Retinal Tears: Symptoms, Diagnosis, and Treatment Options

Q: Retinal Tears: Symptoms, Diagnosis, and Treatment Options

Hello： If there is indeed a tear, I still recommend laser treatment as it is safer. <br>Generally, there is no need for rest after the laser procedure, and there should not be any discomfort. <br>Wishing you good health.

Retinal tear

At the beginning of June, I went to a regional hospital to have my retina examined.
The doctor told me that my retina was fine.
However, a few days ago, when I looked up and shook my head, I saw reflective circles with my eyes closed, and shaking my head also produced similar visual phenomena.
Therefore, I returned to the same hospital but saw a different doctor for another retinal examination.
The doctor examined me for a long time and found that both eyes had small retinal tears.
He suggested that the tears were small enough to either treat with laser or just monitor.
The next day, I went to see an ophthalmologist I had seen during my studies.
Initially, I only mentioned that the previous doctor had found a tear.
After examining my retina, he concluded that there was no tear.
I explained that the other doctor had found it while I was looking down, and he re-examined the lower part of both eyes but still found nothing.
I have high myopia and high astigmatism.
I understand that once a retinal tear is discovered, laser treatment is the best course of action.
However, neither doctor was able to identify it.

Doctor, what should I do now to ensure the best outcome? Should I seek out a doctor who can confirm the diagnosis and perform the laser treatment directly, or should I consult other doctors for further examination? Additionally, if I undergo laser treatment, should I take a few days off to rest, or can I return to work immediately? (My job requires long hours of computer use.) Thank you.

JRH, 20~29 year old female. Ask Date: 2013/07/13

Dr. He Jianxian reply Ophthalmology

Hello: If there is indeed a tear, I still recommend laser treatment as it is safer.
Generally, there is no need for rest after the laser procedure, and there should not be any discomfort.
Wishing you good health.

Reply Date: 2013/07/13

More Info

Understanding retinal tears is crucial, especially for individuals with high myopia, as they are at a greater risk for such conditions. Retinal tears can lead to serious complications, including retinal detachment, which can result in permanent vision loss if not treated promptly.

Symptoms of Retinal Tears
The symptoms of retinal tears can vary, but common signs include:
1. Flashes of Light: Patients may experience sudden flashes of light in their peripheral vision, often described as "lightning streaks."
2. Floaters: The appearance of new floaters, which are small spots or lines that drift across the field of vision.

3. Blurred Vision: Sudden changes in vision, including blurriness or a shadow over part of the visual field.

4. Visual Disturbances: Some patients report seeing a curtain or veil over their vision, which can indicate a more serious issue.

Diagnosis
Diagnosis of retinal tears typically involves a comprehensive eye examination, including:
- Dilated Fundus Examination: This allows the doctor to view the retina in detail.

- Optical Coherence Tomography (OCT): This imaging technique provides cross-sectional images of the retina, helping to identify any tears or detachment.

- Ultrasound: In some cases, ultrasound may be used to visualize the retina if it cannot be adequately examined due to opacities in the eye.

Treatment Options
If a retinal tear is confirmed, treatment options may include:
1. Laser Photocoagulation: This is a common treatment for retinal tears. A laser is used to create small burns around the tear, which helps to seal it and prevent fluid from entering the subretinal space.

2. Cryotherapy: This involves freezing the area around the tear to create a scar that helps to secure the retina in place.

3. Observation: In some cases, if the tear is small and not causing significant symptoms, the doctor may recommend monitoring the condition closely.

What to Do Next
Given your situation, where two different doctors have provided conflicting assessments regarding the presence of a retinal tear, it is essential to seek a third opinion from a retinal specialist. A retinal specialist has advanced training and experience in diagnosing and treating retinal conditions, and they may have access to more sophisticated diagnostic tools.

If a retinal tear is confirmed and treatment is recommended, you may need to take some time off work, especially if your job involves prolonged computer use. After laser treatment, patients are often advised to rest their eyes and avoid strenuous activities for at least 24 to 48 hours. However, many individuals can return to normal activities relatively quickly, depending on their comfort level and the doctor's advice.

Conclusion
In summary, if you suspect a retinal tear, it is crucial to act promptly. Seek a consultation with a retinal specialist who can provide a thorough examination and appropriate treatment options. Early intervention is key to preventing complications and preserving your vision. Additionally, if you undergo laser treatment, follow your doctor's recommendations regarding rest and activity levels to ensure optimal recovery.

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