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Li Zhuo
Ophthalmology
About me
Master supervisor, doctoral graduate, member of the Hunan Society of Bioengineering Materials. Deputy director of the drug clinical trial office at the Second Xiangya Hospital. Graduated from Hunan Medical University in 1999, joined the ophthalmology department of the Second Xiangya Hospital, and has been engaged in clinical ophthalmology work for 20 years. Obtained a doctoral degree in 2007. Attended a one-year advanced study program at THE MEDICAL CITY in the Philippines in 2010-2011, completing training in cataract surgery, optical coherence tomography, fluorescein angiography diagnosis, and 23G minimally invasive vitreous surgery. In 2016-2017, sponsored by the China Scholarship Council, conducted research studies at Thomas Jefferson University in the U.S., visiting the second-ranked Wills Eye Hospital. Led one provincial-level research project, participated in one national-level research project, and one provincial-level research project. Published 3 SCI papers and 3 articles in domestic core journals.
Proficient in diseases
Diagnosis and treatment of retinal vascular diseases, retinal detachment, diabetic retinopathy, fundus diseases, systemic diseases related to retinal diseases, and cataract diseases.
Voices
How to deal with inverted eyelashes
For trichiasis, it first depends on the nature of the ingrown eyelashes. If there are only a few, such as one or two, it is recommended to pluck them out. For some people, once these are plucked, the new eyelashes may grow back in the correct position, so no further treatment is necessary. If the ingrown eyelashes recur repeatedly as individual lashes, electrolysis of the hair follicle can be performed to destroy the follicle, preventing the eyelashes from growing back. However, because this is a destructive procedure, many hospitals have discontinued it, though some still offer this treatment. If there are many ingrown eyelashes, appearing in rows, the treatment depends on the position of the eyelid. Eyelash correction surgery may be necessary. Depending on the specific situation, excision of the tarsal plate to correct the trichiasis can be considered as well.
Can people with night blindness undergo myopia surgery?
Night blindness is mostly due to abnormalities in the retinal pigment epithelial cells, because when these cells are abnormal, it leads to abnormalities in the rod cells, which sometimes leads to night blindness. This is because rod cells are responsible for seeing in low light, proving that this refractive system’s weakness is akin to a camera’s film being damaged. In the case of performing surgery for nearsightedness, it is primarily because there's an issue with the eye’s refractive system, similar to having a damaged camera lens. While a damaged lens can be repaired, if the film is faulty, even a perfectly repaired lens won't improve the camera's imaging function. Thus, night blindness primarily involves the retina, whereas surgery for nearsightedness mainly involves the lens and cornea. If the retina's condition is poor, then vision improvement from nearsightedness surgery will be limited because the effectiveness of such surgery relies on the pre-surgery vision achievable with glasses. If vision with glasses is inadequate, the surgical outcomes tend to be suboptimal. Generally, we do not recommend laser surgery for patients with night blindness.
Causes of Night Blindness
Night blindness generally falls into two categories. The first type is due to a deficiency in Vitamin A, which leads to abnormal metabolism of retinol, preventing the perception of low light and thus causing symptoms of night blindness. The other condition is retinitis pigmentosa, where the photoreceptor cells in our retina responsible for detecting light at night, mainly the rod cells, undergo premature apoptosis, resulting in poor light perception. Retinitis pigmentosa can be congenital, caused by genetic mutations or abnormalities, but it can also be secondary to other diseases. Conditions like choroiditis or choroid retinitis inflammation can lead to abnormalities in the rod cells, which can also result in night blindness. The specific causes need to be examined.
Can people with trichiasis exercise?
Do you mean that it involves usual activities such as running or other sports? Trichiasis primarily results from the poor positioning of eyelashes, which touch the cornea, mainly damaging the corneal epithelium. Treatment can be based on the extent of trichiasis. If there are many inverted eyelashes, a correction surgery for trichiasis can be performed. If there are fewer, plucking them is possible, and corneal nutrients can be administered, such as Hailu eye drops and the antibiotic eye drops ofloxacin. It does not affect normal activities and sports in general. I am not sure if this answers your question; this is a general description of the condition of trichiasis.
Treatment methods for retinal detachment
Retinal detachment surgery primarily refers to the treatment of rhegmatogenous retinal detachment. There are two methods of treatment: one is external surgery, also known as scleral buckling. This involves using a compressive object to indent the sclera to support the choroid, and then employing cryotherapy to create a sterile adhesion between the choroid and the retina, thus treating the retinal detachment. Another method is internal surgery, also known as vitreoretinal surgery. This procedure involves making three incisions in the flat part of the sclera, removing the vitreous from the inside, flattening the retina with heavy water, and using a laser to create a sterile adhesion between the retina and the choroid. Currently, the surgical treatment for retinal detachment consists of these two approaches: internal and external surgeries.
Retinal detachment refers to the condition where the retina pulls away from its normal position.
The structure of the human eye consists of three layers: the sclera, the choroid, and the retina. Retinal detachment is not actually a separation between the retina and the choroid, but rather a separation between the neural epithelial layer and the pigment epithelial layer of the retina, which means it is a detachment between the inner nine layers and the outermost layer of the retina. Retinal detachment can be classified into three types: rhegmatogenous retinal detachment, which is mainly caused by a tear in the retina allowing the vitreous fluid to enter the subretinal space; tractional retinal detachment, which occurs due to vitreous and retinal proliferation exerting traction on the retina, commonly seen in diabetic retinal detachment; and exudative retinal detachment, which is caused by accumulation of fluid between layers due to abnormal choroiditis.
Can children with astigmatism undergo laser surgery?
Firstly, laser surgery is generally performed after the age of 18, as people's eyes continue to grow. This means that just like when a person stops growing taller, the eyes also stop growing at a certain age. If laser surgery is performed too early, while the eyes are still growing, the results may regress over time. Therefore, astigmatism in children should only be addressed after they reach adulthood, usually after the age of 18, but we generally recommend waiting until after the age of 21. Additionally, if the progression of the eye prescription is less than 50 to 100 degrees per year, the surgery outcomes are more likely to be stable. Generally, laser surgery is primarily used for myopia, which pertains to issues with seeing distant scenes, whereas astigmatism, which generally affects horizontal vision, is usually not corrected through laser surgery.
When is the second surgery for retinal detachment?
The question you asked is about when the second surgery for retinal detachment should take place, which implies that the first surgery for retinal detachment failed, necessitating a second surgery. Due to the proliferation of the retina, which generally peaks around two to three weeks, it is recommended that if the first surgery fails, the second surgery should be conducted about 10-14 days after the first surgery, which is about half a month later. This timing can help reduce the failure rate of the surgery and avoid the peak proliferation period of the retina.
Can you take a plane with a detached retina?
Retinal detachment and flying are divided into pre-surgery and post-surgery considerations. Before retinal detachment surgery, it is generally permissible to fly, as this typically does not significantly impact the symptoms of retinal detachment. However, what occurs after the surgery must be considered. If, after surgery, only silicone oil is used as a filler, flying is permissible as it does not affect pressure changes. However, if an inert gas is used as a filler after retinal detachment surgery, it can expand due to changes in air pressure at high altitudes. This expansion increases its volume, which can alter the internal pressure of the eye, potentially compressing the eyeball and the retina, leading to ischemia of the central retinal artery. In such cases, where inert or expansible gases are filled within the eye, flying is not advisable until the gas has dissipated.
What is the vision like after the removal of silicone oil for retinal detachment?
Silicone oil is temporarily used to support the retina in our eyes, and its refractive power is roughly equivalent to that of a 600-degree pair of glasses. Thus, if you are not myopic, you might become nearsighted after the silicone oil is used. After the retina detaches and the silicone oil is removed, the vision mainly depends on the function of the retina, which has no relation to the silicone oil. Just as with myopia, wearing a pair of glasses might change the vision, but once the glasses are removed, the vision will revert to the retina's vision. Therefore, it mainly depends on how much vision was left before the retina detached. The recovery of the retinal function and the optic nerve function is related, and this doesn't have much to do with the silicone oil. The vision primarily depends on the remaining function of the retina.