From the Guidelines
It is normal to experience floaters and flashing lights after laser treatment for a retinal tear, as these symptoms usually diminish over time, sometimes requiring several months. These visual symptoms typically occur as a result of the healing process following the procedure, and are related to the posterior vitreous detachment that can occur after laser treatment 1. Floaters may appear as small dark spots or string-like shapes in your vision, while flashing lights might look like brief sparks or lightning streaks in your visual field.
Key Points to Consider
- The impact of floaters or floater-related visual symptoms may have an adverse effect on a person’s vision-related quality of life 1.
- Pars plana vitrectomy is an option if symptomatic floaters are still bothersome after several months 1.
- Laser treatments and pharmacotherapies have been proposed to decrease these symptoms; however, such therapies currently lack sufficient evidence to support their use 1.
- The goal of treatment for retinal breaks is to create a firm chorioretinal adhesion in the attached retina immediately adjacent to and surrounding the retinal tear using cryotherapy or laser photocoagulation surgery 1.
Important Considerations for Patients
- If you notice a sudden increase in floaters, persistent new flashes, a shadow or curtain appearing in your peripheral vision, or decreased vision, you should contact your ophthalmologist immediately as these could indicate complications such as a new tear or retinal detachment.
- During recovery, it's essential to follow your doctor's specific instructions, which may include limiting certain activities, using prescribed eye drops, and attending follow-up appointments to monitor healing 1.
Treatment Outcomes
- The laser treatment works by creating small burns around the retinal tear, forming scar tissue that helps seal the tear and prevent fluid from getting under the retina, which could lead to retinal detachment 1.
- Sufficient evidence exists to warrant treating acute, symptomatic horseshoe tears 1.
- However, there is insufficient evidence for management of other vitreoretinal abnormalities, and the risks that treatment would be unnecessary, ineffective, or harmful must be weighed against the possible benefit of reducing the rate of subsequent retinal detachment 1.
From the Research
Normality of Floaters and Flashing Lights after Laser Treatment
- Floaters and flashing lights are common ocular complaints that can occur individually or together 2
- These symptoms can be caused by particles or debris in the vitreous gel of the eye, or by aberrations of light in a patient's field of gaze 2
- After laser treatment for a retinal tear, it is possible to experience floaters and flashing lights as the eye heals
- However, there is limited direct evidence on the normality of these symptoms specifically after laser treatment for a retinal tear
Possible Causes of Floaters and Flashing Lights
- Benign, age-related changes of the vitreous 3
- More serious retinal detachment 3
- Retinal tears or holes, including rhegmatogenous retinal detachment 4
- Acute retinal necrosis 5
Effectiveness of Laser Treatment
- Laser photocoagulation is an effective treatment to prevent retinal detachment, especially in the subgroup combined with antiviral therapy and steroid 5
- Prophylactic 360° laser treatment in the fellow eye of patients with an idiopathic giant retinal tear decreased the incidence of retinal detachment 6
- Laser retinopexy is a sparing, safe, and effective method of retinal tear therapy 4