30M High Myope (-5.00) with incidental Lattice Degeneration. Docs suggest barrage laser, but I’m leaning toward watchful waiting. Thoughts on my logic?
TL;DR: Went to the eye doctor for a minor, transient floater. They accidentally found lattice degeneration (no holes/tears). Two doctors recommended prophylactic barrage laser. Because my floaters were mild/temporary and I have zero flashes, I consider myself asymptomatic and want to choose watchful waiting based on the AAO's ~1% detachment risk stats. Am I being reasonable or reckless?
The Background:
- Demographics: 30-year-old Male.
- Prescription: Left Eye -5.00 SPH (-2.00 CYL), Right Eye -1.75 SPH (-1.00 CYL).
- The Incident: I had a minor "black spot" floater in my right eye that lasted maybe 1-2 days and then faded into the background. I went to get it checked out just to be safe.
- The Diagnosis: The dilated exam found textbook peripheral lattice degeneration in my highly myopic left eye. There are no holes, no tears, and no active traction.
- The Recommendation: Two different doctors at two different clinics recommended bilateral barrage laser as a preventative measure.
My Dilemma (The Gray Zone): I fully understand that my -5.00 eye is structurally stretched and at a higher baseline risk. However, I feel like I am being pushed toward over-treatment due to "defensive medicine."
Because I had "floaters" written on my chart as a chief complaint, I suspect I got bumped into the "symptomatic" protocol. But those floaters were transient, completely resolved, and never accompanied by flashes of light.
My Logic for Watchful Waiting: I’ve been reading up on the American Academy of Ophthalmology (AAO) Preferred Practice Pattern. From what I understand:
- Prophylactic laser is not routinely recommended for strictly asymptomatic lattice degeneration.
- Roughly 8-10% of the population has lattice, but the lifetime risk of it causing a retinal detachment is only around 1%.
- I am not getting cataract surgery or LASIK, and I haven't had a detachment in my other eye & neither a case of such in family history.
I am highly diligent about my health. I am more than willing to commit to strict, annual dilated exams and I know exactly what emergency symptoms to look out for (flashes, a sudden shower of new floaters, the "curtain" effect).
My Question for the Sub: Professionals and fellow myopes: Is my logic sound here? Does an isolated, resolved floater justify moving from a "watchful waiting" approach to immediately undergoing barrage laser for intact lattice? I want to make sure I'm not using statistics to talk myself out of a necessary procedure.
(Note: I have fundus photos/OCT scans if anyone needs to see them!)