risk of retinal tear recurrence with myopia

[momcantsee]

Background information:  I am 38 years old, have worn glasses for 30 years, eyes are -6 and -8.  During routine eye exam last Thursday the optometrist noticed one retinal tear in each eye, I was seen by an opthalmologist the following Monday and had the tears lasered.  Since then I've had a blind spot in the right lower visual field of each eye.

I have lost confidence in my eyes and feel I will never rest easy about any flash of light or floater, I feel like I will never be sure if my eyes are headed to a catastrophic event or are just fine.

here are my questions:

1) what is the risk of tear recurrence after one tear in each eye being diagnosed.?

2)  what is the chance that these blind spots will go away?

3) how can I differentiate the normal floaters I see whenever I stare at a blank wall or drive on a foggy day and the normal lights I see with worrisome ones?  I am particularly concerned about this since I do not remember any significant floaters or lights happening to warn me of the tears I have.

4) how long between a retinal detachment starting and surgery before the eye cannot be repaired?  i.e. if you notice the symptoms of an RD how long do you have to get help before its too late, and are retinal specialists on a 24 hour call rotation for retinal emergencies in the middle of the night or weekends?

With sincere appreciation for any help you can give me.

[Michael J Kutryb, MD]

mjk

[dukey]

Well welcome to the world of eye problems!!!! Pretty much everyone on here has had some serious problems with their eyes and many are related to myopia (myself included). You are not alone. Also know that severe vision loss is very rare with high myopia and is becoming rarer with better treatments/surgeries. The good news is you have been caught early, that is great news actually. More good news is that a surprisingly high number of people have retina tears on routine exam and they are usually left alone if asymptomatic. I'm slightly worried you may have had laser for nothing. Anyway:

1) I personally don't know the numbers but I often read about people having multiple tears. I would say its more common to not have multiple tears though.

2) Don't know about the blind spots

3) This goes back to my earlier point. It sounds like your tears were not causing a problem and so could have been left alone. However, if an acute tear develops and is a problem, you will know about it. Commonly people experience a "shower" of floaters which is actually blood. It is also sometimes described like a drop of ink in water. You will probably notice very, very bright, repetitive flashes that are camera flash-like, or are like lightening bolts. If you notice any of these signs, it can be serious and needs to get checked out ASAP.

4) Complete (i.e. black, black, black!) vision loss from an RD can occur in days to weeks and can be completely unrepairable. It is a medical emergency, no question. We are talking ER visits if symptoms suddenly develop on weekends/evenings etc. Caught early, usually vision can be maintained or restored.

To me, it sounds like you are in good shape. You are 38 and have never had any major problems. You are also really not that myopic compared to me and many others on this forum. I think you have a lot to be positive about. Just educate yourself about everything and keep watch for warning signs and you will be fine.  

[momcantsee]

Thank you so much for your reassuring information.  The description of the floaters and light flashes was particularly helpful.  I know I'm going to be very neurotic about any odd occurances in my visual fields, but based on what you're saying, something serious will be fairly obvious.

I hope the tears weren't repaired unnecessarily.  Both the optometrist and the opthalmologist commented on my level of myopia being of concern and also there was some puckering and seepage of vitreous fluid behind the tear on the right eye.  

Thanks again for the info.  This whole issue kinda took me off guard.  I've always been a worrier when it came to my vision, as a young child I remember praying every night not to go blind as my prescription kept getting higher with every visit to the eye doctor, but those fears settled down as I grew up, but now the fears feel very real again.

[momcantsee]

Hi there, your post was blank other than your initials and I'm just wondering if I missed something?  I would really value any information you can give me,

Thanks

[dukey]

"I hope the tears weren't repaired unnecessarily.  Both the optometrist and the opthalmologist commented on my level of myopia being of concern and also there was some puckering and seepage of vitreous fluid behind the tear on the right eye."

Well that is additional info that suggests you were seen just in time. You should be pleased!!!

[Sandy Feldman, MD, MS]

Dear Momcantsee,

1.  It is likely that after treatment, the tears will not recur.  You may develop new ones in different locations.

2.  This is a good question.  I would recommend that you ask your eyeMD this question.  Depending on the location of the tears, the scarring from the tear and/or treatment may induce blind spots; however, so can a retinal detachment.

3.  If you see a change in the number of floaters you have, a curtain coming down or flashing lights that persist with eyelid closure, you should get checked immediately.

4.  The earlier a retinal detachment is treated, the better.  The treatment of retinal detachments which spare the macula or one’s area of central vision have a better attachment rate and visual outcome than do detachments in which the macula is off.  Retinal specialists are usually available on an on call basis for emergencies and are used to seeing patients with detachments at non-office hours.  Sometimes, surgical intervention may be delayed due to the availability of trained staff and is dependent upon the retinal detachment.  


Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[momcantsee]

Thank you so much for the information.  I think I will always feel anxious about my vision and any strange phenomena I notice, but hopefully I will be able to learn to keep it into perspective.  I appreciate living in an era when tears can be caught early and sealed, but fervently hope that I will not have to deal with multiple tears over the next 40 years of my life.  I guess I just have to live with that uncertainty and try not to obsess about it.

thanks again!

[dukey]

"I think I will always feel anxious about my vision and any strange phenomena I notice, but hopefully I will be able to learn to keep it into perspective"

Yeh join the club. Be prepared to become aware of things that you would have just ignored previously. The eyes are an amazing organ and if you are perceptive enough, you can see a lot more than you think if you try hard enough. Just keep busy and move on.

[AnnaE]

mjk enteredonlyhis initials because he did not need to add to Dukey s response.

[AnnaE]

Since I was 18, and warned about my retinas, I said over and over to myseld that I might go blind, at  least once an hour. My daughter was first, but she recovered. I did not recover in one eye, because my doctors would not listen; neither would the hospital.

Also warch out for an obstruction in any part of the outer rim of your eye--like a chunk of
tinted class. Some say a curtain, but I think that is misleading.

Anna

[momcantsee]

Thank you for explaining the post with the initials and for your description of your visual symptoms.

The blind spots have not diminished since the lasering last week, but I do notice my brain is getting better at ignoring them as the day goes on.

[AnnaE]

Good luck.

[MG62]

A related discussion, Vitreous detachment,hemorrhage,retinal tears was started.