Dark spots - post laser

[dannylee718]

Hello,

First I would like to thank you for taking your time to read and answer all of out inquiries.  

Here is my story.  On July 14th, I lost peripheral vision on the lower right side of my left eye.  On July 16th, I got a vitrectomy and gas bubble to fix the detachment.  5 weeks have past and I noticed a new blind spot on the lower right.  I immediately checked myself into the ER and the residents told me that there were a bunch of holes that has formed.  The doctor (not there at the time -- on call) told me to tilt my head to keep the residual bubble over the area where the holes were found.  Three days later, they found that the retina was reattached and I got laser treatment to seal the holes.  Since then, my peripheral vision in the bottom right has not returned.  The doctor found that the retina was still attached.  I went to another doctor to get a second opinion and I got the same story.  The explanation I got was that it could be caused by the laser scarring and that some of the vision would come back.  

Does this sound reasonable to you?  Also, if it is, how long does it usually take for the vision to return?  It has been almost 2 weeks since the laser.

Thank you in advance.

Sincerely,
Daniel

[John C Hagan III, MD, FACS, FAAO]

The recommendations would be the same except measuring the intraocular pressure in the operated eye would be more important that in the fellow eye.

JCH III MD

[dannylee718]

Thank you for the helpful answer.

I should clarify though, the blackouts are happening on the SAME eye that I ot my retinal detachments.

[John C Hagan III, MD, FACS, FAAO]

Hello Dannylee   The mechanism involved in damage to your peripheral vision include: detached retina (the area that was pulled off had its sight pathways severed and now they must reform), laser scars or cryo (freezing) scars (the retina ophthalmologist try to place these away from the center of the eye and try not to over-lap the scars to minimize damage, blockage of the retinal artery or veins and inflammation of the optic nerve.

Once the retina is re-attached recovery is generally SLOW.  That is with a macula off retinal detachment some improvement may continue for as long as a year. So it's going to be some time before you know your final result.

The relationship to the symptoms in the shower is completely coincidential. Don't give up on your personal higiene.

The black outs of your other (left) eye are concerning. While the most likely cause is orthostatic hypotension you should mention this to your retinal surgeon next visit. Your left eye should probably be dilated for a thorough internal examination.

You should also see your personal physician for a complete physicial. Your personal physician can check you blood pressure after laying down for 5-10 minutes then have you stand up quickly, see if this reproduces your symptoms and take your blood pressure at the same time.

If you have multiple risk factors: smoke, high blood pressure, high cholesterol, diabetes, advanced age (>80 y/o), bad family history. You may need carotid dopplers, Sed Rates and CPR blood tests to rule out giant cell arteritis.

JCH III MD Eye Physician & Surgeon

[dannylee718]

Just to add a few more details...  

Both of the times thre symptoms began while I was showering.  Is this just coincidental?
Also, for the past month now, my left eye "blacks out" when I get up from bed or i've been sitting down very long.

My concern is, can the underlying reason behiind this all be a vascular problem?

Thanks again,
Daniel