The story begins with a popular science article.
"High myopia there is a risk of retinal rifts and retinal detachment, so people with high myopia need to pay special attention to fundus health, it is recommended to conduct regular fundus examinations", after the third time in the medical health related public account brushed such a science, left eye myopia 900 degrees, right eye myopia 750 degrees, binocular astigmatism 150 degrees I fell into meditation.
I am a medical student, and I have been wandering in front of the halls of medicine ever since, but I can barely get a glimpse or two. The joke "What to do, afraid of death first" is about people like me: whether it is painful menstruation, nausea or dizziness, I must hear the doctor's jokes and I am surprised to stop.
So I took the opportunity to get new glasses, and I hung up the ophthalmology department of a nearby private hospital.
A thorough examination revealed a hole in the retina of both eyes
Unlike the bustling public tertiary hospitals, private hospitals are highly priced and have a quiet environment. After the slit light examination, I was led into the examination room by the doctor with blurry eyes that could not wear glasses because of the enlarged pupils, and sat in front of the fundus contrast device that was the size of me. Along with the doctor's words "look up, look down", there is yellow-green light in the Prussian blue background field.
Fundus examination results 丨 Author courtesy of the picture
The eyes can also do B ultrasound is something I didn't expect. The tiny probe slid up and down my eyelids, occasionally accompanied by the doctor's uttering, "Don't move!" Don't roll your eyes! I closed my eyes, trying my best to make my eyeballs face forward in the darkness, and I couldn't help but sigh in my heart: "It turns out that when people close their eyes, it is so difficult to control the eyeballs!" ”
B ultrasound check results 丨 Author courtesy of the figure
The inspection was finally done, and several reports were stuffed into my hands, and I couldn't see why. The outpatient doctor's tone also carried a hint of emotion that I could not taste: "You this... A little bit of a problem. ”
She went on to explain: "Retinal rift, you see this lesion area, you have to hit the laser." ”
What do you have to do?
"Hit the laser, that is, you now have the risk of retinal detachment, you have to use the laser to glue the hole." You are still a student, you may have to discuss it with your family, and then make an appointment to do it..."
It took me ten seconds to think about this conclusion.
Later, a friend asked me, why am I uncomfortable to check it out and do surgery? I jokingly replied, no symptoms, listening to popular science articles.
Atropine's pupils recovered quickly, and in the afternoon I was able to pick up my mobile phone to study "retinal laser photocoagulation": "Retinal laser photocoagulation is the purpose of thermal coagulation of retinal tissue on the retina by laser action, thereby increasing the adhesion of the retina to deep tissue, reducing vascular leakage, and sealing abnormal retinal vessels." Retinal laser photocoagulation generally does not require hospitalization and can be done on an outpatient basis. ”
It sounds like a problem that isn't serious, but you can't sit idly by!
Mom and Dad were a little nervous when they heard the news on the phone, and I even took a lot of words to convince them that it wasn't a big deal. Since it was the end of the semester and less than two weeks before the next exam, my parents and I unanimously decided to take a holiday.
Laser surgery has a strange pain
It turned out that it was better to wait until the holidays, otherwise I might not even be able to complete the exam.
After the holiday, my parents accompanied me to a large tertiary hospital. The doctor frowned at the slit lamp, "Why is your lesion area so big?", and gave the same diagnosis and treatment advice. Mom and Dad were worried, asking over and over again: "Do I need to check again?" Is this the case with the usual scenario? Are there any side effects of surgery? How risky is it? How long does it take to recover? ”
Having studied the photocoagulation technique many times earlier, I cried and laughed, resisted the urge to drag the second elder out of the clinic and carry out preoperative missions, and sat on a small bench to listen to the doctor patiently explain. He then signed the informed consent form as a 20-year-old, 11-month-old adult.
The doctor's cloud was light and breezy, I was basically calm, and my parents could not hide their nervousness. But the tension can't change the rule that I can only enter the laser room alone. Hearing the doctor call out my name, my parents stood on tiptoe in the corridor and watched as the door to the treatment room slowly closed.
Retinal laser photocoagulation is done so quickly, so quickly and so easily that doctors disdain to call it "surgery" but a "procedure".
When I went in, the doctor was "operating" for the patient in front of me, and another doctor confirmed the condition of my pupil and dropped two drops of anesthetic into my eyes. After a few minutes, the patient in front of me finished, the doctor gave me a few words, and then beckoned me to go over and sit down.
I didn't wear glasses, I couldn't see the machine clearly, it seemed to look like an optometry instrument, and I needed to put my chin on a table, and my eyes were facing the pores on the machine. I honestly put my chin on it and waited for the doctor to do it.
The laser can only hit one eye at a time, and the next day it can hit the other side, and it is my right eye that goes to the battlefield first.
The doctor incarnated as a soul painter and looked at the bottom of my eyes while drawing it out on the medical record book, which looked like a disc with a special pattern on it.
Doctor's schematic diagram of my right eye fundus 丨 Author courtesy of the author
The doctor picked up a small black unknown object: "Come, open your eyes, don't move!" ”
The next second, a magnifying glass, like the cylindrical magnifying glass worn by a watchmaker on my eyes, suddenly fit on my eyeballs.
"Don't move your chin, try not to turn your eyeballs, I'm going to start." It may be a little sore, if it is really uncomfortable, just tell me. ”
Putting on the magnifying glass, I was in front of a strange field of vision, bright and bright, with a distinct spot in the middle. I stared at the patch, afraid that if I accidentally turned my eyes, the laser would hit the side.
The laser on the retina is felt, warm and hot, and there is a pain that is not easy to describe, similar to closing your eyes and pressing the eyeball hard with your fingers, but with a bit of tingling. This feeling spread from the bottom of the eye to the brain in bursts, and it became more and more intense, although it was not hot, but the bottom of the eyes seemed to burn up. I subconsciously ducked back, the doctor stopped to remind me, and I put myself back in position and continued to accept the welding light.
Interestingly, I can see where and at what angle the laser is emitting, and the pain in the corresponding position of the eye also supports the visual conclusion. The laser played a full circle up and down left, right, left and right, and then made up a circle up and down left and right, and I spent seconds like a year. I don't know how long later, the magnifying glass on the eye was removed, and the doctor breathed a long sigh of relief: "Done!" Your lesion area is also too big. "Say, give me a piece of gauze.
I realized that my eyes were full of tears, so I gently wiped them. Still afraid of the light, I had to close my eyes and go out in the dark.
When I got home and looked in the mirror, I saw that the black pupils had expanded to almost invisible brown irises, like the heirs of magic cursed for angering the gods in the story, and the dilated eyes would glow enchantingly at night, absorbing the moonlight to maintain their poor life, and transforming it into the power to curse others...
When the eyes are completely better, go write a novel, I think.
The next day I cooperated with the operation of my left eye, and my parents still tiptoed to look at the closed door, but they were not so flustered.
Of course, the left eye also has its own schematic diagram.
Doctor's schematic diagram of my left eye fundus 丨 Author courtesy of the author
The doctor instructed that after the operation, you can rest for a day or two to read and write normally. My parents and I happily returned home.
After the operation I became a "presbyopia"
But I didn't expect to have a discussion class during the winter vacation of medical school. At two o'clock in the afternoon on the third day after the operation, a video class discussed the case.
So, after two days without glasses, I finally put on my glasses, turned on the computer, and the next second I found that I couldn't see things at all: closer was more blurry, and a little farther away was barely better. And why are the eyes so tired?
Combined with the comprehensive judgment of physical, biological and medical knowledge, I think it should be that the lens and vitreous body regulation ability is wrong, focusing the light behind the retina. Could it be that I am farsighted on the basis of myopia?
After hearing this, the father said, "Isn't this just presbyopia!" ”
Me: "..."
The course of the class was a disaster for me, and my eyes were too tired to do it. Looking at the computer up close, the presence of the ciliary muscle has never been stronger. Acid, swelling, numbness, pain, the vagueness of the immediacy, each adjective is accurate but not comprehensive. I had to compromise with this protest, taking off my glasses every ten minutes and letting my eyes rest for a while.
Schematic diagram of the structure of the eyeball丨 Ophthalmology (8th edition of the Human Health Edition)
The class was finally reluctantly completed, and a knowledge point was remembered throughout the whole process: the bilateral pupils were large and equal circles, and the reflection of light existed. I can't help but wonder, are my bilateral pupils now equal to the large isosphere? Thoughts flashed by, but they didn't take them to heart.
Reading a book, reading a computer, looking at a mobile phone, my eyes are blurry and tired. In the next few days, the eyes could not use the ears, so "Laughing Proud of the Rivers and Lakes" listened to dozens of chapters, and "Dream of the Red Chamber" also listened to a few chapters sporadically. Unfortunately, I did not have the habit and interest in listening to books, so I no longer insisted. In boredom, I have nothing to do except lie down, get up, and eat every day.
Could it be that the degree of myopia in the eye has changed after surgery? So I suggested: Go get back on your glasses.
I sat down again in front of the refractometer. The owner of the optical shop lightly and familiarly opted in, and then said that the degree was similar to before. "Can't see clearly? How can it be impossible to see? Farsighted? Old flowers? Aren't you in your twenties? He was puzzled.
Suddenly, the boss looked into my eyes and said, "Why are your pupils so big?" ”
After listening, I picked up the camera of my mobile phone and took a picture, only to see that the black pupils were extremely large, and the brown iris was squeezed into a shallow circle. In a trance, I remembered the novel inspiration in my mind that day.
After I explained it, the boss said that the atropine used for pupil dilating was supposed to be able to recover the next day, but due to some unknown reasons, my pupils on both sides did not fully retract back to normal size. The so-called "old flower" symptoms may be caused by this.
The boss also said: "I am not an ophthalmologist major, I don't know what the specific situation is." Hang up another day and take a look. ”
When I got home, it was getting thin and I was sitting in the car feeling restless. Growing up, I wasn't very strong, but I was basically healthy, and the biggest invasive operation I had ever done before was to pull out my crumbling deciduous teeth, and now the scene was beyond my comprehension. I began to panic, will there be any sequelae? Can you continue to go to college? In the wind, I looked at the end of the field of vision, and I couldn't help but think of one thing or another in my mind...
Without further ado, I went to the ophthalmology clinic early the next morning, a week after the surgery.
After listening to my description, the doctor turned on the flashlight and shined it in my eyes, looked at it again with a slit lamp, and then said, "You had more retinopathy areas before, and it was more marginal." When the laser is applied, it may hit the ciliary muscles, causing them to be in a state of congestion and edema. Pupillary contraction requires ciliary muscle adjustment, so the pupillary response will be sluggish. After a while it will be fine, a few days to a month or two is possible, the problem is not big. Don't read books lately, you can't read clearly anyway. You don't need to drop any medicine, just rest well. ”
Outpatient review of medical records 丨 Author courtesy of the picture
This is great news!
In the next few weeks, from not daring to watch anything at the beginning, to being able to watch the Winter Olympics on TV, to going to the supermarket to buy something and read the price tag, and finally to reading the literature... The vision from large to small, the time from short to long, the pupil and the life of the minute and second, have gradually returned to normal. This "storm under the eyes" has finally come to a successful end.
Review of fundus results 丨 Courtesy of the author
Before the start of the school year, I went to the hospital again for a re-examination, and the fundus angiography was renewed, and the edges were complete and smooth. I remembered a saying that my mother often taught me: There are thousands of cells in your body (I interrupted her, is it 10 to the 14th power) working hard, but only when something goes wrong will we realize their existence, and only then will we begin to regret not protecting them, so we must remember to be kind to your cells.
Doctor reviews
Yan Shi | Deputy Chief Physician, Department of Ophthalmology, Second Hospital of Shanxi Medical University
In the mainland, the incidence of myopia is getting higher and higher, and it has become an important social problem that seriously endangers the eye health of the mainland people. Clinically, myopia is more than 600 degrees or the length of the eye axis exceeds 26 mm, which is called high myopia, also known as pathological myopia.
It is called pathological myopia because in addition to ocular refractive abnormalities, it is often accompanied by various pathological lesions of the eyeball, of which degeneration of the retina, hiatus, cleavage, bleeding, detachment and other lesions are the most common. These pathological impairments of the eye prevent a significant proportion of highly myopic patients from achieving clear and satisfactory corrected vision.
The retina is a translucent membrane attached to the bottom of the eyeball, when the degree of myopia continues to increase, the eyeball is extremely elongated, the inner layer of the retina will be thinned by pulling, too thin may occur various pathological damage to the retina, such as the occurrence of a rift, and after the appearance of retinal rifts, it is very easy to secondary retinal detachment.
Patients with high myopia have a 7 to 8-fold higher risk of retinal detachment than non-highly myopic patients. There are some patients with high myopia, whose myopia and eyeball length will continue to increase over life, individual patients will exceed 2000 degrees of myopia, the length of the eye axis exceeds 33 mm, and the risk of the above pathological damage is higher.
Retinal rift 丨Tencent Medical Code
Therefore, it is recommended that patients with high myopia do vision, refraction, and mydriatic fundus examination every six months to one year. In this article, the author found a retinal crack in a routine eye examination, and thus received timely treatment to avoid adverse results, which is worth advocating.
Clinically, xenon lasers can be used for the treatment of retinal tears, and their safety, efficacy and convenience have been generally recognized. The mechanism of laser photocoagulation is to prevent the occurrence of retinal detachment through the thermal effect of the laser to make the retinal nerve epithelium, pigment epithelium and choroidal tissue firmly adhesion. In this article, the author has personally experienced the above-mentioned precision diagnosis and treatment technology of fundus diseases, and is a beneficiary of the development of modern medicine.
Myopia focuses on early prevention, early detection, and early treatment. Children and adolescents should increase outdoor activities, pay attention to eye habits, and regularly conduct eye health checks and establish eye refractive development files to help early detection of poor vision. Children with myopia tendencies and myopia should follow the doctor's advice to scientifically control the development of myopia and avoid the development of high myopia.
Sharing personal experience does not constitute a diagnosis and treatment recommendation, can not replace the doctor's individual judgment of a specific patient, if you need to go to a regular hospital.
Author: Xiao Wang
Editors: Xiao Ai, Li Xiaoqiu