No way to know if flashes in eye will tear retina, until it does or doesn't?

[Curious1100]

At 45 years old and -10 myope,  I needed to have monofocal IOLs implanted 2 months ago, and last week began to notice some new floaters and a persistent flash in the corner of one of my eyes when I move it quickly. My phenomenal surgery results have really been impacted now from the plague of floaters. I returned to my board certified ophthalmologist who conducted a lengthy dilated exam. He rattled off some notes to the assistant, some lattice degeneration, some small pin holes in retina, noticeable floaters. (I had seen a retinologist prior to the surgeries and, although he mentioned some degeneration at that time, didn't feel any pre-surgery laser was required, and pronounced me to be ok for surgery). I also saw a neuro-ophthalmolgist for surgery clearance. So my MD is thorough.

After a very generous amount of time, my MD pronounced that I did the right thing to come in, but that I was fine. Some PVD perhaps tugging at the retina... But evidently none of the pathologies rose to the level of needing laser intervention/surgery by the retinologist. When I asked about getting the laser anyway to be super-cautious a tear, I got what I think was an honest answer- there's data to suggest it doesn't help. RDs happen to some, and don't happen to others, only time will tell. Be alert for dark curtains etc. and come right back in if anything else develops.

I'm really inclined to return to the retinologist anyway, and share with them that I'm super stressed over the flashes and inclined to zapping any of my retina issues. But it that just brings even more risk into play, I would like to know that. Any advice, besides a nice red wine to chill out? How risky is the retina laser itself post-cataract surgery?

[Houman Vosoghi, MD]

You are lucky you went back to the retina specialist!  If the detachment had reached the macula, your vision would never be the same.  Now, assuming a good attachment from the vitrectomy/endolaser, your final vision should be as goood as before (+/- need for cataract surgery depending on if you develop one).  Hang in there and make sure you continue getting regular retina exams in both eyes even after you're fully healed.  You have a greater than 10% chance of developing another tear in either eye (although after a vitrectomy, it would most likely be the other eye that's at risk).

HV

[Curious1100]

Well it got interesting fast.
I did have a tear that was already a partial detachment, but the retinologist tried a pneumatic retinoplexy first. Unfortunately, they bubble didnt go in as one large bubble but rather many small ones. Several slipped up through the tear and behind the retina. I had to tilt 45 degrees away from the tear for a few days while the bubble coalesced. Then tilt a few days the other way to push up the tear and laser it closed.

It didn't work, and I had to go in for a vitrectomy a few days later. Luckily, throughout this all, the macula was not involved. I am now recovering face down in massage chairs and beds while the medical gas bubble buoyancy assists in holding the retina in place while the several hundred laser spot welds heal.
Wish me luck and provide any further assurances you can. Thanks and be careful out there.

[Houman Vosoghi, MD]

In good hands, the laser would have very little in terms of side effects.  Go see the retina specialist anyway given you should be getting serial exams every few weeks for as long as the flashes are happening.  Unfortunately, your story is very common after cataract surgery even if everything went perfect.  I'm a firm believer in frequent dilated exams (at least once a month) for as long as the symptoms are happening along with an urgent visit if anything new develops (new set of floaters, sudden burst of severe flashes, curtain comming over vision, etc.).  Good luck.

HV