Dark Spots After Laser Photocoagulation
Dark spots seen when covering one eye after laser photocoagulation are typically scotomas (blind spots) resulting from the intentional destruction of retinal tissue during treatment and are an expected outcome of the procedure. 1
Understanding Laser Photocoagulation and Scotomas
Laser photocoagulation is a well-established treatment for various retinal conditions, particularly diabetic retinopathy. The procedure works by targeting abnormal blood vessels to reduce the risk of vision loss 2. However, the treatment inherently damages retinal tissue to achieve its therapeutic effect.
When you experience dark spots after laser treatment:
- These are scotomas (blind spots) that occur where laser burns were applied
- They represent areas where retinal tissue was intentionally destroyed during treatment
- This is a normal and expected outcome of the procedure 1, 3
Why Scotomas Occur
The mechanism behind these scotomas is well understood:
- Laser photocoagulation destroys approximately 40% of the retinal area treated 3
- The treatment predominantly affects areas with high concentrations of rod photoreceptors
- This explains why the scotomas may be more noticeable in dim lighting conditions 3
- The laser creates chorioretinal adhesions that appear as dark spots in your visual field 1
When to Seek Medical Attention
While scotomas are expected, you should contact your ophthalmologist if:
- You notice a sudden increase in the number or size of dark spots
- The dark spots are accompanied by flashes of light
- You experience a curtain-like shadow across your vision
- You have a sudden decrease in visual acuity 1
These symptoms could indicate complications such as:
- Macular edema (fluid buildup in the central retina)
- Choroidal neovascularization (abnormal blood vessel growth)
- Retinal detachment 1
Follow-up Care
Regular follow-up is essential after laser photocoagulation:
- Attend all scheduled appointments with your ophthalmologist
- Annual comprehensive eye examinations are recommended 2, 1
- Report any significant changes in your vision promptly
Long-term Outlook
The Early Treatment Diabetic Retinopathy Study (ETDRS) and Diabetic Retinopathy Study (DRS) demonstrated that:
- Laser photocoagulation significantly reduces the risk of severe vision loss in patients with diabetic retinopathy 2
- While the procedure creates scotomas, the benefit of preventing severe vision loss outweighs this side effect
- The scotomas may become less noticeable over time as your brain adapts to them 1
Diagnostic Assessment
If you're concerned about your scotomas, your ophthalmologist may perform:
- Visual acuity testing
- Dilated fundus examination
- Optical Coherence Tomography (OCT) imaging
- Possibly fluorescein angiography to detect any complications 1
Remember that while the scotomas may be bothersome, they represent a successful treatment that has significantly reduced your risk of more severe vision loss from your underlying condition.