Can High Myopia Patients Safely Undergo Gastroscopy? - Ophthalmology

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Patients with high myopia, particularly those with severe degrees like -18.00 diopters in one eye and -13.00 diopters in the other, often have concerns regarding the safety of undergoing procedures such as gastroscopy. This is primarily due to the potential risks associated with their eye condition, particularly the fear of retinal detachment during episodes of vomiting or coughing that may occur during the procedure.

Firstly, it is important to understand that while high myopia does increase the risk of retinal issues, including retinal detachment, the actual risk during a gastroscopy is generally considered low. Gastroscopy is a procedure that involves the insertion of a flexible tube with a camera (endoscope) through the mouth to examine the esophagus, stomach, and the first part of the small intestine (duodenum). The procedure is typically performed under sedation or local anesthesia, which helps minimize discomfort and the likelihood of gagging or vomiting.

For patients with high myopia, the following considerations should be taken into account:
1. Communication with the Healthcare Provider: It is crucial for patients to inform their gastroenterologist and the anesthesiologist about their high myopia and any concerns regarding potential complications. This allows the medical team to take necessary precautions and tailor the sedation approach to the patient's needs.

2. Sedation Options: While some patients may be apprehensive about undergoing a gastroscopy without sedation, there are options available that can help manage anxiety and discomfort. For those who are not suitable candidates for deep sedation due to health concerns, a lighter sedation or even a local anesthetic may be used. This can help reduce the gag reflex and the likelihood of vomiting while still allowing the patient to remain conscious and responsive.

3. Risk of Retinal Detachment: The risk of retinal detachment during gastroscopy is not significantly higher than in other situations where vomiting or coughing might occur. However, patients with high myopia should be cautious and may want to discuss with their ophthalmologist about any specific precautions they should take before undergoing the procedure.

4. Post-Procedure Care: After the gastroscopy, patients should be monitored for any adverse effects from the sedation and the procedure itself. If any unusual symptoms occur, such as sudden vision changes or severe headaches, they should seek medical attention immediately.

5. Alternative Diagnostic Methods: If a patient is particularly anxious about the risks associated with gastroscopy, they may discuss alternative diagnostic methods with their healthcare provider. Options such as non-invasive imaging techniques (like an ultrasound or CT scan) may be considered, although these may not provide the same level of detail as a gastroscopy.

In conclusion, while patients with high myopia can safely undergo gastroscopy, it is essential to have open communication with the healthcare team about any concerns. By discussing sedation options and ensuring proper monitoring, the risks can be minimized. Ultimately, the decision should be made collaboratively between the patient and their healthcare providers, taking into account the patient's overall health, the severity of their myopia, and the necessity of the procedure.