Floaters and Light Flashes: Causes and Solutions for Young Eyes

Vitreous opacities

Hello Doctor: In my first year of high school, I started wearing orthokeratology lenses (OK lenses) at an ophthalmology clinic.
After a few months, I began to see two black floaters.
By the second year, I might have gotten red eye syndrome due to not cleaning the lenses properly, which was quite severe; my eyes were as red as jelly.
Around this time, I noticed that when looking at things, especially white walls or the sky, I would see a lot of small light spots moving around, almost like they were accelerating.
In my third year, I discovered that when I rapidly moved my eyes, I would see flashes of white light.
When I closed my eyes and looked at that light, it resembled a lightning bolt moving from top to bottom.
Sometimes, when looking at certain areas, it appeared as if it were raining, even though it wasn't.

I would like to ask the doctor: A: Are the black floaters, small light spots, and white flashes caused by the OK lenses or the red eye syndrome? B: What type of floaters are these? I found many descriptions online, such as scintillating scotoma or vitreous opacities...
C: If they are not related, why did I suddenly develop the condition of seeing many small light spots? D: Do you have any suggestions? How can my eyes be like this at just 19 years old when I use them appropriately?

Henry, 10~19 year old female. Ask Date: 2017/03/14

Dr. Cai Wenyuan reply Ophthalmology

Hello, the black spots, small light points, and white light you are experiencing are not caused by OK lenses or conjunctivitis.
This type of floaters is generally due to vitreous liquefaction.
Do you have any recommendations? How can my eyes be like this at just 19 years old? I use my eyes moderately, so there’s no need to worry; just regular check-ups are sufficient.
Wishing you safety and health.
Sincerely, Dr.
Tsai Wen-Yuan, Director of Ophthalmology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2017/03/14

More Info

Understanding floaters and light flashes can be quite concerning, especially for young individuals like yourself. Based on your description, it seems you are experiencing a range of visual disturbances, including floaters (the "black mosquitoes" you mentioned), light flashes, and small light points that appear when looking at bright backgrounds. Let's break down your questions and concerns.

A: Are the floaters and light phenomena caused by the OK lenses or the conjunctivitis (red eye)?
While it's difficult to definitively attribute your symptoms to the use of OK lenses or the conjunctivitis you experienced, there are some connections worth noting. Contact lenses, especially if not cleaned properly, can lead to various eye issues, including infections and inflammation, which could potentially exacerbate underlying conditions. Conjunctivitis itself typically does not cause floaters or light flashes, but it can lead to temporary visual disturbances due to irritation or inflammation of the eye.

B: What type of floaters are these?
Floaters are often caused by changes in the vitreous humor, the gel-like substance that fills the eye. As we age, the vitreous can become more liquid and may pull away from the retina, leading to the appearance of floaters. In younger individuals, floaters can also be a result of vitreous detachment or changes in the vitreous gel, which can happen due to various factors, including eye trauma or inflammation. The "small light points" you see could be related to the same vitreous changes or could be a phenomenon known as "photopsia," which is often associated with retinal issues.

C: Why did I suddenly start seeing many small light points?
The sudden onset of visual disturbances like small light points can be alarming. This phenomenon can occur due to several reasons, including:
1. Vitreous Detachment: As mentioned, the vitreous gel can pull away from the retina, leading to floaters and flashes of light.

2. Retinal Issues: Conditions such as retinal tears or detachments can cause similar symptoms and require immediate medical attention.

3. Migraine Aura: Even without a history of migraines, some individuals can experience visual disturbances similar to migraine auras, which can include flashes of light or zigzag patterns.

4. Photophobia: Sensitivity to light can cause discomfort and lead to the perception of light flashes or spots, especially in bright environments.

D: Recommendations and Advice
Given your age and the symptoms you're experiencing, it's crucial to take these visual disturbances seriously. Here are some recommendations:
1. Regular Eye Exams: Continue to have regular check-ups with your eye care provider. If you notice any changes in your vision, such as an increase in floaters, flashes of light, or any new visual symptoms, seek immediate evaluation.

2. Monitor Symptoms: Keep track of when these symptoms occur and any potential triggers, such as lighting conditions or activities. This information can be helpful for your eye doctor.

3. Protect Your Eyes: Ensure that you are using your contact lenses correctly, including proper cleaning and storage. Consider taking breaks from lens wear if you experience discomfort or irritation.

4. Healthy Eye Habits: Maintain a balanced diet rich in vitamins A, C, and E, omega-3 fatty acids, and antioxidants, which are beneficial for eye health. Additionally, practice the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds to reduce eye strain.

5. Seek Specialist Care: If your symptoms persist or worsen, consider seeing a specialist, such as a retinal specialist, who can provide a more in-depth evaluation of your eye health.

In conclusion, while some visual disturbances can be benign, others may indicate underlying issues that require attention. It's essential to stay vigilant about your eye health and communicate openly with your healthcare provider about any changes you experience.

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