Dark Dots After Laser Photocoagulation: Normal Visual Phenomenon
Seeing dark dots when blinking after laser photocoagulation is a normal visual phenomenon and represents the actual laser impacts on the retina. According to the American Academy of Ophthalmology guidelines, these scotomas (blind spots) are an expected outcome of the procedure 1.
Understanding Laser Photocoagulation Effects
Laser photocoagulation is a well-established treatment for various retinal conditions, particularly diabetic retinopathy. The procedure works by:
- Creating controlled burns in the retina that appear as white lesions initially 2
- Targeting abnormal blood vessels to reduce the risk of vision loss 3
- Causing intentional, localized damage to the retinal pigment epithelium (RPE) 4
Normal Post-Procedure Visual Changes
After laser photocoagulation, patients commonly experience:
- Dark spots or scotomas in the visual field, especially noticeable when blinking
- These spots correspond to the actual laser treatment areas
- The outer retina and RPE remain disrupted at the laser spots even after one year 4
When to Seek Further Evaluation
While dark dots are normal, patients should be monitored for:
- Changes requiring immediate attention:
- Significant worsening of vision
- Increasing number or size of scotomas
- Development of new visual symptoms
The American Academy of Ophthalmology recommends that patients experiencing scotomas after laser photocoagulation should:
- Report any changes in vision to their ophthalmologist
- Undergo OCT imaging to assess for potential complications like macular edema or choroidal neovascularization 1
Long-term Expectations
- The choriocapillaris (blood vessels in the choroid layer) beneath laser spots may initially be disrupted but can recover within weeks 4
- The retinal pigment epithelium at laser spots typically remains permanently altered 4
- The scotomas may persist but often become less noticeable as the brain adapts to them
Follow-up Care
Patients who have undergone laser photocoagulation should:
- Attend all scheduled follow-up appointments
- For diabetic retinopathy patients, yearly examinations are recommended 3
- Report any new or worsening visual symptoms promptly
Conclusion
Dark dots seen when blinking after laser photocoagulation represent the expected outcome of the treatment. While these scotomas are normal, any significant changes in vision should prompt evaluation to rule out complications that may require additional treatment.