Lase Photocoagulation for peripheral retinal tear with fluid

[jashish]

I was having symptoms in periphery of right eye as if bulb was going off. I was detected with retinal tear in periphery with subretinal fluid. It has been lasered immediately by doctor. I was told that no surgery is required and I can see him after 1 month. I am bit concerned about following things:

1. Will subretinal fluid absorb on it own? Since it is present with tear I am bit nervous about it seeping below retina.
2. I am seeing more floaters and occassional flashes 3-4 days after laser surgery. I went again after a week and checked with doctor, he did fundus examination and said everything looks good. He can see laser marks and there is no sign of extension. Should I be worried about these flashes and floaters? How long does it take to resolve them.

[jashish]

I have been told by an another retinal specialis that fluid below retina is very small and only require laser. I still see flashes and he mentioned it is due to vitreous rubbing with retina. How long will it take for flashes to subside down? They are really annoying and scary.

[JohnHaganMD]

No possible to tell you when, or if, flashes will stop

[jashish]

Just a followup question. Flickers which started 2-3days after laser has stopped after a week but flashes started a week after laser. I have been checked by two different retinal specialist and they said laser looks good. These flashes occur once every hour and last for 1-2 seconds. Should I be concerned about it? It scares me a lot when I see them.

[JohnHaganMD]

To reassure you a surgeon needs to look in your eye and see what's going on so you really need to ask your surgeon I can't tell you the answers you seek.

[jashish]

So it might be possible for Liquid to be present in hole but not behind retina?

[JohnHaganMD]

You are trying to put too fine of a point on this. All holes have fluid in them either liquid or gel vitreous. The problem when the fluid extends back from the hole under the retina.

[jashish]

Also is their difference between fluid and subretinal fluid? In my case it is pocket of subretinal fluid as mentioned by retinal specialist.

[JohnHaganMD]

Subretinal fluid is the "bad" fluid. There are lots of fluids in the eye: aqueous, vitreous which may be a gel or liquid and blood

[jashish]

Thanks for your reply. I have couple of more questions:

1. For first few days my flashes stop completely after laser. Now it started again but they are different from previous one. These are arc like flashes which I see few times a day on periphery. What are the causes of such flashes?

2. The fluid is present in hole and not outside it. Does it mean it is minimum fluid or more? how to identify?

[JohnHaganMD]

The causes can be due to vitreous tug and traction on the retina and/or can be due to scar formation and contraction. The laser works by forming a burn that scars and the scars seal the holes shut.

The fluid is present under the retina and is what detaches the retina. The fluid enters through the hole. You can have a hole without fluid and without RD. Those can be treated with laser or freezing (cryotherapy). If a lot of fluid and RD the fluid must be drained. Since you had only laser likely you had little or no fluid under retina. Your surgeon can confirm

[JohnHaganMD]

Same mechanism: traction or tug from vitreous, scar formation. Size and shape can vary depending on where traction coming from and whether the eye is dark or light adapted.

[JohnHaganMD]

1. You did have surgery. Laser surgery.
2. Usually if laser is used and nothing else there is miminum or  no fluid. If a lot of fluid then scleral buckle or gas injection is done.
3.The laser doesn't treat floaters. They may be their indefinitely. The flashes generally stop over 4-8 weeks but you can find multiple postings on this forum of people that have had laser or RD surgery who have had flashes for over a year.