Vitreous Detachment: Symptoms and Concerns for High Myopia

Flashes caused by vitreous traction on the retina?

Hello Doctor, I am highly myopic (approximately 800 degrees after dilation) and have recently started experiencing floaters over the past few months.
I would like to ask you the following questions:
1.
One of the floaters, which was originally 2 cm long, has grown to 5-6 cm, and it seems to be getting longer.
I recently had a dilated eye exam, and the doctor mentioned that the floaters are more concentrated, possibly due to eye strain or lack of sleep.
If it continues to grow (get larger), should I seek further examination?
2.
What are the typical circumstances under which flashes caused by vitreous traction on the retina occur?
3.
Is it possible that the following symptoms are manifestations of flashes due to vitreous traction on the retina? Occasionally, when I open my eyes, I see white light spots flickering, and sometimes I see blue light spots that appear for a second or two and then disappear.
4.
Do retinal tears usually present with symptoms?
5.
After retinal detachment surgery, is it possible for vision to recover to the level it was before the detachment? I am quite anxious, so I have many questions.
Thank you very much for taking the time to answer them.

Miss Chen, 20~29 year old female. Ask Date: 2016/08/26

Dr. Cai Wenyuan reply Ophthalmology

1.
If there are changes in floaters, it is still recommended to seek medical evaluation.
2.
It is difficult to determine from the pattern of flashes.
3.
Possible.
4.
Not necessarily, depending on the size of the retinal tear.
5.
Very few.
Thank you.

Reply Date: 2016/08/26

More Info

Understanding vitreous detachment and its implications, especially in the context of high myopia, is crucial for maintaining eye health. High myopia, defined as a refractive error greater than -6.00 diopters, can lead to various complications, including vitreous detachment, retinal tears, and even retinal detachment.
1. Regarding the increase in the size of your floaters: Floaters are often caused by changes in the vitreous gel that fills the eye. As we age or in the case of high myopia, the vitreous can become more liquefied and pull away from the retina, leading to the perception of floaters. If you notice that a floater is increasing in size, it is advisable to seek further evaluation from an eye care professional. While floaters can be benign, significant changes, especially in the context of high myopia, warrant a thorough examination to rule out any potential retinal issues.

2. Vitreous traction and flashes of light: Flashes of light, or photopsia, can occur when the vitreous gel pulls on the retina. This traction can stimulate the retinal cells, causing the sensation of light. Flashes are often described as brief and may occur in peripheral vision. If you experience persistent flashes, it is important to consult an ophthalmologist, as this could indicate a more serious condition, such as a retinal tear.

3. White and blue light spots: The appearance of white or blue light spots can indeed be related to vitreous traction. These phenomena may occur when the vitreous is exerting pressure on the retina. However, it is essential to differentiate between benign flashes and those that could signify a retinal issue. If these occurrences are frequent or accompanied by other symptoms, such as an increase in floaters or a shadow in your vision, an immediate evaluation is necessary.

4. Symptoms of retinal tears: Retinal tears may not always present with obvious symptoms, but they can be associated with sudden increases in floaters, flashes of light, or a shadow or curtain effect in the peripheral vision. If you experience any of these symptoms, it is crucial to seek medical attention promptly, as early intervention can prevent retinal detachment.

5. Recovery of vision post-retinal detachment surgery: The prognosis for vision recovery after retinal detachment surgery varies. Factors influencing recovery include the duration of the detachment, the area of the retina affected, and the presence of any complications. Some patients may regain vision close to their pre-detachment level, while others may experience permanent changes. Regular follow-ups with your ophthalmologist are essential to monitor recovery and manage any complications.

In summary, as a person with high myopia, it is vital to remain vigilant about changes in your vision, particularly the appearance of new floaters or flashes of light. Regular eye examinations and prompt attention to any concerning symptoms can help mitigate the risks associated with vitreous detachment and retinal complications. If you have any further questions or concerns, do not hesitate to reach out to your eye care provider for personalized advice and management.

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