerning and warrants further discussion. This phenomenon can be attributed to several factors:
1. Corneal Edema: Following trauma or surgery, the cornea may become swollen (edematous), leading to a hazy vision. This condition can occur if the corneal cells are damaged or if there is an increase in intraocular pressure, which can happen after surgery or due to inflammation.

2. Vitreous Changes: The vitreous gel's composition and its interaction with the retina can also contribute to visual disturbances. If the vitreous is still in the process of reattaching or if there are residual changes from the trauma, it may cause a perception of haze.

3. Post-Surgical Inflammation: Inflammation is a common response to eye surgery. If the inflammation is significant, it can lead to a temporary decrease in visual clarity. This is often managed with anti-inflammatory medications, which your doctor may prescribe.

4. Retinal Changes: Although the laser surgery aims to repair the retina, there may still be residual effects from the trauma or the surgery itself. Changes in the retinal structure can lead to altered visual perception, including the sensation of a veil or haze.

5. Intraocular Pressure: If your intraocular pressure remains elevated, as noted in previous discussions, it can also contribute to visual disturbances. Elevated pressure can lead to optic nerve damage and further complications, so monitoring and managing this is crucial.

In terms of management, it is essential to maintain regular follow-ups with your ophthalmologist. They may conduct a thorough examination, including optical coherence tomography (OCT) or other imaging techniques, to assess the retina and vitreous status. If corneal edema is suspected, treatments may include hypertonic saline drops or other medications to reduce swelling.

Additionally, if inflammation is present, corticosteroids may be prescribed to help alleviate symptoms. It is also vital to monitor intraocular pressure closely, especially if you have a history of elevated pressure or glaucoma.

In conclusion, while some visual disturbances post-trauma and surgery can be expected, persistent symptoms like haze and halos should be evaluated further. Your ophthalmologist will be the best resource for determining the underlying cause and appropriate treatment plan. It is crucial to communicate any changes in your vision promptly, as early intervention can significantly impact your recovery and overall visual outcome.