Changes in Floaters: When to Seek Eye Care

Changes in the pattern of floaters?

Hello, Dr.
Gao.
I started experiencing floaters over a month ago.
I have undergone 1-2 dilated retinal examinations, which showed no issues, except for a larger than normal optic nerve head cupping.
Currently, both OCT and visual field tests are normal, and I am continuing to monitor the situation.
Initially, when looking at the sky, I saw what resembled television static with a few single-celled organisms.
Recently, when looking at a white ceiling, I noticed solid white circles that fade when I stare at them for too long.
I went for another dilated examination, and there were no abnormalities.
However, in the past couple of days, when looking at a white ceiling with one eye (both eyes are affected), I see faint yellow spiderwebs, which are less noticeable when using both eyes.
I understand that there are many types of floaters, but it is concerning that I have experienced different types in just over a month.
As I am highly myopic (with prescriptions of -8.00 to -8.25), I am worried that my floaters may be worsening and whether there could be retinal pathology.
I am also anxious about whether I need to undergo another dilated examination.
I would like to ask you, Dr.
Gao:
1.
If the appearance or type of floaters changes (for example, initially seeing solid white circles and then also noticing spiderwebs, with both types present), do I need to undergo another dilated examination? (I just had a dilated exam the day before, and then new symptoms appeared the next day, which is quite distressing.)

2.
I have read that if there is a significant increase in floaters or a change in their appearance, accompanied by flashes of light or blurred vision, immediate medical attention is necessary.
Do all these conditions need to be met to indicate a potential retinal pathology?
3.
Following up on the previous question, how can I determine if there is a significant increase in floaters? Currently, I see them as noise and cannot confirm their actual number.
If there were a significant increase, would it be easy to notice?
4.
I visited an eye clinic where they provided information on dilating drops, mentioning that there is a very small chance of side effects.
If I frequently undergo dilated examinations, could this potentially harm my eyes in the long term?
I apologize for the numerous questions, and I appreciate your time in addressing them.
Thank you.

Ms. Chen, 20~29 year old female. Ask Date: 2016/06/08

Dr. Gao Pilin reply Ophthalmology

Hello Ms.
Chen,
1.
Floaters generally do not have a fixed shape, and since you were examined just the day before, it should not be related.
2.
Floaters are essentially a degeneration of the vitreous body and are not associated with retinal diseases.
However, sometimes when the vitreous degenerates, it can pull on the retina, leading to an increase in the number or change in the shape of floaters, accompanied by flashes of light or blurred vision.
Additionally, when there is a retinal tear or bleeding into the vitreous, a different type of floaters may occur.
3.
A significant increase in floaters will be very noticeable and may also cause changes in your visual field.
4.
If the examination results are normal, there is no need for frequent dilated eye exams.
The likelihood of side effects is actually quite low.
At the E-Hospital in Puzi, Taiwan, the ophthalmology department is open Monday to Friday from 8:00 AM to 12:00 PM and Wednesday afternoons from 1:00 PM to 4:30 PM.
Please note that online responses are for reference only, and it is essential to seek medical attention at a healthcare facility if necessary.
I hope to have the opportunity to serve you.
Best regards,
Gao Pilin

Reply Date: 2016/06/08

More Info

Hello! Thank you for your detailed questions regarding your experience with floaters and your concerns about potential retinal issues. It’s understandable to feel anxious, especially when experiencing changes in your vision. Let’s address your questions one by one.

1. Changes in Floaters and Need for Further Examination: It’s common for individuals with high myopia (nearsightedness) to experience floaters, and these can change in appearance over time. If you notice new types of floaters, such as the appearance of a spider web pattern, it’s advisable to consult your eye care professional. While you recently had a dilated retinal exam that showed no issues, any new or significant changes in your floaters warrant further evaluation. This is particularly important for high myopes, as they are at a higher risk for retinal tears or detachments.

2. Indicators of Retinal Issues: You are correct that an increase in floaters, especially when accompanied by flashes of light (often described as "lightning" or "flashes") and changes in vision (like blurriness), can be signs of potential retinal problems. However, not all changes in floaters indicate a serious issue. It’s crucial to monitor your symptoms and seek immediate care if you experience a sudden increase in floaters, especially if they are accompanied by flashes or a shadow in your peripheral vision. These symptoms could indicate a retinal tear or detachment, which requires urgent attention.

3. Determining an Increase in Floaters: The term "massive increase" can be subjective. If you feel that the number of floaters has significantly increased to the point where they are affecting your daily activities or vision, it’s worth discussing this with your eye doctor. Many patients describe a sudden onset of floaters as a noticeable change, often feeling overwhelmed by their presence. If you find that your floaters are becoming more distracting or numerous, it’s a good idea to have them evaluated.

4. Frequency of Dilated Exams and Potential Risks: Dilated eye exams are essential for monitoring eye health, especially for individuals with high myopia. While there are some risks associated with the use of dilating drops (such as increased sensitivity to light and blurred vision for a few hours), these are generally minimal and temporary. The benefits of regular monitoring, especially in your case, far outweigh the risks. Frequent examinations can help catch any potential issues early, which is crucial for maintaining your vision.

In summary, while floaters are often benign, changes in their appearance, especially in the context of high myopia, should be taken seriously. Regular follow-ups with your eye care provider are essential to ensure your retinal health is monitored closely. If you experience any new symptoms or significant changes, don’t hesitate to seek care. Maintaining a proactive approach to your eye health is the best way to manage your concerns and ensure your vision remains stable.
Lastly, managing anxiety related to vision changes can be challenging. Consider discussing your feelings with your eye care provider, who can provide reassurance and guidance tailored to your specific situation. Remember, you are not alone in this, and there are professionals ready to help you navigate these concerns.

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