Retinal Holes: Symptoms, Treatments, and Concerns

Retinal tear

Hello Doctor: I have myopia with degrees of -4.50 and -5.75.
Recently, during a retinal examination at the clinic, a small hole was found, and I was referred to a hospital.
Subsequently, two doctors mentioned that it did not appear to be a hole; one of them suggested that a small white spot looked like degeneration.
Ultimately, the referring doctor confirmed a small hole and performed laser treatment immediately.
I have a few questions:
1.
A week after the laser treatment, I sometimes see flashes of light in the corner of my eye.
Is this a normal phenomenon? (The follow-up doctor said there are no issues with the retina.)
2.
Will the scabbed area from the laser treatment be at risk of being torn by the vitreous, potentially causing a larger hole?
3.
Occasionally, when I look at the wall at night, it appears as if lights are flashing in a broad area, not at a specific point, and this occurs in both eyes.
Is there something wrong with my eyes?
4.
One doctor mentioned there are no tears; could this indicate a different definition of a tear? I am very concerned about the possibility of retinal detachment.
Thank you, Doctor.

Miss Zhan, 20~29 year old female. Ask Date: 2019/01/07

Dr. Cai Wenyuan reply Ophthalmology

Hello, regarding the laser coagulation area, will it be torn by the vitreous, causing a larger hole? No, it will not.
Wishing you safety and health.
Sincerely, Dr.
Wen-Yuan Tsai, Director of the Department of Ophthalmology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2019/01/07

More Info

Hello, and thank you for your questions regarding retinal holes and related symptoms. It's understandable to feel anxious about your eye health, especially after experiencing changes in your vision and receiving varying opinions from different doctors. Let’s address your concerns systematically.

1. Flashes of Light Post-Laser Treatment: Experiencing flashes of light, especially after laser treatment for a retinal hole, can be a common occurrence. This phenomenon, known as photopsia, can happen as the retina heals and can be related to the vitreous gel in the eye pulling away from the retina. If your doctor has assessed your retina and confirmed that there are no new issues, this is likely a temporary effect. However, if these flashes become more frequent or are accompanied by other symptoms such as increased floaters or a shadow in your vision, you should seek further evaluation.

2. Risk of Larger Holes from Laser Scarring: After laser treatment, the area where the laser was applied will form a scar. This scar tissue is generally stable and should not lead to further tearing or holes in the retina. However, the vitreous gel can still exert traction on the retina, especially if it is still in the process of detaching. Regular follow-ups with your eye doctor are essential to monitor any changes in your condition.

3. Seeing Lights on Walls: The perception of lights or flashes when looking at surfaces, especially in low-light conditions, can be related to several factors, including the health of your retina and the state of the vitreous gel. If this is a new symptom, it’s important to discuss it with your eye care provider. They may want to conduct a thorough examination to rule out any potential issues, including retinal detachment.

4. Differing Opinions on Retinal Holes: The term "retinal hole" can sometimes be used interchangeably with "retinal tear" or "retinal break," but they can refer to different conditions. A retinal hole is a small defect in the retina, while a tear involves a more significant separation of the retinal layers. The fact that different doctors have different opinions can be confusing, but it’s crucial to trust the assessment of a specialist who has performed a thorough examination and imaging if necessary. If you feel uncertain, seeking a second opinion from a retinal specialist can provide clarity.

Additional Considerations: Given your history of myopia (nearsightedness), it’s important to be vigilant about your eye health. High myopia is associated with an increased risk of retinal issues, including holes and detachments. Regular eye exams are crucial, especially if you notice any changes in your vision.

In conclusion, while some of the symptoms you are experiencing can be common after laser treatment, it is essential to maintain open communication with your eye care provider. If you have any new or worsening symptoms, do not hesitate to reach out for further evaluation. Your peace of mind and vision health are paramount, and proactive monitoring can help prevent potential complications.

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