Post-Laser Discomfort and Complications After Retinal Treatment

Prolonged discomfort after retinal tear laser treatment?

Dear Doctor,
Eight months ago, I underwent nearly 200 laser treatments for multiple retinal tears in both eyes.
My attending physician has not been very responsive to my questions, so I would like to consult you regarding the following issues:
1.
Why do I have multiple retinal tears despite having only -4.25 diopters of myopia in both eyes and no astigmatism?
2.
Before the laser treatment, I had no issues with flashes or shadows in my vision.
However, even after eight months post-treatment, I still experience flashes of light in the areas where the laser was applied, and I notice some visual disturbances, such as missing sections and shadows at certain angles, along with numerous floaters.
Despite adequate rest, my eyes continue to have these symptoms.
3.
One night before going to bed, I suddenly saw a dark cloud-like formation in the lower part of my vision, which obscured my lower central vision.
However, when I moved to a well-lit area, the dark cloud diminished.
After sleeping, the dark cloud disappeared.
I immediately consulted a doctor the next day, who said it was a type of floater, but I am still confused about what it actually was.
4.
Is it excessive to have undergone nearly 200 laser treatments?
5.
Does laser treatment leave scars on the retina? Are there any potential side effects?
After experiencing these issues, I promptly returned to the physician who performed the laser treatments.
After thorough examinations, they stated that my retina appears normal and that there are no significant problems with the areas treated by the laser.
Nevertheless, my symptoms began only after the laser treatment, which I find puzzling.
Each time I visit the doctor, I am told that the laser has no side effects (though I feel otherwise) or that I am overthinking (which I suspect is an attempt to avoid responsibility).
I have sought opinions from multiple hospitals and doctors, but I have not received any answers, leaving me very distressed.
Please help me with my concerns! I would be extremely grateful!

Qing Tian, 20~29 year old female. Ask Date: 2015/11/13

Dr. Wang Zhishun reply Ophthalmology

Hello, the laser itself can leave scars on the retina; the number of shots depends on the size of the lesion, and there have been cases with over 2000 shots.
Although high myopia is more prone to issues, various degrees can also experience problems, and there is no direct correlation.
Your current condition is likely due to vitreous opacities, which may be somewhat bothersome, but as long as the retina is normal, it is recommended to have regular follow-ups.

Reply Date: 2015/11/13

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your post-laser treatment experience. It’s understandable to feel anxious when experiencing unusual symptoms after a procedure, especially one as delicate as retinal laser treatment. Let’s address your questions one by one.

1. Why do I have multiple retinal tears with only -4.25 diopters of myopia and no astigmatism?
Retinal tears can occur in individuals with various degrees of myopia, not just high myopia. The risk factors for retinal tears include not only the degree of myopia but also the structural characteristics of the eye, such as the shape of the eyeball and the condition of the vitreous gel. Even mild to moderate myopia can predispose individuals to retinal issues, particularly if there are other underlying factors like lattice degeneration or a family history of retinal problems.

2. Why do I experience flashes and shadows after laser treatment?
Flashes of light and the perception of shadows or dark spots can be concerning. These symptoms may be related to the changes in the vitreous gel that occur after laser treatment. The laser can cause the vitreous to pull away from the retina, which can lead to the perception of flashes (photopsia) and floaters. It’s not uncommon for these symptoms to persist for some time after treatment, but if they worsen or are accompanied by a sudden increase in floaters or a curtain-like shadow in your vision, it’s crucial to seek immediate medical attention.

3. What was the black cloud I saw before sleeping?
The phenomenon you described, where you experienced a sudden appearance of a black cloud obstructing your vision, could be related to a temporary change in the vitreous gel or a transient visual disturbance. This could also be a form of floaters or a visual migraine. If it resolved after sleeping and did not recur, it may not be a cause for concern. However, if you experience similar symptoms again, it’s essential to have a thorough examination to rule out any serious issues.

4. Is it excessive to have undergone nearly 200 laser treatments?
The number of laser applications can vary significantly based on the individual’s condition and the extent of the retinal issues being treated. While 200 treatments may seem high, it’s essential to consider the specific circumstances of your case. Your ophthalmologist would have determined the necessary number of treatments based on the severity and location of the retinal tears. If you have concerns about the number of treatments, it’s worth discussing them with your doctor or seeking a second opinion.

5. Does laser treatment leave scars on the retina? Are there side effects?
Laser treatment can cause changes to the retinal tissue, and while it is designed to create controlled damage to promote healing, it can sometimes lead to scarring. However, most patients do not experience significant long-term effects from laser treatment. Side effects can include temporary visual disturbances, such as the ones you are experiencing, but serious complications are rare. It’s important to maintain regular follow-ups with your ophthalmologist to monitor your retinal health.

In conclusion, while your symptoms are concerning, they are not uncommon after laser treatment. It’s crucial to maintain open communication with your healthcare provider and express your concerns clearly. If you feel your questions are not being adequately addressed, seeking a second opinion from another retinal specialist may provide you with additional reassurance and clarity. Remember, your vision is paramount, and you deserve thorough answers and care.

Take care, and I hope you find relief from your symptoms soon.

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