Retinal Holes: Causes, Treatments, and Future Risks

Q: Retinal Holes: Causes, Treatments, and Future Risks

Hello： 1. <br>High myopia is prone to complications, but it is not the only condition that can lead to issues. <br>Sometimes, vitreous traction can also cause retinal tears. <br>2. <br>Laser treatment involves using high-energy light to create mild burns through heat, with the go

Retinal tear

Hello Doctor: A few days ago, I went to an ophthalmologist due to floaters and was found to have a small hole in the retina of my left eye.
The doctor immediately used a laser to repair the hole, but my prescription is only -4.00, which is not considered high risk.
I would like to ask: 1.
Why can a retinal tear occur even without high myopia? Is it due to inherent physical factors? 2.
After the laser treatment, the doctor prescribed steroid eye drops, but I have been feeling a pressure sensation in my left eye and the left side of my head for the past few days.
Is this related to the laser treatment or the eye drops? 3.
It is said that long-term use of steroids can lead to increased intraocular pressure.
What is considered "long-term use"? How long does one need to use them for it to be classified as long-term? 4.
I am in my 30s and already have a retinal tear.
Does this mean I may experience more eye problems in the future? Thank you for your help, Doctor.

fang ke, 30~39 year old female. Ask Date: 2017/12/19

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
High myopia is prone to complications, but it is not the only condition that can lead to issues.
Sometimes, vitreous traction can also cause retinal tears.
2.
Laser treatment involves using high-energy light to create mild burns through heat, with the goal of forming scabs that seal the hole.
This may cause temporary discomfort.
3.
Some individuals may be more sensitive to steroids, which can lead to increased intraocular pressure; however, most people do not experience this.
If treatment is necessary, it should still be used, but it should be discontinued if not needed.
Measuring intraocular pressure during follow-up visits will indicate whether there is an impact.
4.
If you have experienced such issues, you should have regular check-ups every year, although it may not necessarily lead to future complications.
The Ophthalmology Department at Puzi Hospital in Taiwan is open Monday to Friday from 8:00 AM to 12:00 PM and Wednesday from 1:00 PM to 4:30 PM.
Online responses are for reference only; it is essential to seek medical care at a healthcare facility when necessary.
I hope to have the opportunity to serve you.
Gao Pi-Lin.

Reply Date: 2017/12/19

More Info

Understanding retinal holes is crucial for anyone experiencing vision issues, especially those who have recently been diagnosed with such conditions. Retinal holes can occur for various reasons, and it is essential to understand the underlying causes, treatment options, and potential future risks associated with them.

1. Causes of Retinal Holes: While high myopia (nearsightedness) is a well-known risk factor for retinal holes due to the elongation of the eyeball and thinning of the retina, it is not the only cause. Retinal holes can also occur in individuals with normal vision. Factors such as age-related changes, vitreous detachment, and genetic predispositions can contribute to the formation of retinal holes. The vitreous gel, which fills the eye, can pull away from the retina, leading to tears or holes, even in those without high myopia. This means that individuals with a refractive error of -400 degrees, like yourself, can still be at risk due to these other factors.

2. Post-Laser Treatment Symptoms: After undergoing laser treatment for a retinal hole, it is not uncommon to experience some discomfort or unusual sensations in the eye. The feeling of pressure or a "full" sensation in the eye and head could be attributed to either the laser procedure itself or the steroid eye drops prescribed. The laser treatment creates a controlled burn around the hole to promote healing, which can lead to temporary inflammation. Steroid drops are intended to reduce inflammation but can also cause side effects, including increased intraocular pressure in sensitive individuals. If these sensations persist or worsen, it is essential to follow up with your ophthalmologist for further evaluation.

3. Long-term Use of Steroids: The concern regarding steroid use and elevated intraocular pressure is valid. Long-term use typically refers to the continuous use of steroid medications over weeks to months. However, the exact duration can vary based on individual sensitivity. Some patients may experience increased eye pressure after just a few days of steroid use, while others may not notice any changes for weeks. Regular monitoring of intraocular pressure during treatment is crucial, especially if you are using steroids for an extended period.

4. Future Eye Health Risks: Having a retinal hole at a relatively young age does not necessarily mean you will experience more eye problems in the future. However, it does indicate that you may be at a higher risk for other retinal issues, such as retinal detachment, especially if there are underlying factors like vitreous degeneration. Regular eye examinations are essential for monitoring your retinal health, particularly since you have already experienced a retinal hole. Your ophthalmologist may recommend annual or biannual check-ups to ensure any changes are detected early.

In conclusion, while retinal holes can be concerning, understanding their causes and treatment options can help alleviate anxiety. It is essential to maintain regular follow-ups with your eye care provider, adhere to prescribed treatments, and report any new symptoms promptly. By doing so, you can manage your eye health effectively and reduce the risk of future complications. Remember, knowledge and proactive care are your best tools in maintaining your vision and overall eye health.

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