Retinal Degeneration: Eye Movement and Light Perception Risks

When moving the eyeball in the dark with the right eye, there is a perception of light around the visual field?

Hello, Dr.
Tsai.
I have a few questions I would like to ask, and I would appreciate your responses.
To provide some background, my current situation is as follows: I have myopia of -4.50 in my left eye and -6.75 in my right eye, along with floaters, with the number of floaters in my right eye being approximately 4-5 times that of my left eye.

1.
A few weeks ago, I underwent a fundus examination, and the doctor mentioned that the peripheral retina in the upper and lower right areas of my right eye is thinning and showing signs of degeneration.
When I close my eyes in the dark and slightly move my eyeball, I can perceive a sensation of light in the corresponding areas.
After researching online, I found that this may be due to the degenerative vitreous pulling on the retina.
Therefore, I would like to ask if such eye movements could potentially cause retinal tears or detachment.
If so, I am more concerned because it is impossible for a person to avoid moving their eyes throughout the day.
Does this mean that for me, a tear or detachment is just a matter of time? Even if I maintain good eye habits and supplement with lutein from now on, is there no hope? Is there any chance for me to prevent further deterioration?
2.
If, unfortunately, a tear occurs in the future, is there a risk of failure with laser surgery performed at a clinic? For example, could the laser be misapplied? In the absence of considering the subsequent development of the retina, is this surgery considered to be 100% successful?
I apologize for the length of these questions, and I would greatly appreciate your insights, Dr.
Tsai.
Thank you.

Mr. Yu, 20~29 year old female. Ask Date: 2018/11/29

Dr. Cai Wenyuan reply Ophthalmology

Hello, the probability of failure in laser surgery is low; however, if the hole is too large and the tension is too strong, there is a risk of retinal detachment.
Wishing you safety and health.
Sincerely, Dr.
Tsai Wen-Yuan, Director of the Ophthalmology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2018/11/29

More Info

Hello! Thank you for reaching out with your concerns regarding retinal degeneration and its implications on eye movement and light perception. I understand that you have a history of myopia, floaters, and recent findings of retinal thinning and degeneration in your right eye. Let’s address your questions one by one.

1. Eye Movement and Risk of Retinal Detachment: It’s true that the vitreous gel in the eye can exert traction on the retina, especially if it is degenerating or if there are areas of thinning. When you move your eyes, particularly in a dark environment, the movement can cause the vitreous to pull on the retina, which may lead to a retinal tear or detachment. However, it’s important to note that not all eye movements will result in a tear, and many people with similar conditions do not experience retinal detachment.
Maintaining good eye health is crucial. While you cannot completely eliminate the risk of retinal tears or detachment, you can minimize it by avoiding activities that put excessive strain on your eyes, such as heavy lifting or high-impact sports. Regular eye examinations are essential, as they allow your eye care professional to monitor any changes in your retina. Additionally, while supplements like lutein may support overall eye health, they are not a guaranteed preventive measure against retinal degeneration.

2. Laser Surgery for Retinal Tears: If a retinal tear occurs, laser surgery is a common and generally effective treatment option. The procedure involves using a laser to create a scar around the tear, which helps to seal it and prevent fluid from entering the space underneath the retina, thus reducing the risk of detachment. While laser surgery is typically successful, like any medical procedure, it does carry some risks. These can include the possibility of the laser not being applied precisely, which could lead to incomplete treatment or complications. However, when performed by an experienced ophthalmologist, the success rate is quite high, often cited at over 90%.

It’s also important to understand that while laser surgery can effectively treat retinal tears, it does not prevent future tears or detachment from occurring. Therefore, ongoing monitoring and follow-up with your eye care provider are essential.

In summary, while there are risks associated with eye movement and retinal degeneration, maintaining regular check-ups and following your doctor’s advice can help manage these risks. If you experience any sudden changes in your vision, such as an increase in floaters, flashes of light, or a shadow in your peripheral vision, seek immediate medical attention. Your proactive approach to understanding your condition is commendable, and I encourage you to continue discussing your concerns with your eye care provider for tailored advice and management strategies. Thank you for your questions, and I wish you the best in your eye health journey!

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