Thin Peripheral Retina: Concerns and Management for High Myopia

Q: Thin Peripheral Retina: Concerns and Management for High Myopia

Hello： Based on the situation you described, the physician recommends regular monitoring and observation, which is reasonable. <br>Here are some suggestions to improve eye health and reduce the risk of retinal tears： <br>1. <br>Maintain regular follow-ups： According to the physic

The peripheral retina is very thin?

Dear Doctor,
I have high myopia in both eyes (L: 900, R: 1000) and high astigmatism (L ~ 400, R ~ 400).
Both my left and right eyes underwent retinal laser treatment this year.
During a retinal examination yesterday, the doctor noticed something unusual in the upper part of my right eye (which had a tear earlier this year in March and was treated with laser).
When the doctor adjusted the light to white and increased the brightness for a closer look, they found that the previously treated area of the peripheral retina was extremely thin.
The doctor informed me that it is currently very thin but not yet torn, so there is no need for laser treatment at this time; regular monitoring will suffice.
I was told that having a thinner peripheral retina is normal, and that performing laser treatment could potentially lead to scarring and slight contraction of the retina, making it more fragile.
I am genuinely worried about this issue.
I have already undergone three retinal laser treatments and numerous dilated eye examinations this year, hoping to reinforce the thinner areas of my retina for safety.
However, it seems that neither laser treatment nor abstaining from it is a clear solution.
What should I do in this situation? Are there really no other preventive measures, and should I just wait for regular observations? I am truly afraid that one day it might suddenly tear without me noticing, and by the time I experience symptoms and return for an examination, it could be too late...
I apologize for the confusion in my message; I am feeling very anxious and overwhelmed.
What else can I do to effectively prevent my eyes from developing retinal tears that could ultimately lead to retinal detachment? Thank you! Wishing you all the best!

Gao Du Jin Shi Gong Cheng Shi, 30~39 year old female. Ask Date: 2024/01/13

Dr. Gao Pilin reply Ophthalmology

Hello: Based on the situation you described, the physician recommends regular monitoring and observation, which is reasonable.
Here are some suggestions to improve eye health and reduce the risk of retinal tears:
1.
Maintain regular follow-ups: According to the physician's advice, have regular ophthalmic examinations to detect any changes in a timely manner.
This helps in early detection of issues and taking necessary actions.

2.
Protect your eyes from trauma: Avoid collisions and injuries, use protective eyewear, and be cautious to avoid any activities that may cause harm to your eyes.

3.
Maintain a healthy lifestyle: Good habits are beneficial for eye health.
This includes a balanced diet, adequate sleep, regular exercise, and avoiding smoking.

4.
Ensure proper vision correction: Make sure your glasses prescription is appropriate and have regular vision checks to ensure your eyesight is properly corrected.

5.
Avoid eye strain: When using electronic screens, reading, or engaging in other visual tasks for extended periods, take regular breaks using the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds.

While there may not be direct preventive measures to completely eliminate the risk of retinal tears at this stage, the above suggestions can help maintain eye health and reduce factors that may lead to problems.
If you experience any new symptoms or changes, please seek an ophthalmic examination immediately to take appropriate action in a timely manner.

Reply Date: 2024/01/13

More Info

High myopia, particularly at the levels you are experiencing (L: 900, R: 1000), poses significant risks for retinal complications, including thinning of the peripheral retina, retinal tears, and detachment. Your concerns about the thin peripheral retina and the management strategies are valid and important to address.

Firstly, it is essential to understand that a thin peripheral retina is a common finding in individuals with high myopia. The elongation of the eyeball associated with high myopia can lead to structural changes in the retina, making it more susceptible to thinning. Your ophthalmologist's observation that the retina is currently thin but not torn is a positive sign. Regular monitoring is crucial, as it allows for timely intervention if any changes occur.

The decision not to perform laser treatment at this time is based on the understanding that while laser therapy can help reinforce areas of weakness in the retina, it can also lead to scarring and further thinning in some cases. This is particularly true in already compromised areas. Your doctor’s recommendation for regular follow-ups is standard practice in managing high myopia and its associated risks. It is essential to adhere to these follow-up appointments, as they provide an opportunity for early detection of any changes that may require intervention.

Regarding your anxiety about potential retinal tears or detachments, it is understandable given the nature of your condition. Here are some strategies to help manage your concerns and potentially reduce the risk of complications:
1. Education and Awareness: Understanding the signs and symptoms of retinal detachment can empower you. Symptoms may include sudden flashes of light, an increase in floaters, or a shadow or curtain effect over your vision. If you experience any of these symptoms, seek immediate medical attention.

2. Lifestyle Modifications: While there is no guaranteed way to prevent retinal issues, maintaining a healthy lifestyle can support overall eye health. This includes a balanced diet rich in antioxidants (like vitamins C and E, omega-3 fatty acids), staying hydrated, and avoiding smoking.

3. Protective Eyewear: If you engage in activities that could pose a risk to your eyes (like contact sports), wearing protective eyewear can help prevent trauma that could lead to retinal issues.

4. Limit Eye Strain: Given your high myopia, it is crucial to manage eye strain. Take regular breaks from screens, ensure proper lighting while reading, and consider using blue light filters if you spend extended periods on digital devices.

5. Regular Eye Exams: Continue with your scheduled eye exams and follow your ophthalmologist's recommendations. If you feel anxious between appointments, consider scheduling them more frequently for peace of mind.

6. Mental Health Support: Anxiety about health issues can be overwhelming. Consider speaking with a mental health professional who can help you develop coping strategies to manage your fears and anxiety related to your eye condition.

In summary, while the thin peripheral retina is a concern in high myopia, regular monitoring and a proactive approach to eye health can help mitigate risks. Trust your ophthalmologist's expertise, and don't hesitate to voice your concerns during your appointments. They can provide reassurance and adjust your management plan as needed. Remember, you are not alone in this, and many individuals with high myopia successfully manage their conditions with appropriate care and support.

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