Post-Laser Complications After Retinal Hole Treatment: What to Expect?

Complications after retinal hole laser treatment?

On November 22 of last year, I went to the hospital to check for floaters and unexpectedly discovered that I had a hole in my eye and retinal detachment.
After researching the symptoms and listening to the doctor's explanation, I understand that retinal detachment is a serious condition.
I have about eight black spots from floaters, which is not as numerous as a rain-like quantity.
At that time, I underwent laser treatment to seal the area around the hole.
A week later, during a follow-up visit, the doctor said that my right eye needed another laser treatment.
After the second laser procedure, I experienced some phenomena: near the nose area of my right eye, there seemed to be intermittent white or black shadows, which were not well-defined and difficult to describe.
I was unsure if this was a normal post-surgery occurrence or perhaps a psychological effect.
During the day, I noticed small white flashes in the same area, but they did not last long and appeared only on certain days, about twice a day.
My question is whether these symptoms are typical after experiencing retinal detachment.
However, my situation seems to be the opposite; these phenomena appeared only after the second laser surgery.
Could there have been an error during the surgery that caused these issues? The doctor instructed me not to move my eye during the laser treatment, warning that it could affect other areas, but I tried my best to remain still.
Could this have exacerbated my underlying condition? My myopia is -5.00 in the right eye and -4.50 in the left eye.
The doctor mentioned that I have high myopia, but isn't high myopia defined as being over -6.00? The doctor stated that high myopia was the cause of my hole and retinal detachment.
Since I work in the United States and needed to return quickly, I did not seek a second opinion.
I asked the doctor who performed the laser treatment about my concerns, but he did not address my questions directly, only stating that the important factors were whether the black spots had enlarged, whether the floaters had increased, and whether I experienced flashes of light.
My issue is that I did not have these symptoms before; they only appeared after the second laser treatment, and the doctor could not explain this to me.
Can you help clarify my concerns?
I will be returning to the United States in a month, and I am worried that my condition and the frequency or quantity of symptoms may worsen.
Initially, I had only a few floaters, but now they seem to have formed a web-like pattern.
In my right eye, near the nose area, whenever there is a bit of light, I feel as if there are ripples moving throughout the day without needing to focus on that area.
Additionally, I sometimes perceive a grayish haze near the nose, which feels like something sticky is on it—sometimes present, sometimes absent.
During the day, when I close my eyes, I still feel ripples in that area.
Moreover, in complete darkness at night, I occasionally sense a white fluid-like sensation passing by near the nose.
To reiterate, before the laser treatment, I had none of these symptoms, and my floaters were minimal.
Lastly, throughout the entire surgical process, I felt quite isolated.
The doctor only informed me about the condition of my eyes, mentioning multiple holes and retinal detachment, but I did not see any of this myself; it was solely based on the doctor's word.
At that moment, I did not seek a second opinion and was asked to sign a consent form while dilated, without being able to read it.
After the issues arose, my questions were not answered directly, and I was told that the faint gray haze was due to my retinal detachment, which I was advised to adapt to, as it would persist.
The important point is that I did not have these symptoms before; they arose immediately after the laser treatment.
Logically, if the eye was altered during the procedure, it should have caused these changes.
Any responsibility for flaws should lie with the surgical judgment and process, as this is a straightforward cause-and-effect relationship.
I was a healthy person before this illogical situation occurred.
Could you please assist me? Thank you very much.

Shaun Li, 40~49 year old female. Ask Date: 2014/01/21

Dr. Wang Zhangji reply Ophthalmology

The purpose of the laser treatment is to control the extent of holes or small areas of retinal detachment, preventing further detachment from occurring.
If the laser treatment had not been performed at that time, it is likely that there would be extensive detachment now, requiring expensive surgery in the United States to preserve vision, with a potentially poor prognosis.
The symptoms you described are not common complications of laser treatment; they may indicate a slight progression of the detachment.
It is recommended to visit a local ophthalmologist for a detailed dilated fundus examination to obtain answers.
Please note that the latest equipment still cannot capture all the holes that physicians can see for patients to view.

Reply Date: 2014/01/21

More Info

After undergoing laser treatment for a retinal hole, it is not uncommon to experience a range of visual disturbances, including the symptoms you have described. The concerns you have regarding the appearance of new visual phenomena, such as flashes of light, shadows, or changes in your perception of floaters, are valid and warrant careful consideration.

Firstly, it is important to understand that laser treatment for retinal holes is intended to prevent further complications, such as retinal detachment. However, the procedure itself can sometimes lead to temporary changes in vision as the eye adjusts to the treatment. The symptoms you are experiencing, such as intermittent flashes or shadows, may be a result of the laser treatment and the underlying condition of your eye. These symptoms can be exacerbated by the presence of high myopia (nearsightedness), which you mentioned is a factor in your case. High myopia can lead to structural changes in the retina, making it more susceptible to issues like retinal holes and detachments.

Regarding your concern about whether the laser procedure could have caused additional problems, it is essential to note that while complications can occur, they are generally rare. The laser is designed to target specific areas of the retina, and while movement during the procedure can potentially affect the outcome, it is unlikely that minor movements would lead to significant complications. However, if you feel that the procedure was not conducted properly or that you were not adequately informed about the risks, it is advisable to seek a second opinion from another ophthalmologist. They can provide a thorough examination and help clarify whether your current symptoms are typical post-operative effects or if they indicate a more serious issue.

As for your concerns about the changes in your floaters and the new visual disturbances, it is crucial to monitor these symptoms closely. If you notice an increase in the number of floaters, especially if they are accompanied by flashes of light or a curtain-like shadow over your vision, you should seek immediate medical attention. These could be signs of retinal detachment, which is a serious condition requiring prompt intervention.

In terms of your vision recovery and what to expect moving forward, it is essential to maintain regular follow-up appointments with your eye care provider. They can assess the health of your retina and monitor any changes in your vision. If your symptoms persist or worsen, further diagnostic tests, such as optical coherence tomography (OCT), may be necessary to evaluate the condition of your retina more closely.

Lastly, regarding your question about whether you will have to live with these symptoms long-term, it is difficult to provide a definitive answer without a comprehensive evaluation. Some patients find that their symptoms improve over time as the eye heals and adapts to the changes. Others may experience persistent visual disturbances. Engaging in healthy eye care practices, such as protecting your eyes from strain, maintaining a balanced diet rich in nutrients beneficial for eye health (like omega-3 fatty acids, lutein, and vitamins A, C, and E), and avoiding activities that could put undue stress on your eyes, can be beneficial.

In conclusion, while it is understandable to feel anxious about the changes in your vision following laser treatment, it is crucial to stay proactive about your eye health. Regular check-ups, open communication with your eye care provider, and seeking second opinions when necessary can help ensure that you receive the best possible care and support as you navigate your recovery.

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