Does having 1 retinal tear normally cause more tears in both eyes?

[frossia935804]

Hello hoping to get some info please. I'm 48 year old female , I've always been a high myopic -16 which has been stable all of my life. About 5 years ago I had PVD in both eyes with ongoing floaters , these have never decreased if anything they appear more of a problem will this ever improve? This year I've had a few issues however , 3 months ago I started suffering from severe dry eye to the point my eyes became swollen ESP my right eye , it was visibly swollen under my eye. I went to an optician who gave me drops and lubricant for my eyes which fixed the problem after a week but she also said I had high pressure in my eyes which I'd never had before , she told me to go back in a few months to check again . I did this and the pressure was fine again on rechecking but this time she found a tear in the bottom inside left of my right eye. I'd never had tears or detachment a before , my question is could this have been caused by the earlier high eye pressure or is it from the PVD 5 years ago? I had the tear treated with laser surgery and due to have it checked soon I'd like to know because I've had a tear am I now more likely to get further tears in the other eye and/or same eye? Also about 25 years ago I had laser surgery around my retinas as a precautionary measure because of my very stretched retinas? Finally can I ask does having such high myopia mean I've got pathological myopia? If not can it develop into this in the future?  U
So far other than stretched retinas I've always been told my retinas look healthy. Thank you for your time! Hope someone's got some answers for me having this tear has made my a little anxious! Cheers!

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

Can't tell you how much my wife and I enjoyed our 3 weeks in touring Australia.

The laser is not applied to the retina tear but to attached retina around the base of the tear. So even if treatment works the hole is still there and usually remains open. If treatment is successful however the 360 degree circle of fused (scarred, welded, adhesied etc) of retina holds the retina in place against traction by vitreous and is "water-tight_ so that liquid vitreous coming through the hole does not dissect back into attached retina and cause it to come lose. So those are two purposes 1. resist traction 2. block fluid.  The flap never goes away.  Go on google images and type in something like "horseshoe retina tear"  and "laser sealed retinal tear" it will enable you to conceptualize better.  DD = disk diameter  Since both of the Scots Eye MD thought you would be okay that should be re-assuring. Keep your follow up when you get home.

JCH MD

[frossia935804]

Hello thank you so much again for all your assistance! I've been In Scotland since January and going back to Australia in mid August.
The saga continues!
I was experiencing a few unusual pin point type floaters in my treated eye so went to optician. He checked my retina but was concerned because he said it appears retina tear still present with a flap and vitreous attached as well, he initially said it didn't look like it hadn't been lasered I assured him it was! He got a colleague to look as well they then said I appears the laser was surrounding the tear but tear still there. They said it should be ok because it should prevent tear from getting bigger. The tear size is 1DD.
My question is does it sound right to you? I suppose I thought the tear would be seen to be healed over not having a flap hanging? I will see a different retinal Dr in a few weeks for a second opinion , would you think I should act any earlier or just keep a watch out for further usual symptoms? Again I can't thank you enough you are the only professional that is prepared to explain things to me thanks again!

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

1. Your first question cannot be answered. It's possible a different laser power or placement might have sealed the hole or the proper power/placement may not have worked because of the eye not producing adhesions (how it works) or there could be more traction on the retina holding it away from the back of the eye.
2. What country are you located in? It will take 6-8 weeks for adhesions to form and know if the second laser was a success. Given your degree of high myopia our practice would be to schedule a follow up in 1-2 weeks just to make sure things were progressing.  

JCH MD

[frossia935804]

Hello DR thank you so much for your response!
After the laser surgery I went back after 10 days to have it checked , the Retinal DR said the tear hadn't adhered properly to the back of my retina so he lasered it again. This time the laser seemed a lot stronger , the first laser treatment was done by a different DR i think he was a registrar . My question is could the previous laser treatment not worked because it wasn't strong enough? Also following this second laser the DR said he doesn't need to check it for 2 months and didnt seem concerned saying i had 90% chance of it being ok .I thought he'd want to check it a lot earlier because its a second repeat of same tear and my -16 high myopia. Do you believe that's normal to wait so long? I'm considering seeing another DR?
Once again thank you so much for your time !

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

High pressure in the eye does not cause retinal holes/tears. They are almost always due to weak spots in the retina, vitreous traction/PVD, trauma.  You have high myopia.  Eye MDs differ in their definition of "Pathologic" high myopia. Some require evidence of damage to eye from the very long highly myopic eye.  Your retina tears would be one such condition. You can ask your ophthalmologist what he/she calls it and be happy with that.  You are more likely than normal to have a hole/tear/retinal detachment in either eye than a non-high myopic person but the odds are in your favor that you will not have any of them.

Only your Eye MD can give you more specific information

JCH MD