Floaters, Retinal Tears, and Vision Changes in Myopia - Ophthalmology

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Thank you for your detailed questions regarding your vision concerns, particularly related to myopia, floaters, and retinal health. It’s understandable to feel anxious about changes in your vision, especially given your history of retinal issues. Let’s address your questions one by one.

1. Increase in Astigmatism: The increase in your astigmatism, particularly the 25-degree change in the last five years, is not uncommon in individuals with high myopia. Astigmatism can fluctuate due to various factors, including changes in the shape of the cornea or lens, and it may not always indicate a pathological condition. However, significant changes in refractive error should be monitored closely, especially in the context of high myopia, as it can be associated with other ocular conditions.

2. Thin Retina and Preventive Laser Treatment: The presence of a thin area in your retina is a common finding in individuals with high myopia. The decision to proceed with preventive laser treatment often depends on the degree of thinning, your overall retinal health, and the opinion of your eye care providers. If two out of three doctors recommend observation, it may be prudent to follow that advice, especially if your retinal examinations show no signs of progression. Regular monitoring is essential, and if you notice any new symptoms, such as flashes of light or an increase in floaters, you should seek immediate evaluation.

3. Risk of Recurrent Retinal Tears: Having had a retinal tear previously does increase the risk of future tears, particularly in the context of high myopia. The vitreous gel can continue to change and pull on the retina, which may lead to new tears. It’s crucial to remain vigilant for any new symptoms, such as sudden increases in floaters or flashes of light, as these can indicate a new tear or detachment.

4. Vitreous Detachment: In high myopia, the vitreous typically undergoes changes and may detach from the retina earlier than in individuals with normal vision. While there is no specific age at which this occurs, many people experience complete vitreous detachment by their late 50s to early 60s. However, this can vary widely among individuals. Once the vitreous is fully detached, the risk of new retinal tears decreases, but it is still important to monitor for any changes.

5. Monitoring Floaters: Floaters are common and can be particularly noticeable in individuals with high myopia. While it’s normal to see some changes in the number and appearance of floaters, you should be concerned if you notice a sudden increase in floaters, especially if accompanied by flashes of light or a shadow in your peripheral vision. If you find yourself fixating on floaters, it may contribute to anxiety. It’s important to remember that floaters are often benign, and many people learn to ignore them over time. Regular eye exams will help ensure that any significant changes are monitored appropriately.

In summary, while your concerns are valid, many of the changes you are experiencing can be typical for someone with high myopia. Regular check-ups with your eye care provider are essential to monitor your condition and address any new symptoms promptly. If you find that your anxiety about your vision is affecting your quality of life, consider discussing this with your doctor, who may provide strategies to help manage your concerns. Remember, maintaining a healthy lifestyle, including a balanced diet rich in antioxidants, can also support your overall eye health.