retinal hole

[pperez5]

I am 23 years old and was diagnosed with a retinal tear in my left upper eye two years ago. It hasn't changed in size and i have never had any floaters, loss of vision,etc. My perscription is - 1.50 and i have been wearing glasses or contact since i was 16. My doc. is recommending laser treatment for the hole to decrease the chance of a retinal detachment and due to the location...i am still debating..if i don't get it does my age have any effect on the likelihood of detachment? does anyone know the numbers of the laser surgery preventing detachment? also he said a risk of the surgery is developing epilespy but i haven't found anything that confirms that?..

[Superay]

Dear Doctor,

Thank you so much for sharing your professional opinions to us all and your generous helps here are highly appreciated always.

I think I will take your advise to go for a third opinion and I do have some concerns:

Can pupil be dilated frequently? like 2 or 3 times a week ?

If everything goes fine after this final(hope so) eye exam, how frequent would you suggest to go for an eye exam ? twice a year? yearly ? (I am 37 btw)

Thank you so much aagain and best wishes,

Ray

[John C Hagan III, MD, FACS, FAAO]

1. standard would be a dilated exam with slit lamp, direct and indirect ophthalmoscope with scleral depression. Use of a goniolens (the thing that touches the eye while a slit lamp is used) is optional.
2. It would not be good practice to look at the retina without doing direct and indirect ophthalmoscopy. The latter is when the "headlight" is on the Eye MD and he/she holds a lens in their hand, then scleral depression is when an instrument is used during this exam to put gentle pressure on the eye to see the periphery.
3. Basically they both should be ophthalmologists eye MDs. if one or both were optometrists I would not be satisfied with either exam. If one was OD and one was MD I would go with the better trained Eye MD.
4. If both MDs then if one was a retina specialist I would go with that opinion.
5. If neither was a retina specialist then I would seek a third opinion. Find one near you at www.aao.org

JCH MD

[Superay]

Dear Doctor,

I am 37, male, I got my eyes examined few days ago, several retinal holes detected in my right eye and retinal photocoagulation was recommended.  After viewing your comments in this web site I decided to go for a second opinion today and the doctor said I was only retinal degeneration, no retinal holes were found.

The first eye doctor examined my eyes by Slit lamp, then Opthalmoscope plus magnifying lens, finally Slit lamp plus supplementary lens which attached onto my eye balls and retinal holes were detected.

The second one just used Slit lamp only without any supplementary lens onto my eyes and commented my retinal is just degenerating, few parts are getting thinner and no treatment to be needed.

Certainly, both examinations were done after pupil dilated and  my questions are:

1) What are the procedures of a normal detailed eye examination should be ? What does it cover? and what equipments to be used ?

2) Can the retina be clearly seen by just Slit lamp without any supplementary lens after pupil dilation ?

3) I am very confused of the results now. Any comment you have for both examinations ? or should I go for a 3rd opinion ?


Thanks so much in advance and look forward to your reply soon.

Ray

[John C Hagan III, MD, FACS, FAAO]

You will have to check with your insurance company.

JCH MD

[pperez5]

thanks! do you know if this surgery is covered by bluecross/blueshield (PPO)? if not how much is it?

[John C Hagan III, MD, FACS, FAAO]

No risk of epilepsy from the surgery. Not sure where that came from. Totally out in left field.

There is no agreement among surgeons on which holes need to be treated and which don't.

Consider getting a second opinion from a retina surgeon. In the USA find one at www.aao.org

JCH MD