Do I Need an Urgent Eye Exam for Glaucoma or Macular Degeneration?

Do I need to see a doctor immediately to check for glaucoma and macular degeneration?

Hello Doctor: I have myopia in both eyes under 200 degrees and astigmatism over 300 degrees.
I just underwent retinal laser surgery on October 20th, so I am very attentive to symptoms of other eye diseases.
Today, on November 7th, after reading about the symptoms of glaucoma, I noticed that one of the symptoms is seeing halos around streetlights at night.
Upon closer observation of streetlights at night, I found that I could see a halo, and the edges of the halo seemed to be a bit red (but not layered like a rainbow).
I am unsure if this indicates an acute glaucoma attack or if I am just overly worried.
I would like to ask if I need to see a doctor urgently to check for acute glaucoma.
Here are a few additional points about my situation for your reference:
1.
When I was in elementary school, I noticed a rainbow-like effect around streetlights while walking around the sports field at night, but at that time, I had no knowledge of glaucoma symptoms and did not think much of it.
Does this mean I have been developing chronic glaucoma since elementary school?
2.
I do not experience headaches, nausea, or a feeling of pressure in my eyes.

3.
I had four eye examinations on October 20, October 22, October 27, and November 6, where I underwent dilated retinal examinations.
In all four visits, my intraocular pressure was normal before the examinations.
However, on October 22, my vision was 1.0 in the right eye and 0.8 in the left eye, and in the most recent examination on November 6, my vision in both eyes was 0.8.
I am very concerned that this decline in vision may be a symptom of glaucoma or macular degeneration.
After these retinal examinations, the doctor only noted a retinal tear on October 20 and performed laser surgery; during the other visits, he stated that the retina was fine and did not mention any other issues.
I would like to ask if a retinal examination would also reveal any glaucoma or macular degeneration issues?
4.
During the vision test on November 6, shortly after staring at the vision chart, I suddenly began to see a grid-like black shadow covering the vision test chart (the background of the vision test chart lights up in a grid pattern).
The edges of the grid-like black shadow were very clear, and even the curvature of the four corners matched exactly with the "grid-like background of the vision test chart." However, after leaving the vision testing room, I did not feel any black shadow in the center of my vision when covering one eye.
Could this be a sign of macular degeneration?
5.
After the eye examination on November 6, the doctor only informed me that the area of the retina that underwent laser treatment and other parts of the retina were fine.
When I asked him if I had macular degeneration or glaucoma, he scheduled me for a "visual field test" on December 6.
I would like to ask if the visual field test is related to retinal detachment, glaucoma, and macular degeneration? (I only know for sure that the visual field test can check for glaucoma.) I apologize for having so many questions, and I appreciate your help in answering them one by one.

Jiao Lü de Zhi Xun Zhe, 20~29 year old female. Ask Date: 2015/11/07

Dr. Wang Zhishun reply Ophthalmology

Hello, your description is very clear.
In summary, the main concerns are macular degeneration and glaucoma.
You can search online for "AMSLER GRID" to perform a test; if you have macular degeneration, you will likely notice issues with the grid.
Glaucoma generally does not present symptoms, except in cases of acute glaucoma; diagnosis primarily relies on regular follow-up examinations by an ophthalmologist.
Visual field tests are related to conditions such as retinal detachment, glaucoma, and macular degeneration.
Based on your description of the current situation, it is advisable to follow the examination schedule arranged by your doctor.

Reply Date: 2015/11/07

More Info

Based on your detailed description of your eye health concerns, it is understandable that you are feeling anxious about the possibility of glaucoma or macular degeneration, especially after your recent retinal laser surgery. Let’s address your concerns systematically.

1. Urgency of Eye Exam: Given that you have noticed halos around lights, particularly at night, it is wise to consult an eye care professional. While halos can be a symptom of various conditions, including dry eyes or refractive errors, they can also indicate issues related to glaucoma, especially if accompanied by other symptoms such as blurred vision or eye pain. Since you have a history of retinal issues and have recently undergone surgery, it is prudent to have a thorough examination to rule out any complications or new developments.

2. History of Symptoms: Your experience of seeing halos around lights since elementary school does not necessarily mean you have chronic glaucoma. Halos can occur for various reasons, including corneal irregularities or refractive errors. However, it is essential to monitor any changes in your vision, especially after your recent surgery.

3. Lack of Acute Symptoms: The absence of headache, nausea, or eye pain is a positive sign, as acute glaucoma often presents with these symptoms. However, the absence of these symptoms does not completely rule out the possibility of glaucoma. Regular monitoring of intraocular pressure (IOP) and visual field tests are crucial, especially for someone with your history.

4. Visual Changes: The recent decrease in visual acuity from 1.0 to 0.8 in your right eye and the appearance of a grid-like shadow during the vision test could be concerning. While it is good that your retina was checked and found to be stable, the appearance of shadows or distortions in your vision warrants further investigation. This could be related to retinal changes or even macular issues, which should be evaluated.

5. Comprehensive Eye Exams: During a comprehensive eye exam, including retinal examinations, eye care professionals can assess for signs of glaucoma and macular degeneration. They typically check for optic nerve health, retinal integrity, and any signs of fluid accumulation or abnormal blood vessels. The visual field test you have scheduled is an important tool for detecting peripheral vision loss associated with glaucoma.

6. Next Steps: Given your concerns and the recent changes in your vision, I recommend that you keep your appointment for the visual field test. This test will provide critical information about your peripheral vision and help determine if there are any signs of glaucoma. Additionally, if you continue to experience visual disturbances or if your symptoms worsen, do not hesitate to seek an earlier appointment with your eye care provider.

In summary, while your symptoms may not immediately indicate an urgent issue, they do warrant careful monitoring and follow-up. Regular eye exams, especially after significant procedures like retinal laser surgery, are essential for maintaining eye health. It is always better to err on the side of caution, so if you feel uncertain or anxious about your symptoms, seeking an earlier consultation is advisable. Your eye health is paramount, and staying proactive about it will help ensure the best outcomes.

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