High myopia and tennis

[AAA&BBB]

Hello I am a 31 years old male with high myopia（both eyes over 1000）. I has LASIK surgery 3 years ago and result is very good. I give up basketball because of concern of any possibility of retinal tear or detachment. Now I am considering to learn playing tennis. My question is for my individual case or generally speaking can high myopia person like me play tennis? Thank you very much.

[tsk777]

Hello Doctor,
I would like to know few things from your side, sorry for bothering you. I am 22 years old, my eye sight is -6.5 both eyes. Is it safe for me to drive. But personally I dont feel comfortable in driving. Please let me know is it safe to drive with -6.5 eye power. Thanks.

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

Your final okay comes from your surgeon so ask. In general you would not need to give up your dancing and risk is rather low.

JCH MD

[Joyzo]

I currently have a PVD (high myopia). I have a past history of tears, holes, snailtract and lattice degeneration. There is a suspicious area the first doctor suggest laser and the doctor who was going to do the laser decided to put me in the wait and see in one week bracket.
1. At what point can I resume dancing? I do salsa which is extremely energetic and involves lots of spinning.
2. How safe is it for me to travel to Dominican republic I leave on 25th February 2011.
3. Is this a hobby that you think I should consider changing?
Thanks Joy

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

__________________

[AAA&BBB]

Thank you Doctor. I will learn to relax because of your professional advice. Best wishes to you!!!

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

You're going to give yourself an ulcer.

1. No its not a danger signal its a phophene.
2. I have no idea, perhaps because you're more aware now.
3. No, cough away.

Relax

JCH III MD

[AAA&BBB]

Dear Doctor,

One question about phosphene (seeing quick flash after rapid eye movement in the dark or big sneeze).

1. I remember very well one year ago I don't have that kind of phenomenon. However now I do for one eye. For high myopia person like me (both > 10.00 diopter) is that still harmless and very common OR it is sort of pre-signal and should be warning something, such as retina at some direction is becoming weaker and more sensitive?     I have a thorough dilated eye exam after I had phosphene in the dark and result is no problem.  

2. If it is OK then why I don't have it one year ago then I have it now?

3. Even if phosphene is harmless do you think I should try best to control sneezing / cough and rapid eye movement in order to avoid as much as possible the mechanical pull to retina?

Thanks a lot.

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

You're welcome
JCH III MD

[AAA&BBB]

Thanks a lot Doctor. Your professional advice really really relieve my anxiety.  I am so sorry to bother you too much. Again thanks a million.

All best wishes to you and Medhelp.org!!!

[AAA&BBB]

Thanks a lot Doctor. Your professional advice really really relieve my anxiety.  I am so sorry to bother you too much. Again thanks a million.

All best wishes to you and Medhelp.org!!!

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

1. Jogging, swimming and golf--three of my favorite activites are fine for you.
2. I think for most people if a thorough dilated retina exam shows no suspicious areas and the Retinal physician agrees that once a year is enough. HOWEVER you are so anxious about this that the reassurance of an exam every 6 months may be worth it to your peace of mind.
3. The rate of RD is not proportional to the degree of myopia in a linear or predicable way. I don't think there are any studies of retinal detachment in myopia >10.00 diopters. You may be able to find one if you spend enough time.
4. Most patients (>51%) of my 10+ diopter myopes have good vision no RD and no macular degeneration
5. New York City has lots of excellent retina ophthalmologists and lots of excellent medical schools and also Manhattan Eye & Ear which is arguably probably the best known.

JCH III MD

[AAA&BBB]

Thanks for your kind help Jodie. I appreciate it very much.

Dear Doctor JH can you also kindly provide your advice for my questions above?

[JodieJ]

You could try www.castleconnolly.com to locate a retinal specialist in NYC.  For a nominal fee, you will have access to a data base of specialists who were nominated by other docs as someone that they'd see themselves or send a family member to see.

I believe that both long eyes and steep corneas can cause high myopia, although it's just the long eyes that are related to a higher probability of retinal detachment.  And 10 diopters of myopia doesn't sound all that bad to me.  There have been recent posts on this forum from people with more than 20 diopters of myopia.  Based on the above statistics, your chances of having a retinal detachment that cannot be reattached is only .0025 percent (i.e., extremely low), and you'd still have another eye.  This is probably much lower than your chances of being hit by a drunk driver while crossing the street.  I think you're worrying too much--just about everyone's at a higher risk for some condition.  

[AAA&BBB]

Thanks Doctor, based on your comment 5 questions:

1.   My both eyes are over 10.00 diopter myopia before LASIC in 2004. In your opinion do you think I can (1) jogging; (2) swimming BUT NOT diving; (3) playing golf.

2.   One of my big concern is whether RD has any preceding symptom or signal that we can detect through regular (saying every 6 months) dilated eye exam OR felt by myself (for example see light flash in the dark even if there is no rapid eye movement)?     My anxiety is some RD comes suddently without any preceding signal and I really need a well defined emergency plan to act ASAP.         I know I am a little nervous. Pls kindly understand I have a good family, wife and will have my baby soon. Realisticly I can't accept serious eye problem before 50 or 60 y/o. I need to support and care my family instead of burdening them.

3.   Also I guess the ratio of 2-5% is for the population of >6.00 diopter myopia. Statistically if the population only include people with over 10.00 myopia (like my case) will the ratio be much higher than that? Based on your professional knowledge and experience is the ratio significantly correlated with degree of myopia dipoter? OR all those 5% RD patients evenly distribute in each group, I mean 6.00, 7,00, 8,00, 9,00, 10,00 etc.

4.   One maybe naive question. In you high myopia patients are there someones with over - 10.00 BUT not experiencing RD and maintain good health status of retina, even they could be old people over 50 y/o?

5.  I will be in New York City next month and really want to find a retina specialist and MD to have 360 exam and assessment for my eyes. Can you kindly recommend the clinic and doctor or weblink?

Tons of thanks!!

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

1. That is what that paper says although there is no specific paper cited that these figures came from. I would believe a figure of 2-5% for > 6.00 diopter of myopia.
2. I believe that is a coincidence rather tha a cause.
3. Look at the figures optomistically, even accepting the figure you cite you have a 95% of NOT having a retinal detachment. If you do have a retinal detachment there is a 95% chance that it can be successfully reattached.

JCH III MD

[AAA&BBB]

Doctor yesterday one of my friends also with high myopia in US (both eyes over -1000) sent me one link of website "www.sightwise.org", which was built up by one US 45 y/o engineer/consultant who experienced RD in 1999. Through this website I got a little PD anxiety. Can you kindly help provide answers for following questions:

1. Through the web "If you're very nearsighted* & over 40 (maybe younger) you are more susceptible to Detached Retina-You have a 1 in 20 (5%) chance in your life time versus 1 in 10,000 for the general population".       Is that true based on the scientific research?  It is said the result is from the following paper:    

http://www.emedicine.com/emerg/topic504.htm

2. Some 28 y/o young male reported he got RD when jogging and another woman reported RD case because of one big sneeze. It is terrible.

Do you think I should give up jogging and swimming Doctor? I have given up basketball and tennis because prudent concern of future RD. What shall I do?

3. In you high myopia patients are there someones with over - 1000 and 50 y/o not experiencing RD and maintain good health status of retina? I know no guarantee from doctors. I just don't want to be so desperate. Do I still have chance to stay away from RD? I am 31 y/o male with both eyes high myopia over -1000.

Thank you so much Doctor. I am really sorry to bother you several times.

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

Your are welcome.

JCH IIIMD

[AAA&BBB]

Got it. Thank you very much Doctor.

[AAA&BBB]

Got it. Thank you very much Doctor.

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

Unless your ophthalmologist tells you differently once/year.

[AAA&BBB]

Sorry Doctor, in the No. 2 question above would you please tell what should be my best eye & retinal exam frequency (3, 6 or ? months) based on my profile: 31 years old male. LASIK surgery 3+ years ago and result is very good. Both eyes are over -1000 myopia before operation. From 2004 to now totally had about 6-8 times of dilated eye exam and both retinas are good.

[AAA&BBB]

Thanks a lot Doctor for your quick and professional advice. Appreciate it very much.

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

1. PVD are a function of age and often degree of myopia. You can't prevent them.
2. PVD can be diagnosed but there is no treatment for them.
3. No
4. Most PVDs are assymptomatic and don't cause symptoms. You need to go in with sudden increase of floaters, flashes of light like lightening or loss of peripheral vision.
5. Very, very few PVDs lead to retinal detachment. The greatest risk of a RD or retinal tear is in the first 6-8 weeks from when the PVD begins.
6. You can do on line searches and pull up different series. The risk of RD in a highly myopic patient that has not had cataract surgery is roughly 1 in 500 to 1 in 1000
7. No way I can answer that since you might be in a country with good medical care or in a country without a retinal specialist.
8. Some retinal detachments cannot be repaired perhaps 3-4% and lead to blindness. The retina may be put back in place and it may not recover normal vision or it may recover completely. It depends a lot on whether the macula is pulled off or not. Cost and recovery are too variable to even give you a ball park figure.

JCH III MD

[AAA&BBB]

Hi Doctor, my brief eye profile is: 31 years old male. LASIK surgery 3+ years ago and result is very good. Both eyes are over -1000 myopia before operation.From 2004 to now totally had about 6-8 times of dilated eye exam and both retinas are good.

Some quick questions about PVD for your profession advice

1. Is that true that I can't do anything to reasonably prevent or delay occurrence of PVD?  It is all by God and personal luck?

2. Can PVD be medically diagnosed and treated? If yes based on my personal eye profile what would your recommendations be about eye exam frequency? I am a risk adverse person and very concerned eye health. I am willing to invest money and time to do detection from the most prudent perspective.

3. If conducing dilated eye exam every 3 or 6 months does it hurt eyes or have serious side effect?

4. Besides medical check, from individual aspect what I can do to have very timely detection for PVD or the warning symptoms? You know if PVD occurs right within interval between 2 checks I really need to do it myself.

5. From PVD to possible retinal tear then to retinal detachment what is the average interval time? I saw one of your comments about PVD in another thread and you said TIMING is very key to have medical treatment.

6. Is there any kind of formal or informal descriptive statistics about what percentage of people with high myopia would have PVD / retinal tear / retinal detachment?

7. Now I am fine, however I would like to know what I need to do if I get possible retinal tear or detachment. I mean the emergency plan, especially on business travel / out of big town with good medical conditions or even at night there is no good retinal specialist in hospital available within 12 hrs.

8. From corrective perspective if I can have timely medical treatment for possible retinal tear or even detachment what would be the final result of vision recovery? Usually good or not very good based on current skills and technology. Furthermore the cost and recovery timeframe?

Thanks a million Doctor for your time. I know it is a long list.