Retinal Laser Treatment for Floaters and Vision Issues

Q: Retinal Laser Treatment for Floaters and Vision Issues

Hello, Xiao Lin： 1. The self-repairing retina can be treated or not treated. If not treated, you need to pay extra attention. 2. It will be more stable after 2-3 weeks, so try to avoid vigorous head movements or heavy lifting during this period. 3. High m

Some issues regarding retinal laser treatment and floaters?

Hello Dr.
Gao: I have some questions to ask you.
I am highly myopic with -9.00 and -10.00 diopters, and I have some thinning in the peripheral retina along with floaters and flashes (light balls sliding from the edges of my eyes—left eye on the left side, right eye on the right side, and sometimes when I close my eyes, light spreads from the periphery).
I previously had a hole that self-healed.
The doctor did not specifically recommend whether I should undergo laser treatment; he said it could be done if I wanted, or I could just observe it more closely.
The thinning is at the very edge, and the doctor had to use special equipment and look down to see it.
Since the ophthalmologist who examined me was in a hurry and I couldn't ask all my questions, I would like to ask you:
1) Does the self-healed retina need additional laser treatment?
2) I heard that for one to two weeks after laser treatment, the retina can be very fragile.
How can I avoid re-tearing or retinal detachment?
3) During my examination, the doctor initially sat down and used instruments but couldn't find any issues; he only noticed the thinning when he stood up and looked down, which was surprising.
Is it common in clinical practice to see cases of extreme peripheral retinal thinning?
4) I suspect I am experiencing posterior vitreous detachment (PVD), but the doctor said I am too young and that the retinal photos do not show any signs.
Can Dr.
Gao determine if there is vitreous atrophy or aging after dilation (or through OCT)?
5) Due to my work, I need to look at screens for long periods.
The doctor said this would not significantly affect the retina, and only strong external impacts would cause detachment.
I am a bit skeptical because the information I have received indicates that excessive eye use is also a risk factor.
Is this understanding correct, Dr.
Gao?
6) Recently, I noticed that the floaters in my left eye have become somewhat larger.
Does the size of floaters depend on their distance from the retina?
Thank you for your time, Dr.
Gao.

Xiao Lin, 20~29 year old female. Ask Date: 2020/11/13

Dr. Gao Pilin reply Ophthalmology

Hello, Xiao Lin:
1.
The self-repairing retina can be treated or not treated.
If not treated, you need to pay extra attention.
2.
It will be more stable after 2-3 weeks, so try to avoid vigorous head movements or heavy lifting during this period.
3.
High myopia is quite common.
Since the peripheral retina is not visible from the front, you need to look down when standing to see it.
4.
PVD (Posterior Vitreous Detachment) cannot be seen because the interface is transparent and indistinguishable.
It can only be confirmed if a Weiss ring appears.
5.
Excessive eye use does not cause retinal detachment.
Retinal detachment is usually caused by retinal tears or vitreous traction.
6.
Different floaters can vary in size, and the distance of the same floater from the retina can also change.
At the E-Hospital in Puzi, Taiwan, the ophthalmology department is open on:
Monday, Tuesday, Thursday, and Friday from 8:00 AM to 12:00 PM
Wednesday from 2:00 PM to 4:30 PM
Online responses can only serve as a reference; it is necessary to seek medical attention at a healthcare facility if needed.
I hope to have the opportunity to serve you.
Gao Pi-Lin

Reply Date: 2020/11/13

More Info

Hello! Thank you for your detailed inquiry regarding your eye health, particularly concerning retinal issues and the potential for laser treatment. Given your history of high myopia, floaters, and flashes, it's essential to address your concerns comprehensively.

1. Self-Healing Retina and Laser Treatment: If your retina has previously healed from a tear or hole, it may not require additional laser treatment unless there are new developments or concerns. Laser treatment is typically recommended to prevent further complications, especially if there are signs of new tears or if the retina is at risk of detachment. It's crucial to have regular follow-ups with your ophthalmologist to monitor any changes in your condition.

2. Post-Laser Treatment Care: After undergoing laser treatment, the retina may indeed be more vulnerable for a short period. To minimize the risk of further tears or retinal detachment, it’s advisable to avoid strenuous activities, heavy lifting, and any actions that could lead to significant eye strain or trauma. Your doctor may provide specific guidelines tailored to your situation, so following their advice is essential.

3. Peripheral Retinal Thinning: It is not uncommon for individuals with high myopia to experience thinning of the peripheral retina. This condition can be more pronounced in some patients, and while it may not always lead to immediate complications, it requires careful monitoring. Your ophthalmologist's surprise at the findings indicates that they are vigilant about your eye health, and it’s good that they are taking the time to assess these areas thoroughly.

4. PVD and Vitreous Changes: Posterior Vitreous Detachment (PVD) is a common condition, especially in individuals with high myopia. While your doctor may not have observed signs of PVD during your examination, it can sometimes be subtle. Advanced imaging techniques like Optical Coherence Tomography (OCT) can help visualize the vitreous and any changes more clearly. If you suspect you are experiencing PVD symptoms, it’s worth discussing this further with your ophthalmologist.

5. Screen Time and Retinal Health: The relationship between prolonged screen time and retinal health is complex. While excessive screen time can lead to eye strain and discomfort (often referred to as digital eye strain or computer vision syndrome), it is not typically a direct cause of retinal detachment. However, maintaining good eye hygiene, taking regular breaks, and ensuring proper lighting while using screens can help mitigate discomfort and potential strain.

6. Size of Floaters: The size of floaters can indeed vary based on their distance from the retina. Floaters that are closer to the retina may appear larger and more pronounced, while those further away may seem smaller. Changes in the size or number of floaters can be concerning, especially if they increase suddenly or are accompanied by flashes of light or a shadow in your vision. If you notice significant changes, it’s important to seek prompt evaluation from your eye care provider.

In summary, given your high myopia and the symptoms you are experiencing, it is crucial to maintain regular check-ups with your ophthalmologist. They can provide the best guidance on whether laser treatment is appropriate and how to manage your symptoms effectively. Additionally, keeping an eye on any changes in your vision and discussing them with your doctor will help ensure your eye health is monitored closely. Remember, early detection and intervention are key in managing retinal health, especially in high-risk individuals.

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