Anyone know an expert on laser eye damage?
July 28, 2023 11:42 AM
What causes sudden floaters if it's not retinal damage?
Hi, long story short, three weeks ago, I got flashed in the eyes from about 15 feet away with a Class 4 portable infrared laser used to deliver heat to patients for wound care and arthritis. The laser diode emits at 915nm, 808nm, and less powerfully at 635nm.
After I saw the flash, I got a headache but didn't notice any instant visual changes. I looked up general laser injury guidelines online which basically said 'if you can read this, don't panic, and take an anti-inflammatory for a few days.' My visual acuity was fine so I convinced myself I'd been far enough away that no serious harm was done.
However, over the next few days, I noticed a steady increase in floaters until it felt like I was living inside of a snow globe, and there were easily ten times as many floaters as I've ever experienced before. I went to my optometrist who did a dilated exam and took photos of my retina, and she said she didn't see retinal damage, and there was nothing to do about floaters but try to ignore them. I tried that for a week, but I felt dread watching them swirling around, particularly a cloud-like one that is 10 times larger than any regular floater, so I made an appointment with an ophthalmologist. I told her everything that happened, and she said she didn't know how the laser caused the floaters. She re-confirmed that my retinas look ok with an OCT scan, and she didn't have any other recommendation.
I don't know what else to do - my visual acuity is thankfully fine, but my visual quality has substantially decreased. Are there any vitreous specialists or ophthalmologists who know about these kinds of lasers? I know the infrared supposedly promotes collagen synthesis; could it have made the collagen in the vitreous more likely to bind together? Thanks so much for any unofficial guidance.
Hi, long story short, three weeks ago, I got flashed in the eyes from about 15 feet away with a Class 4 portable infrared laser used to deliver heat to patients for wound care and arthritis. The laser diode emits at 915nm, 808nm, and less powerfully at 635nm.
After I saw the flash, I got a headache but didn't notice any instant visual changes. I looked up general laser injury guidelines online which basically said 'if you can read this, don't panic, and take an anti-inflammatory for a few days.' My visual acuity was fine so I convinced myself I'd been far enough away that no serious harm was done.
However, over the next few days, I noticed a steady increase in floaters until it felt like I was living inside of a snow globe, and there were easily ten times as many floaters as I've ever experienced before. I went to my optometrist who did a dilated exam and took photos of my retina, and she said she didn't see retinal damage, and there was nothing to do about floaters but try to ignore them. I tried that for a week, but I felt dread watching them swirling around, particularly a cloud-like one that is 10 times larger than any regular floater, so I made an appointment with an ophthalmologist. I told her everything that happened, and she said she didn't know how the laser caused the floaters. She re-confirmed that my retinas look ok with an OCT scan, and she didn't have any other recommendation.
I don't know what else to do - my visual acuity is thankfully fine, but my visual quality has substantially decreased. Are there any vitreous specialists or ophthalmologists who know about these kinds of lasers? I know the infrared supposedly promotes collagen synthesis; could it have made the collagen in the vitreous more likely to bind together? Thanks so much for any unofficial guidance.
Lots of floaters suddenly could be retinal detachment unrelated to the laser exposure. That’s an eye-doc-now emergency.
[On actually reading tfq, uh, sorry. If I were you I’d either go back to the doc b cause it’s not clearing up, or seek a second opinion urgently.]
posted by BrashTech at 1:49 PM on July 28, 2023
[On actually reading tfq, uh, sorry. If I were you I’d either go back to the doc b cause it’s not clearing up, or seek a second opinion urgently.]
posted by BrashTech at 1:49 PM on July 28, 2023
I don't know what's wrong with your eye but an ophthalmologist (not an optometrist) will. And choose an ophthalmologist who specializes in eye problems not someone who specializes in Lasik and does eye health on the side. I was under-diagnosed and under-treated by my local Lasik clowns resulting in partial, irreversible loss of sight and complete, irreversible rage. Good luck: I hope your problem turns out to be minor.
posted by gerygone at 2:18 PM on July 28, 2023
posted by gerygone at 2:18 PM on July 28, 2023
Class 4!! Oh my gosh.
I had a whole bunch typed out based on my laser safety course but basically what gerygone said above. Not having any immediate vision problems is a good sign but I’d definitely continue to get it checked out.
Ask be sure to get a health and safety report filed at work! That’s some serious lack of safety protocol on the employers part. I’m mad on your behalf.
posted by St. Peepsburg at 2:24 PM on July 28, 2023
I had a whole bunch typed out based on my laser safety course but basically what gerygone said above. Not having any immediate vision problems is a good sign but I’d definitely continue to get it checked out.
Ask be sure to get a health and safety report filed at work! That’s some serious lack of safety protocol on the employers part. I’m mad on your behalf.
posted by St. Peepsburg at 2:24 PM on July 28, 2023
(And if it wasn’t work but a clinic, file a complaint. Christ almighty. Class 4! What kind of children are Willy nilly shining that shit around.)
posted by St. Peepsburg at 2:32 PM on July 28, 2023
posted by St. Peepsburg at 2:32 PM on July 28, 2023
Did you get a retinal field test (white background, wiggling patches of contrast that you register detection with a button press)?
Did you optometrist mention a posterior vitreous detachment, which is not a detached retina? The increase in floaters and the "cloud like" one matches a relatively normal manifestation. PVD generally happens after the age of 60.
Had you been seeing any white, streaky flashes at the periphery of your vision *before* you were laser flashed? Perhaps it is a PVD that is unrelated to your laser flash.
posted by the Real Dan at 3:14 PM on July 28, 2023
Did you optometrist mention a posterior vitreous detachment, which is not a detached retina? The increase in floaters and the "cloud like" one matches a relatively normal manifestation. PVD generally happens after the age of 60.
Had you been seeing any white, streaky flashes at the periphery of your vision *before* you were laser flashed? Perhaps it is a PVD that is unrelated to your laser flash.
posted by the Real Dan at 3:14 PM on July 28, 2023
Seconding The Real Dan—this sounds like my symptoms after a posterior vitreous detachment (PVD). I’ve had one in each eye, neither one with an obvious cause, just seemed spontaneous.
In reading up a little on them, it seems PVD can be brought on by trauma, and it’s possible the laser could be classified as trauma: “Posterior vitreous detachment is rare in people under the age of 40, and increasingly common during advanced age. Additional risk factors for PVD include myopia (nearsighted- ness), trauma, and recent eye surgery such as a cataract operation. Patients who experience PVD in one eye will often experience PVD in the other eye within 1 year. ”
There’s a risk of retinal detachment with PVD, and I had quite a weak spot on one retina after mine (lattice degeneration), so the opthalmologist did a repair, using, ironically, a laser. This strengthened the weak spot so that it would be less likely to result in a retinal detachment.
Did the person you saw mention PVD at all to you?
posted by hurdy gurdy girl at 5:41 PM on July 28, 2023
In reading up a little on them, it seems PVD can be brought on by trauma, and it’s possible the laser could be classified as trauma: “Posterior vitreous detachment is rare in people under the age of 40, and increasingly common during advanced age. Additional risk factors for PVD include myopia (nearsighted- ness), trauma, and recent eye surgery such as a cataract operation. Patients who experience PVD in one eye will often experience PVD in the other eye within 1 year. ”
There’s a risk of retinal detachment with PVD, and I had quite a weak spot on one retina after mine (lattice degeneration), so the opthalmologist did a repair, using, ironically, a laser. This strengthened the weak spot so that it would be less likely to result in a retinal detachment.
Did the person you saw mention PVD at all to you?
posted by hurdy gurdy girl at 5:41 PM on July 28, 2023
These symptoms do sound like my vitreous membrane detachment, including the giant floater, which eventually disappeared. I went to the ER when this happened (twice - once in each eye). It is very common in older people.
Per the Mayo Clinic, floater surgery exists, but it sounds like it doesn't work very well and isn't used often. Was the ophthalmologist you saw at a university-affiliated medical center? That's where I would start. I just saw an ophthalmologist in a private clinic who sent me to the university center, and there was a big difference (my insurance won't pay for the university center unless there's a problem).
(Good luck with this - what a nightmare.)
posted by FencingGal at 5:20 AM on July 29, 2023
Per the Mayo Clinic, floater surgery exists, but it sounds like it doesn't work very well and isn't used often. Was the ophthalmologist you saw at a university-affiliated medical center? That's where I would start. I just saw an ophthalmologist in a private clinic who sent me to the university center, and there was a big difference (my insurance won't pay for the university center unless there's a problem).
(Good luck with this - what a nightmare.)
posted by FencingGal at 5:20 AM on July 29, 2023
Lots of floaters can be indicative of damage to the eye arising from high blood pressure. Consider taking a few BP readings and if they are in the dangerzone seek medical attention.
posted by biffa at 9:11 AM on July 29, 2023
posted by biffa at 9:11 AM on July 29, 2023
I don't know how common this is but my city has an eye hospital that has an emergency room. Not saying it's an emergency, I have no idea, just wanted to mention that can be a resource in some places.
posted by sepviva at 4:02 PM on July 29, 2023
posted by sepviva at 4:02 PM on July 29, 2023
This thread is closed to new comments.
posted by beagle at 12:07 PM on July 28, 2023