When a doctor tells you a five-minute procedure could save you from going blind, it seems like “yes” would be the automatic answer.
So this doctor was shocked when the patient refused care—but this isn’t the first time it’s happened. The refusal, plus the fear tied to it, is more common than you might think. Commenters are split on what they would do in the same situation.
Eye Doctor In Disbelief
In a TikTok with more than 5,300 views, retina specialist Zack Oakey, MD (@drzackoakey), recounts a patient encounter that clearly stuck with him.
He explains that a woman in her mid-60s had slipped and fallen in the shower, briefly lost consciousness, and ended up in the emergency room. The day after she was discharged, she started noticing floaters in her left eye. She went to an optometrist at Costco, got an image taken, and was referred to Dr. Oakey after the optometrist flagged something worth looking into, and upon inspection he found a retinal tear.
“To me, a retinal tear is almost like having a heart attack,” he says. “And a retinal detachment is like dying or having really severe heart failure from a heart attack.”
His recommendation was laser treatment. It’s a quick fix by most medical standards. Five minutes, some bright light, a couple of what he describes as “zingy feelings,” and done.
Dr. Oakey explains that it substantially reduces the risk of the tear progressing into a full retinal detachment, which can cause permanent blindness. Dr. Oakey walked her through the risks, benefits, and alternatives the way he does with every patient. The alternative to laser, he explained, is doing nothing. And doing nothing means a serious risk of going blind.
And that’s what she chose. The woman told him she didn’t want the laser.
“It kind of shook me a little bit,” he admits. But he didn’t push back hard or make her feel judged. He told her he disagreed with her decision. He says he gave her a document from the American Society of Retina Specialists explaining retinal tears and why treatment is almost always recommended. And he made clear he’d be ready whenever she changed her mind.
“It’s their body,” he says. “They’re fully informed. They know what the risks are. I try not to be angry or mad or sad or whatever. I just recognize it’s that person’s body. I’m only making a recommendation. And they accept the risk.”
What Is A Retinal Tear?
The retina is a thin, light-sensitive layer of tissue at the back of the eye. According to Cleveland Clinic, a retinal tear happens when the gel-like vitreous humor inside the eye pulls on the retina and causes a split. It’s not the same as a retinal detachment, but an untreated tear can absolutely become one.
Symptoms can include a sudden increase in floaters, flashes of light, and blurred vision, though Cleveland Clinic notes you can also have a tear with zero symptoms at all, which is part of what makes them so dangerous. Risk factors include getting older, being nearsighted, and having a family history of retinal detachment.
As for the laser procedure itself, it works by creating small burns around the tear that form scar tissue, sealing it off and preventing fluid from getting behind the retina.
Medical News Today reports success rates over 90%, with the whole thing typically wrapping up in under 15 minutes. Recovery is minimal. Most people are back to normal within a few weeks. And a study published via the American Academy of Ophthalmology found that patients who underwent laser prophylaxis developed retinal tears or detachments at a rate of only 17% over a five-year followup. That’s compared to 41% in those who skipped treatment.
Commenters React
“At the age 65 the term LASER is very intimidating,” a top comment read.
“I am an optometrist in Costco and I had a patient with an asymptomatic retinal tear; I sent her to my wonderful retina specialist who of course recommended laser. The patient called me, extremely skeptical. She called me to say ‘I don’t understand why I need laser. I was FINE until you took that picture of my eye.’ Thank goodness I was able to convince her and the procedure went very well,” a person said.
“Off the options presented to me (lazer, surgery , blindness) I thought the lazer sounded pretty chill! It’s not the best but it’s doing some great work for me,” another wrote.
“Married to an ophthalmologist, I had a retinal tear. The recommendation was laser surgery. (I’m pretty sure my husband likes me and wanted the best for me) My husband’s partner did the laser surgery and I’m very thankful!” a commenter added.
@drzackoakey How would you feel if you were in my shoes? #eyes #retina #retinaldetachment #retinaltear #vision
BroBible reached out to Zack Oakey, MD for comment via email and Instagram direct message.