Retinal Exams for High Myopia: Risks and Recommendations

Retinal examination for high myopia, eye fatigue?

Hello, Doctor.
I have a high myopia of -1100 diopters.
I would like to ask the following questions:
1.
During retinal examinations, strong light is used.
If these checks are done too frequently (once a month), is there a possibility of causing harm to the eyes?
2.
Half a month ago, I noticed some bright spots and a decline in my vision.
I had a retinal examination, which showed an increase of 100 diopters in one eye and that my retina was fine, but I suspect I have been seeing light shadows (sometimes a bright spot appears in the corners when I move my eyes).
Is it advisable to have another examination? Would it be safer to get checked at different hospitals?
3.
The doctor prescribed me methylsulfate neostigmine to be used four times a day.
However, I heard this could potentially cause retinal detachment.
If I am not fatigued, can I skip the drops, or is it necessary to use them four times a day for effectiveness? On the first day of using the drops, I noticed a thick, mucus-like discharge from my eyes upon waking the next day, which lasted for about two days.
Recently, by the afternoon, my eyes feel sore and I feel dizzy.
Could this be due to my prescription changing or the eye drops?
4.
Currently, my vision differs by 100 diopters between both eyes.
Can I first visit an ophthalmologist for an examination and ask for a prescription to get glasses? Is there anything specific I should be aware of when getting glasses with a 100 diopter difference between my eyes? Thank you for your answers.

Xun, 20~29 year old female. Ask Date: 2016/01/19

Dr. Wang Zhishun reply Ophthalmology

Hello, 1.
The main goal is to avoid prolonged direct light exposure to the macula (which the physician will monitor).
2.
If there are changes in symptoms, you can consult a trusted physician for a re-evaluation.
3.
Methylnaltrexone bromide primarily alleviates eye fatigue and is generally considered safe.
4.
A one-degree difference in vision is manageable; a qualified optical shop should be able to provide proper fitting.

Reply Date: 2016/01/19

More Info

Hello! Thank you for your detailed questions regarding retinal exams and your concerns about high myopia. Let’s address each of your inquiries systematically.

1. Frequency of Retinal Exams and Eye Safety: Retinal exams often involve the use of bright lights and specialized equipment to assess the health of the retina. While it is true that frequent exposure to bright light can cause discomfort, the risk of permanent damage from routine retinal exams is minimal. Most eye care professionals recommend regular check-ups, especially for individuals with high myopia, as they are at a higher risk for retinal issues such as detachment or tears. Having a retinal exam once a month is generally considered safe, but if you experience discomfort or have concerns, you should discuss this with your eye doctor. They can provide personalized advice based on your specific situation.

2. Concerns About Visual Changes and Multiple Exams: Given your recent experience with visual changes, such as seeing bright spots and a decrease in vision, it is prudent to have another examination. If you feel uncertain about the findings or the care you received, seeking a second opinion from another qualified eye care provider can provide peace of mind. Different hospitals may have varying technologies and expertise, which can be beneficial in ensuring a comprehensive evaluation of your retinal health. However, it is essential to communicate your history and concerns clearly to each provider to ensure continuity of care.

3. Medication and Potential Side Effects: You mentioned being prescribed Methacholine sulfate (硫酸甲酯新斯狄明) to be used four times a day. While this medication can help with certain eye conditions, it is crucial to follow your doctor's instructions regarding dosage. Stopping the medication prematurely may hinder its effectiveness. The side effects you experienced, such as mucous discharge, can occur with some eye medications, but if you notice persistent or worsening symptoms, you should contact your eye doctor. Regarding the concern about retinal detachment, it is essential to weigh the benefits of the medication against any potential risks. Discussing your concerns about side effects with your doctor can help you make an informed decision about your treatment plan.

4. Vision Differences and Prescription Glasses: If there is a significant difference in prescription between your two eyes (in your case, a difference of 100 degrees), it is essential to have this properly addressed when getting new glasses. An eye care professional can help determine the best approach for your lenses, ensuring that they accommodate the difference in vision. It is common for individuals with high myopia to have varying degrees of vision in each eye, and proper corrective lenses can significantly improve your visual comfort and clarity.

In summary, regular retinal exams are crucial for monitoring eye health, especially for those with high myopia. While the frequency of exams is generally safe, always communicate any discomfort or changes in vision to your eye care provider. If you have concerns about medications or treatment plans, do not hesitate to discuss them with your doctor. Lastly, ensure that your prescription glasses are tailored to your specific vision needs to enhance your overall visual experience. Always prioritize your eye health and seek professional advice when in doubt.

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