Assessing Risks of Retinal Tears and Detachment in High Myopia Patients

Q: Assessing Risks of Retinal Tears and Detachment in High Myopia Patients

Hello： 1. <br>The Taoyuan General Hospital is a regional teaching hospital, so there should be no issues with retinal examinations and laser treatments. <br>Preventive laser therapy typically carries very low risk. <br>2. <br>Generally, fluorescein fundus photography is not neces

Check for the risk of retinal perforation or detachment?

Dear Dr.
Gao,
I am seeking a preventive examination at the Taoyuan General Hospital due to my high myopia.
Currently, there are no abnormalities when viewing the Amsler grid.
The main purpose of the examination is to check for the risk of retinal perforation or detachment.
If there is a risk (or if it has already occurred), I plan to undergo preventive (therapeutic) laser treatment.
1.
Could you please advise on the risks associated with this procedure? Is it necessary to have the surgery performed at a medical center? I have seen many alarming side effects online, such as decreased vision.
Given my current condition, what is the likelihood of these issues occurring?
2.
The ophthalmology department at Taoyuan General Hospital does not offer fluorescein angiography on Saturdays.
Will this affect the diagnosis? Would you recommend scheduling an appointment on another day when this examination is available for a more accurate diagnosis?

Qiu, 20~29 year old female. Ask Date: 2023/12/20

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
The Taoyuan General Hospital is a regional teaching hospital, so there should be no issues with retinal examinations and laser treatments.
Preventive laser therapy typically carries very low risk.
2.
Generally, fluorescein fundus photography is not necessary, so there is no need for concern.
If the physician deems it necessary after the examination, it can be arranged accordingly.

Reply Date: 2023/12/20

More Info

Assessing the risks of retinal tears and detachment in patients with high myopia is a crucial aspect of managing this condition. High myopia, defined as a refractive error greater than -6.00 diopters, is associated with various ocular complications, including retinal tears and detachment. These complications arise due to the elongation of the eyeball, which can lead to structural changes in the retina and vitreous body.

1. Surgical Risks and Necessity of Medical Center Consultation: The risks associated with preventive (or therapeutic) laser treatment for retinal tears or detachment are generally low. Laser photocoagulation is a common procedure used to treat retinal tears by creating a barrier that prevents fluid from entering the subretinal space, thereby reducing the risk of detachment. While there are potential side effects, such as temporary visual disturbances or, in rare cases, a decrease in vision, the overall incidence of significant complications is low.
It is advisable to have such procedures performed at a medical center or a facility with specialized ophthalmic care, especially for high myopia patients. These centers typically have the necessary equipment and expertise to handle potential complications effectively. The likelihood of experiencing severe side effects from the procedure is relatively low, particularly when performed by experienced ophthalmologists. However, it is essential to discuss all concerns with your eye care provider, who can provide personalized advice based on your specific condition and risk factors.

2. Impact of Not Having Fluorescein Angiography: Fluorescein angiography is a diagnostic tool that allows for detailed visualization of the retinal blood vessels and can help identify areas of ischemia or leakage. While it is a valuable test, its absence does not necessarily preclude an accurate diagnosis of retinal conditions. Many retinal issues can be assessed through comprehensive eye examinations, including optical coherence tomography (OCT) and fundus examination.
If your eye care provider believes that fluorescein angiography is necessary for a more accurate diagnosis, they may recommend scheduling it for another day. It is essential to follow their guidance, as they will consider your overall eye health and the specific risks associated with your high myopia.

In summary, while high myopia does increase the risk of retinal complications, proactive monitoring and timely intervention can significantly mitigate these risks. Regular eye examinations, including assessments for retinal health, are crucial for early detection and management of potential issues. If you experience any new symptoms, such as flashes of light, floaters, or changes in vision, it is vital to seek immediate medical attention. Your concerns about the risks associated with surgery and diagnostic tests are valid, and discussing them openly with your eye care provider will help you make informed decisions about your eye health.

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