Should everybody with peripheral retinal pathology be treated?
This is controversial. The best data that we have would indicate it is reasonable to observe a lot of peripheral retinal pathology as the amount of subsequent retinal detachments are infrequent therefore one would have to treat a lot of patients to prevent one retinal detachment. However if you ask any retinal surgeon which they would prefer to treat; an atrophic hole with laser in the office or a retinal detachment in the operating room I know which one they would opt for!
So how do we decide?
I tend to treat patients that are symptomatic with flashing lights, or who have had a retinal detachment in the other eye, or who have a strong family history of retinal detachment. The risk of laser is minimal so I also offer each patient with peripheral pathology the option of prophylactic laser. Regardless of the decision to treat or observe nearsighted individuals should follow regularly with an ophthalmologist. And those that have peripheral retinal pathology should see a retina specialist once a year.
Henry Holt, MD
1801 N.H. Medical Park Drive
Wilmington, N.C. 28403