Floaters, Flashes, and Amsler Grid Distortions in Vision

Amaurosis fugax, floaters, flashes?

Good evening, I apologize for disturbing you during your busy schedule.
First of all, thank you very much for taking the time to answer my questions.
I have floaters in my vision and just finished an appointment with an ophthalmologist today, but I feel that my regular eye doctor couldn't fully address my concerns.
1.
After dilating my pupils, I followed the instructions to look at the Amsler grid and noticed that the lines were moving around.
It looked like small bugs or electric currents, about 2 to 3 squares long, twisting here and there, not fixed in one place, and appearing and disappearing across the entire grid.
It also resembled a very thin black line that seemed to be causing small distortions.
I felt like the whole grid was constantly twisting behind a heat haze, which was quite nauseating.
When wearing glasses, the situation was very obvious when my vision was blurry; however, if I forced my eyes to focus on the grid (like cross-eyed), the issue disappeared.
2.
Occasionally, I see a point that resembles a negative image drifting by; sometimes it’s a bright spot, and other times it’s a dark spot.
It drifts a very small distance before disappearing, lasting no more than a second, but it appears in a similar location each time, almost certainly the same point, though it is not fixed and moves slowly.
The ophthalmologist suggested that this might be a discharge phenomenon from retinal degeneration remnants.
Is this a serious condition? (This situation has been ongoing for a while, though I’m not sure how long; it should be shorter than the duration of my floaters.)
3.
When I close my left eye, I occasionally see faint flashes of light.
When I open my eyes, I can't confirm this due to interference from other light sources.
This occurs mostly within the first five minutes after closing my eyes, and then it almost never happens.
Research indicates that this could be due to vitreous pulling on the retina, but the doctor said my retina is "fine." How "fine" is it if I am experiencing flashes?
4.
When I close my eyes, I see extremely faint bright spots drifting around.
I am trying to rationally describe my symptoms in hopes of causing you the least trouble possible.
Additionally, I feel bad for bothering you, but due to my location and family circumstances, it is not very convenient for me to seek treatment in other cities.
Could you recommend an ophthalmologist in Taipei?
What should I do to take better care of my eyes? I enjoy reading, drawing, and watching animated works; does this mean I can no longer do these things? The doctor I saw was very conservative, but I am genuinely scared.
My eyesight has not been good since birth, with astigmatism and amblyopia.
I have had floaters since middle school, and honestly, I am terrified; even the slightest issue makes me panic.
Am I going to go blind one day? I’m not joking; I am really scared, but no one believes me.
Everyone says I’m overreacting and worrying unnecessarily...
I have done research, read articles, and consulted doctors, but the more I find out, the more scared I become.
What should I do?

Star, 20~29 year old female. Ask Date: 2018/08/27

Dr. He Jianxian reply Ophthalmology

1.
When examining the Amler's grid, please test without using dilating drops.
2 & 3.
If there are no issues found during the dilated examination, there is generally no need for concern.
4.
You can basically do whatever you like, and it will not affect your eye health.
I do not have any specific ophthalmologists to recommend in Taipei.
Worrying unnecessarily is completely unhelpful; if the examination shows no problems, you should feel reassured.

Reply Date: 2018/08/27

More Info

Understanding floaters, flashes, and distortions in vision can be quite complex, especially when you are experiencing symptoms like yours. Let's break down your concerns and provide some clarity.

1. Floaters and Amsler Grid Distortions: Floaters are tiny spots or strands that drift through your field of vision. They are often caused by changes in the vitreous gel that fills the eye, which can become more liquid and allow these particles to float. When you observe distortions in the Amsler grid, such as lines appearing wavy or moving, it can be indicative of issues related to the retina or the vitreous body. The fact that you see these distortions more prominently when your vision is blurred suggests that your eye may be straining to focus, which can exacerbate the perception of these floaters.

2. Flashes of Light: The flashes you describe, especially when closing your eyes, could be due to the vitreous gel pulling on the retina. This is known as posterior vitreous detachment, which is common and usually not serious. However, if you experience an increase in flashes or new floaters, it is essential to consult an eye care professional, as these can sometimes indicate retinal tears or detachment.

3. Color Changes in Vision: The presence of colors in the Amsler grid, especially if they are inconsistent, can be related to how your brain processes visual information. This could be a benign phenomenon, but it’s crucial to monitor any changes. If your eye doctor has ruled out significant issues during your examinations, it’s a good sign, but continuing to observe your symptoms is wise.

4. Managing Anxiety About Eye Health: It’s understandable to feel anxious about your vision, especially given your history of eye problems. It’s important to remember that while floaters and occasional flashes are common, they should be monitored. Regular check-ups with your eye doctor are essential, and if you feel that your symptoms are worsening, don’t hesitate to seek further evaluation.

5. Eye Care and Maintenance: To maintain eye health, consider the following tips:
- Regular Eye Exams: Keep up with your scheduled eye exams, especially since you have a history of eye issues.

- Protect Your Eyes: Wear sunglasses to protect against UV rays and reduce glare.

- Limit Screen Time: Take regular breaks when using screens to reduce eye strain (the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds).

- Healthy Diet: Consume a diet rich in antioxidants, omega-3 fatty acids, and vitamins A, C, and E, which are beneficial for eye health.

- Stay Hydrated: Drink plenty of water to keep your body and eyes hydrated.

6. Engaging in Hobbies: You mentioned enjoying reading, drawing, and watching animations. These activities are generally safe for your eyes, but be mindful of how long you spend on them. Ensure you have good lighting and take breaks to prevent fatigue.

7. Finding a Specialist: If you are looking for an eye doctor in Taipei, consider seeking recommendations from local health forums or community groups. You can also check with hospitals that have reputable ophthalmology departments.

In conclusion, while your symptoms can be concerning, many individuals experience similar issues without serious consequences. Continue to monitor your symptoms, maintain regular check-ups, and practice good eye care habits. If you ever feel uncertain or anxious, don’t hesitate to reach out to your eye care provider for reassurance and guidance.

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