Retinal Laser Treatment: Insights and Concerns for Patients - Ophthalmology

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Retinal laser treatment


1.
After going to the ophthalmology clinic for an evaluation of my myopia surgery, I discovered that both of my eyes had holes during the retinal examination.
The right eye was more severe, showing signs of retinal detachment.
The doctor performed laser treatment immediately.
After the laser procedure, the doctor took photos and explained that the current approach is to create a "barrier" to prevent further detachment.
Two days later, I returned for laser treatment on my left eye, where the doctor noted that there was also fluid accumulation, describing it as a shallow "puddle." He added that my retina is indeed very weak, which made me fear that I might lose my vision.

After returning home, I researched and found that most cases of retinal detachment lead to immediate surgery, while laser treatment is more common for holes that have not yet resulted in detachment.
Does this mean that my current detachment is not severe enough to require surgery?
2.
The clinic specifically advised against rubbing my eyes after the laser treatment, but I find myself unconsciously rubbing my eyes one or two times while sleeping.
I have been trying to restrain myself.
Will this have a negative impact on the results of the retinal laser treatment?
3.
In the first month, I visited two other clinics for evaluations regarding my myopia surgery.
The first clinic specifically mentioned that my retina was thin and recommended additional laser treatment, while the second clinic simply stated that there were no issues with my retina.
This raises questions for me, as the third clinic's findings indicated that my retina had been accumulating fluid for some time.
Is it possible that the first two clinics missed the signs of detachment, or could my retina have developed fluid accumulation within the two weeks between visits?

Wendy, 20~29 year old female. Ask Date: 2022/05/22

Dr. He Jianxian reply Ophthalmology


1.
A retinal tear, if accompanied by a localized detachment that is very small, can indeed be treated with laser therapy.
Surgery is only necessary if the area of detachment continues to expand after the laser treatment.
2.
It is best not to rub the eyes, but if rubbing does cause problems, there is no choice but to find a solution afterward.
3.
In fact, various situations are possible, and it is not appropriate to comment casually.
Dr.
He Jianxian, Ophthalmology Department, Nantou Hospital.

Reply Date: 2022/05/22

More Info


Retinal laser treatment is a crucial intervention for patients with retinal issues, particularly those at risk of retinal detachment. Your experience highlights several important aspects of this treatment and the concerns that often accompany it. Let’s address your questions and provide some insights into the situation.

1. Severity of Retinal Condition: The fact that your doctor performed laser treatment rather than immediate surgery suggests that your retinal detachment is not yet severe. Laser treatment is often used as a preventative measure to seal holes or tears in the retina before they lead to more serious complications, such as a full detachment. This approach is common when the retina is still intact but at risk. If your condition were more advanced, surgical intervention would likely have been recommended immediately. Therefore, while it is essential to take your situation seriously, the fact that you received laser treatment indicates that your doctor believes there is still a good chance to stabilize your condition without surgery.

2. Avoiding Eye Rubbing: It is crucial to follow your doctor's advice regarding not rubbing your eyes after laser treatment. Rubbing can increase intraocular pressure and potentially disrupt the newly treated areas of the retina, leading to complications. If you find yourself rubbing your eyes unconsciously while sleeping, consider using a sleep mask or placing a soft cloth over your eyes to help prevent this. It’s essential to be mindful of this behavior, as even minor disturbances can affect the healing process.

3. Inconsistent Diagnoses: The discrepancies between the evaluations from different clinics can be concerning. Retinal conditions can change rapidly, and it is possible that your retina deteriorated between visits. However, it is also possible that the earlier clinics did not conduct thorough examinations or that their assessments were less detailed. Retinal evaluations often require specialized equipment and expertise, and not all clinics may have the same level of diagnostic capability. If you feel uncertain about the evaluations, seeking a second opinion from a retinal specialist may provide clarity and reassurance.


Additional Insights:
- Understanding Retinal Laser Treatment: Laser treatment for retinal issues typically involves using a focused beam of light to create small burns around the retinal tear or hole. This process helps to create scar tissue that can seal the retina to the underlying tissue, preventing further detachment. It is a relatively quick procedure and can be performed in an outpatient setting.

- Post-Treatment Care: After laser treatment, patients are usually advised to avoid strenuous activities, heavy lifting, and any actions that could increase eye pressure. Follow-up appointments are critical to monitor the retina's condition and ensure that the treatment is effective.

- Long-Term Monitoring: Given your history of retinal issues, regular follow-ups with your eye care provider are essential. They will monitor for any changes in your retina and can intervene early if new problems arise.

- Lifestyle Considerations: Maintaining a healthy lifestyle can support overall eye health. This includes a balanced diet rich in antioxidants, regular exercise, and avoiding smoking. Additionally, managing underlying health conditions, such as diabetes or hypertension, is crucial for preventing further retinal complications.

In conclusion, while your situation understandably causes anxiety, the fact that you received laser treatment indicates that your condition is being managed proactively. Adhering to your doctor's recommendations, avoiding eye rubbing, and maintaining regular follow-ups will be essential in ensuring the best possible outcome for your vision. If you have further concerns or experience changes in your vision, do not hesitate to reach out to your eye care provider for guidance.

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