Floaters: Common Concerns and Eye Health Insights - Ophthalmology

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Floaters issue?


Hello, Doctor.
I discovered a shadow in my vision on December 31, 2016.
After undergoing a dilated eye exam at the ophthalmologist on January 2, 2017, I was diagnosed with floaters.
The doctor mentioned that there were no holes in my retina and suggested that it might be due to fatigue.
However, I did notice a black spot closer to the optic nerve.
I have high myopia, with both eyes at -8.00 diopters (also experiencing flashes).
After dilation, my prescription decreased to -6.50 diopters.
I only have floaters in my left eye, while my right eye is unaffected.
The shape of the floaters seems to change slightly every day, but they are all black (like spots) and drift with my line of sight.
The number has not increased, but when I look at a clear sky, I notice some translucent ripples and additional spots.

I have several questions for you, Doctor:
1.
The floaters appear to be in the upper left of my vision, but they sometimes move around and obstruct my sight before drifting away.
Is this related to my condition?
2.
The doctor mentioned that the black spot near the optic nerve could be a concern for traction.
What does that mean?
3.
Why did my myopia decrease to -6.50 diopters after dilation?
4.
Ever since the examination revealed the floaters, I've felt something unusual in my left eye; it feels tight at the corner and occasionally has a slight sting.
Is this an issue with my cornea or retina?
5.
It seems easier to ignore the floaters when looking at distant objects, but they are more noticeable when looking at things up close.
Is this normal?
6.
During the examination, the doctor only checked my left eye (possibly because I was too nervous and scared).
Should both eyes be examined?
7.
Besides flashes of light, does retinal detachment also cause pain?
Thank you very much, Doctor! I apologize for having so many questions.

An, 30~39 year old female. Ask Date: 2017/01/05

Dr. Gao Pilin reply Ophthalmology


Hello: 1.
This is a phenomenon of floaters, which can appear to drift and fluctuate.
2.
It is likely that during vitreous detachment, it may pull on the optic nerve or retina.
3.
After dilation, myopia usually decreases because the ciliary muscle is almost completely relaxed.
4.
A stinging sensation is likely an issue with the external part of the eye and should not be related to the retina.
5.
Yes, it is related to refraction.
6.
It is best to have both eyes examined.
7.
Usually not.
Taiwan E-Hospital Puzi Hospital Ophthalmology: Monday to Friday from 8:00 AM to 12:00 PM and Wednesday from 1:00 PM to 4:30 PM.
Online responses can only serve as a reference; it is necessary to seek medical attention at a healthcare facility.
I hope to have the opportunity to serve you.
Gao Pilin

Reply Date: 2017/01/05

More Info


Understanding floaters and their implications for eye health is crucial, especially for individuals with high myopia, as they may be at a greater risk for various eye conditions. Based on your concerns and the information provided, let's address your questions and provide some insights into floaters, their causes, and what you should be aware of regarding your eye health.

1. Floaters and Their Movement: Floaters are small specks or strands that drift through your field of vision. They are typically caused by changes in the vitreous gel that fills the eye. When you notice them moving or obstructing your vision, it can be concerning. However, this is a common experience, especially in individuals with high myopia. The fact that they seem to move with your gaze is normal, as they are suspended in the vitreous fluid and will shift as your eyes move.

2. Black Dot Near the Optic Nerve: When your doctor mentioned that a black dot is near the optic nerve, they were likely referring to a floater that is situated close to the area where the optic nerve exits the eye. This can be concerning because if the vitreous gel pulls on the retina (which can happen with floaters), it could potentially lead to retinal tears or detachment. Regular monitoring and follow-up with your eye care professional are essential to ensure that no significant changes occur.

3. Decrease in Myopia After Dilation: The reduction in your myopia measurement after dilation can occur due to several factors. Dilation allows the eye care professional to get a better view of the retina and vitreous. Sometimes, the measurement can appear lower because the eye's focusing mechanism is temporarily altered during the dilation process. This is not a permanent change in your prescription.

4. Discomfort and Tightness in the Eye: The sensation of tightness or mild pain in your eye could be related to several factors, including eye strain, dry eyes, or even anxiety about your eye condition. It's essential to communicate these symptoms to your eye doctor, as they can help determine if there is an underlying issue with your cornea or retina.

5. Visibility of Floaters: It is common for floaters to be more noticeable when looking at a plain, bright background, such as a clear sky. This is because the contrast makes them stand out more. When looking at detailed or darker objects, they may be less noticeable, which is a normal experience.

6. Bilateral Eye Examination: While your doctor focused on your left eye, it is generally a good practice to have both eyes examined, especially if you have concerns about your vision. If you feel anxious during examinations, consider discussing this with your doctor beforehand, as they may have strategies to help you feel more comfortable.

7. Symptoms of Retinal Detachment: Retinal detachment can occur without pain, but some individuals may experience flashes of light or a sudden increase in floaters. Pain is not a typical symptom of retinal detachment. If you experience sudden changes in vision, such as a curtain-like shadow or a significant increase in floaters, seek immediate medical attention.

In conclusion, while floaters are often benign, especially in the context of high myopia, it is crucial to maintain regular eye examinations to monitor any changes in your condition. Your eye care professional can provide tailored advice and reassurance based on your specific situation. Additionally, managing eye strain through proper breaks during screen time, maintaining good hydration, and using artificial tears for dryness can help alleviate some discomfort. Always prioritize open communication with your healthcare provider regarding any new or worsening symptoms.

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