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I had laser surgery 2 weeks ago to encapsulate some of the…

I had laser surgery 2...
I had laser surgery 2 weeks ago to encapsulate some of the suspected capillaries which showed some blood spots on my retina. For the first 6 days after the laser treatment, all was well. On the 7th day I noticed that when I would arise in the morning or whenever I would stretch or bend down and get up during the day increasing blood flow or pressure to my head, that eye would go blind for a second or two then return to normal vision. I am 61 years old, do not have high blood pressure or diabetes, and my vision (other than that) is fine. Is this normal? Will I have to live with this forever? Could there have been a problem with the treatment?
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Answered in 4 hours by:
5/22/2014
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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 12,131
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.
First of all this is not normal.
Nor is it related to your laser treatment.
That being said, this is a very, very worrisome symptom you are having. Please allow me to explain:
It sounds like what you are suffering from is something called Amaurosis fugax (AF).
Amaurosis fugax is the transient loss of vision in one eye. It has many causes and, in the early 1990's, a study called the Amaurosis Fugax Study Group defined and grouped them to help with diagnosis and treatment of this problem.
What can cause AF? It can be due to an embolism, problems with the blood, problems with the eye itself or, sometimes due to no cause we can figure out (idiopathic). I would be happy to go through all the different diagnostic possibilities in each of these categories but I don't think that is the best use of your time.....you need to know what to do.
AF is a symptom that something serious is wrong. It can be a warning that you are heading toward a dangerous vascular event such as a TIA, stroke or even death. It is important for you to see your ophthalmologist and possibly your internal medicine physician ASAP. What will they do? A complete history and physical, a complete eye examination, maybe a fluorescein angiogram of your retina, laboratory tests, possibly ultrasound of your carotid arteries or an CT/MRI of your head.
Treatment depends on what is found on the above workup.
I can not stress enough the need for you to be seen for a complete exam as soon as possible.
Does this make sense to you?
I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you can please give me the top rating in all areas. It has been a pleasure to assist you today.
Thanks in advance,
Dr. Rick MD FACS
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Customer reply replied 4 years ago

Thanks for the information. I recently had a Lifeline Screening with normal ranges in all areas except PAD which showed as inconclusive.

I have an appointment in the afternoon with my retina doctor tomorrow and will see the nurse practitioner at my regular doctor's office in the morning. I will bring along what your reply with me to both places.

Chas. Ricci

Ricci,
Sounds like an excellent plan.
Let me know how things turn out.
Don't forget to mash the positive feedback button for me...the one labeled "excellent" is the most fun to push by far ;)
It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
Dr. Rick MD FACS
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Customer reply replied 4 years ago

Hi Dr. Rick,

I went to see my Health care provider but was only able to see the Nurse Practitioner. She didn't think I had AF because the blacking out of my eye happens when the blood returns to normal and not when pressure builds up to my head. She did Boston blood work-up and gave me an Rx for an EBT/ Heart calcium score test. After seeing her I went to my retina specialist. He examined me and said that the surgery was fine. The capillaries were sealed and there was no retina tearing or detachment. He told me to contact a cardiologist to see if I do have AF (as you suggested) or if it is merely Orthostatic hypotension. I had previously had a carotid artery scan at the end of January this year. The results were normal. No blockages.

I will send you a follow-up when I get some of the results.

Thanks so much for apprising me of the possible diagnosis.

Chas Ricci

Morris Plains, NJ


***@******.***
Morris,
Thanks for the update. Your NP's reasoning makes no sense...but that is the difference between a Nurse and a Doctor :)
I'm glad you are getting the AF workup...I hope everything turns out OK.
Dr. Rick
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 12,131
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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