Retinal Tears: Concerns, Symptoms, and Treatment Options

Follow-up on retinal traction issues?

Hello Dr.
Gao, I am the questioner Tong from #155019.
I have a few more questions regarding retinal traction that I would like to ask you.
Thank you.

Regarding the previous questions:
1.
Will retinal traction become more severe over time? You answered, "Depending on the degree of vitreous degeneration, it can sometimes be severe but may later alleviate." If it alleviates, does that mean there is a possibility it will not lead to retinal detachment? However, during my follow-up visit, the doctor mentioned that the traction is still present and has increased slightly since the last visit...
(this made me quite anxious).
5.
If air pollution (PM2.5) can lead to vitreous liquefaction, how can I prevent it (I am concerned)? You answered, "Vitreous liquefaction is a normal degeneration that almost everyone experiences, but the occurrence of retinal disease is very rare, so there is no need to worry." Does this mean that vitreous degeneration will always cause traction on the retina, or is retinal traction a rare occurrence? If there is traction, does it necessarily lead to a tear?
6.
Can exercise cause retinal traction? (Intense exercise, e.g., HIIT/TABATA) You answered, "If there is traction, or if there is thinning or a tear in the retina, one should avoid intense exercise." Since I have already been told by an ophthalmologist that I have retinal traction, should I avoid intense exercise? Also, does this mean I should not participate in amusement park rides like roller coasters or pirate ships, which are stimulating?
Additionally, one of the eye drops prescribed by the ophthalmologist is FOXONE OPHTHALMIC SUSPENSION 0.2MG/ML, which primarily addresses symptoms such as blepharitis, conjunctivitis, keratitis, scleritis, episcleritis, iritis, and iridocyclitis (according to my online search).
What benefit does this have for the symptoms of retinal traction? Furthermore, the side effects of this eye drop include elevated intraocular pressure, which may lead to glaucoma, optic nerve damage, vision loss, or narrowing of the visual field, as well as subcapsular posterior cataracts and delayed recovery...
Should I continue using this eye drop, or should I follow the prescription and use it for the number of days indicated?
Another question is whether retinal traction will inevitably cause a tear or detachment (I am worried).
I read an article online titled "A Brief Discussion on Vitreous Degeneration," which mentioned, "As vitreous detachment occurs, the vitreous that was originally attached to the retina pulls away, but since there are no pain-sensing nerve fibers on the retina, the patient does not feel pain.
However, vitreous traction on the retina may cause abnormal stimulation, leading to flashes." If I am currently not experiencing flashes (but have floaters), does that mean I only need to have regular follow-ups? (Is a follow-up every month sufficient? I am very concerned about sudden eye issues).
A friend suggested switching to another clinic for examination and monitoring; is this necessary?
Since the eyes are very important, I have been quite anxious and wanted to ask again.
Thank you once again for your responses.
Thank you.

Tong, 30~39 year old female. Ask Date: 2020/04/12

Dr. Gao Pilin reply Ophthalmology

Hello,
1.
The pulling sensation is still present and slightly more than last time.
This pulling is a normal phenomenon of vitreous degeneration and does not necessarily lead to retinal detachment; sometimes it is just a transitional phase.

5.
Does vitreous degeneration always pull on the retina? When the vitreous detaches from the retina, it can cause pulling.
However, pulling does not always result in a tear.

6.
I have been told by an ophthalmologist that I have retinal traction, so I should avoid vigorous exercise.
Does this mean I should also avoid amusement park rides like roller coasters or pirate ships? It is advisable to refrain from such non-essential activities as much as possible.

Foxone is an anti-inflammatory medication and is unrelated to the retina.
Adjustments should be made based on your condition.
The side effects are actually quite low.
As long as you have regular check-ups, it doesn't matter where you go for them.
If your symptoms are stable, you don't need to check every month.
Return for a follow-up only if there are changes.
Many people experience these symptoms, but the likelihood of retinal detachment is not very high.
Stay vigilant, but do not overly worry to the point of affecting your daily life.

Taiwan E-Hospital Puzi Hospital Ophthalmology: Monday, Tuesday, Thursday, and Friday mornings from 8:00 AM to 12:00 PM, and Wednesday afternoons from 2:00 PM to 4:30 PM.
Online responses can only serve as a reference; if necessary, you should seek medical attention at a healthcare facility.
I hope to have the opportunity to serve you.

Gao Pilin

Reply Date: 2020/04/12

More Info

Understanding retinal tears is crucial for maintaining eye health, especially for individuals who have experienced symptoms or have been diagnosed with conditions that may lead to such issues. Retinal tears can occur when the vitreous gel that fills the eye shrinks and pulls away from the retina, potentially leading to serious complications like retinal detachment if not monitored and treated appropriately.

Concerns about Retinal Tears
1. Progression of Retinal Tears: Retinal tears can indeed worsen over time, particularly if there is ongoing vitreous degeneration. However, in some cases, the condition may stabilize or even improve, reducing the risk of retinal detachment. If your doctor has noted an increase in the extent of the tear, it is essential to follow up closely with your eye care provider. Regular monitoring is crucial, as early detection of any changes can significantly affect treatment outcomes.

2. Impact of Environmental Factors: Concerns about environmental factors such as air pollution (PM2.5) affecting vitreous health are valid. While vitreous degeneration is a normal part of aging, certain environmental stressors may exacerbate these changes. To mitigate risks, maintaining a healthy lifestyle, including a balanced diet rich in antioxidants, staying hydrated, and protecting your eyes from excessive UV exposure, can be beneficial.

3. Exercise and Physical Activity: If you have been diagnosed with a retinal tear, it is advisable to avoid high-impact activities or exercises that could increase intraocular pressure or strain the eyes, such as high-intensity interval training (HIIT) or amusement park rides. These activities could potentially exacerbate the condition or lead to further complications.

Treatment Options and Medications
The eye drops you mentioned, such as FOXONE OPHTHALMIC SUSPENSION, are typically used to treat inflammatory conditions of the eye, including conjunctivitis and keratitis. While they may not directly address retinal tears, they can help manage any associated inflammation or discomfort. However, it is essential to be cautious with prolonged use, as corticosteroids can increase intraocular pressure, leading to glaucoma or cataract formation. Always follow your doctor's instructions regarding the duration and frequency of use.

Risk of Retinal Detachment
It is a common concern that retinal tears may lead to retinal detachment. While not all retinal tears result in detachment, the risk increases if the tear is not monitored or treated. Symptoms such as flashes of light or an increase in floaters (like your experience with "flying spots") should be taken seriously, as they can indicate changes in the retina. Regular follow-ups, typically every month or as advised by your ophthalmologist, are essential for monitoring your condition.

Seeking Further Evaluation
If you feel uncertain about your current treatment or diagnosis, seeking a second opinion from another eye care professional can provide additional reassurance and clarity. Different specialists may offer varied perspectives on your condition and treatment options, which can be beneficial for your peace of mind.

Conclusion
In summary, while retinal tears can be concerning, many individuals live with them without experiencing severe complications. Regular monitoring, avoiding high-risk activities, and adhering to prescribed treatments are key strategies for managing your eye health. If you notice any new symptoms or changes in your vision, do not hesitate to contact your eye care provider immediately. Your vision is invaluable, and proactive management is the best approach to preserving it.

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