retinal tear: solution laser 360 degrees circumference

[Pouatchee]

Dear @Sheryl

I have a retinal tear in my right eye. many floaters coming in and flashes. I went to see my optometrist 2 weeks ago and at first she could not find the tear. following a panoply of tests she found it and tried to laser it. she said it was difficult to access and after the surgery i still had the flashes but they were lesser. 

 

On thursday, my doctor booked me for next friday to do a follow up. her plan is to laser my retina in a 360 degree circumference. the laser smarts like heck just when she did the small spot and I know i am going to cringe when she plans to do the whole eye.

 

my questions:

1. is this normal practice?

2. are there risks other than she lasering somewhere by accident? 

3. what is the long term prognostic?

4. if for some reason i get hit by say, a tennis ball, can it cause retinal detachment more easily than if i dont have the procedure?

 

Maybe its just me, but I had my left eye done first (same issue a while ago) and last time my right eye hurt like heck and to this day i still need to put eyedrops every 20 minutes.

 

any help or advice will be greatly appreciated.

 

Edited Saturday at 04:15 AM by Pouatchee

[connda]

I'm sorry to hear that.  I've have laser surgery in my eye and it is not pleasant.  Hope all works out for you.  Best wishes!

[Sheryl]

360 degree laser has advantage of getting even tears that cannot be seen. Prognosis is very good, and in skilled hands risk is quite low.

 

You will not be at increased risk of retinal detachment due to having the procedure. You are at increased risk of detachment if the tear is not corrected.

 

That said, quite small retinal tears do sometimes heal themselves. It needs a highly experienced specialist to determine, on a case by case basis,  which tears can safely be just monitored rather than immediately  treated.

 

Basically your choices are: 

 

1. Follow your doctor's advice.

 

2. Get another opinion. If you opt for that, do it at Rutnin in Bangkok, preferrably with Dr. Roy. Rutnin had very advanced equipment which might enable them to identify exactly  where  the tear is.  Possibly then you could avoid the 360 laser (but no guarantee). 

 

Regarding your concern about pain, you should share this with the doctor ask about an injected local anesthetic rather than just the numbing drops. (The injection is not into the eye but below it)  Can also request an oral sedative beforehand.  

[Pouatchee]

thank you for this detailed explanation. i will walk in to the operating room a lot more reassured. my left eye is starting to act up again, so if this is bearable i will likely ask to do it too. i dont get it... i had cataract surgery in both eyes and i read that following surgey retinal tears are relatively rare. yet, i am lucky enough to have it in both eyes and i am not even 60 yet.

 

sucks to be me...

 

thanks sheryl

[FarangRimPing]

I had laser surgery to repair a tear about a month ago. The doctor wasn't sure that the procedure would be successful because there was a lot of blood in the vitreous.

 

For me, it was not painful at all but it was very uncomfortable during the procedure because of the bright lights hitting my good eye. No pain afterward either. (I only had a local prior to the procedure but used no medication afterward.)

 

It seems to have gone well. The blood is dissipating but I still have quite a ways to go.

Edited Saturday at 05:58 AM by FarangRimPing

[Pouatchee]

2 hours ago, connda said:

I'm sorry to hear that.  I've have laser surgery in my eye and it is not pleasant.  Hope all works out for you.  Best wishes!

 

thanks for that

 

35 minutes ago, FarangRimPing said:

I had laser surgery to repair a tear about a month ago. The doctor wasn't sure that the procedure would be successful because there was a lot of blood in the vitreous.

 

For me, it was not painful at all but it was very uncomfortable during the procedure because of the bright lights hitting my good eye. No pain afterward either. (I only had a local prior to the procedure but used no medication afterward.)

 

It seems to have gone well. The blood is dissipating but I still have quite a ways to go.

 

you are very fortunate. for me... it burns and my eyes dry up, hence the need for constant eye drops. my doctor had warned me of this.

 

Quote

No pain afterward either. (I only had a local prior to the procedure but used no medication afterward

 

as sheryl said, there are 2 options. numbing eye drops or injected local anesthetic. my doc gave me the numbing... as you said, you had a local. i guess that helps. because of the amount of 'laser zaps' (over a 100 according to the doc) i will likely ask for the local anesthesia

[FarangRimPing]

3 hours ago, Pouatchee said:

 

thanks for that

 

 

you are very fortunate. for me... it burns and my eyes dry up, hence the need for constant eye drops. my doctor had warned me of this.

 

 

as sheryl said, there are 2 options. numbing eye drops or injected local anesthetic. my doc gave me the numbing... as you said, you had a local. i guess that helps. because of the amount of 'laser zaps' (over a 100 according to the doc) i will likely ask for the local anesthesia

Sorry, I wasn't clear and should have been more careful. When I said local, I meant the external numbing drops. (Google generated: 'Medicine applied externally to a particular part of the body; local: a topical anesthetic.')

[Mike Lister]

I had a retinal tear that wasn't spotted for three weeks, eventually it was and it was lasered by a very panicked Dr. Later, I consulted a second opthamologist who recommended 360 degree laser treatment, in both eyes! I became very confused about this so I went to see Dr Roy at the Rutnin. Dr Roy did all the tests and took all the pictures before shaking his head at the previous diagnosis and suggested I get a new Opthamologist. This was in Chiang Mai two years ago. 

[Pouatchee]

3 minutes ago, FarangRimPing said:

Sorry, I wasn't clear and should have been more careful. When I said local, I meant the external numbing drops. (Google generated: 'Medicine applied externally to a particular part of the body; local: a topical anesthetic.')

 

you are fortunate...had my left eye done around 3-4 years ago and still feels like i have sand in it. i have a high level tolerance for pain... generally, but my eyes? not at all... complete waste

[Pouatchee]

3 minutes ago, Mike Lister said:

I had a retinal tear that wasn't spotted for three weeks, eventually it was and it was lasered by a very panicked Dr. Later, I consulted a second opthamologist who recommended 360 degree laser treatment, in both eyes! I became very confused about this so I went to see Dr Roy at the Rutnin. Dr Roy did all the tests and took all the pictures before shaking his head at the previous diagnosis and suggested I get a new Opthamologist. This was in Chiang Mai two years ago. 

 

so what was the prognostic... what did you end up doing?

 

i think my doctor (considering my left eye also has problems) is going to do this to avoid future issues...

Edited Saturday at 10:12 AM by Pouatchee

[Mike Lister]

1 minute ago, Pouatchee said:

 

so what was the prognostic... what did you end up doing?

 

i think my doctor (considering my left eye also has problems) is going to do this to avoid future issues...

I had the original tear lasered and nothing more, I ignored completely the recommendation for 360 degree laser, on the basis of Dr Roys advice. One year later I had a piece of retina detach in my other eye and cause a large floater but it didn't tear. 

 

The logic I was given for having 360 degree laser treatment was that if one retina tears, the other will tear also. Medically, that was not supported by the condition of the retina's as photographed in high res at the Rutnin. The scuff/floater in the second eye a year later was not at the edge and would have not been prevented by 360 degree laser treatment. DTW, flashing lights are feature and have been for over two years, they are considered normal given the state of the vitreous fluid and my age. Wearing dark glasses helps a lot

[Sheryl]

@PouatcheeJust to be clear, the above poster's issue was that his doctor wanted to do 360 on both eyes, including an asymoptomatic one.

 

That said, it would be very worthwhile for you to get a second opinion from Dr,. Roy at Rutnin (and might avoid the need for the 360  procedure, though no guarantee) if you can make the trip to Bangkok.

 

 

[Pouatchee]

thanks sheryl. in my case i am symptomatic in both eyes and i am getting these weird flashes in my left eye which was treated 3-4 years ago. this week... and no i am not on drugs... i had a light flash that had the shape of a circle with lines around it... just like a crude drawing of a child. i think that if i dont do the 360 degree on both eyes i might be in for a surprise down the line... specially considering i am not in my 60's yet.

 

thanks all... good posts

Edited Saturday at 10:59 AM by Pouatchee