Retinal Holes: Symptoms, Treatments, and Travel Concerns - Ophthalmology

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Retinal hole


Hello, doctor.
I discovered floaters in March and have been undergoing regular dilated eye examinations.
During the March check-up, the doctor mentioned that there were white spots on the retina of my right eye and advised that no treatment was necessary, just regular follow-ups.
Subsequently, I noticed that I experience periodic flashes of light in specific areas of my vision.
I'm unsure if this symptom can improve and what might be causing the regular flashes.
This month, during the follow-up, the doctor found an atrophic hole in my right eye and suggested laser treatment, allowing me to consider it.
I would like to ask if the white spots from March and the atrophic hole are the same condition.
Is laser treatment absolutely necessary? I am concerned about flying soon and whether my eyes might have issues while abroad.
Thank you, doctor.

Ling, 30~39 year old female. Ask Date: 2023/11/06

Dr. Gao Pilin reply Ophthalmology


Hello: 1.
White spots and atrophic holes: White spots and atrophic holes are two different eye conditions.
White spots may refer to a small area on the retina, while atrophic holes refer to a small tear or hole on the surface of the retina.
They are distinct issues that require different management approaches.
2.
Regular flashes: The regular flashes you describe may be indicative of some abnormal activity on the retina.
The flashes could be a response to pressure or traction on the retina.
This may require further evaluation to determine the cause and whether treatment is necessary.
3.
Laser treatment: Your ophthalmologist has recommended laser treatment to address the atrophic holes, which may help prevent more serious issues such as retinal detachment.
You should carefully consider the physician's advice and ask them questions before proceeding with treatment to ensure you fully understand the treatment options and risks.
4.
Traveling abroad: If you are concerned about experiencing eye problems while traveling abroad, it is advisable to consult your ophthalmologist again before your trip to ensure your eye condition is stable.
They may provide additional recommendations or precautions to help maintain good eye health during your travels.

Reply Date: 2023/11/06

More Info


Understanding retinal holes and their associated symptoms is crucial, especially for individuals who have experienced changes in their vision, such as floaters or flashes of light. Your situation, involving a diagnosis of a retinal hole and the presence of flashes, raises several important considerations regarding symptoms, treatment options, and travel concerns.


Symptoms and Causes
The symptoms you describe, including the appearance of floaters and flashes of light, are common indicators of retinal issues. Floaters are often caused by changes in the vitreous gel that fills the eye, which can pull away from the retina and create shadows on the retina, perceived as floaters. Flashes of light, on the other hand, occur when the retina is stimulated, either due to traction from the vitreous or from a retinal tear or hole.
The white spot noted in your March examination could represent a variety of conditions, including a retinal tear, a hole, or even a benign condition. The fact that your doctor recommended monitoring it suggests that it may not have posed an immediate risk at that time. However, the subsequent diagnosis of an atrophic retinal tear indicates a change in your retinal health that warrants attention.


Treatment Options
Regarding the recommendation for laser treatment, this is often advised for retinal holes or tears to prevent further complications, such as retinal detachment. Laser treatment works by creating a scar around the hole, which helps to seal it and prevent fluid from entering under the retina. The decision to proceed with laser treatment should be made after careful consideration of the risks and benefits, especially in light of your upcoming travel plans.

If your doctor has suggested that the white spot and the atrophic hole are related, it is essential to understand that while they may be connected, they could also represent different stages of retinal changes. The key is to follow your doctor's advice regarding the laser treatment, as it is designed to protect your vision.


Travel Concerns
Traveling, especially by air, can raise concerns for individuals with retinal issues. Changes in cabin pressure and prolonged periods of inactivity can potentially exacerbate eye conditions. However, if your doctor has cleared you for travel, it is likely that the risk of complications during your trip is low. Nonetheless, it is wise to take precautions:
1. Follow-Up Care: Ensure you have a follow-up appointment scheduled after your trip to reassess your retinal health.


2. Emergency Plan: Familiarize yourself with local healthcare facilities at your travel destination in case you experience any sudden changes in vision or discomfort.

3. Avoid Strain: Limit activities that could strain your eyes, such as prolonged screen time or reading in poor lighting.

4. Protective Measures: Wear sunglasses to protect your eyes from UV light, which can be particularly harsh in certain environments.

5. Hydration: Stay hydrated during your flight to help maintain overall eye health.


Conclusion
In summary, the presence of flashes and floaters, along with the diagnosis of an atrophic retinal hole, necessitates careful monitoring and possibly treatment. While the white spot and the hole may be related, your healthcare provider is best positioned to determine the appropriate course of action. If you have concerns about traveling, discussing them with your eye care professional can provide peace of mind and ensure you are prepared for any eventualities. Safe travels, and prioritize your eye health during your journey!

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