Vitreous Detachment: Managing Floaters and Flashes in Myopia

Floaters, vitreous degeneration, retina?

Hello! I have high myopia and astigmatism in both eyes, with myopia over 600 degrees and astigmatism over 300 degrees.
In August of this year, I noticed black shadows floating in my vision.
After an examination, it was confirmed that I have floaters, and the doctor explained that my high myopia has led to vitreous liquefaction, causing the floaters.
Additionally, due to the high myopia, my retina is thinner, but the examination showed no tears, only some points where the vitreous is pulling on the retina more strongly.
The doctor recommended laser treatment as a preventive measure.
Less than a week after the laser treatment, I noticed flashes of light in the upper part of my left eye, but the number of floaters did not increase, and there were no obstructive shadows in my vision.
Concerned, I went for a second consultation, and the doctor said the flashes were due to the vitreous pulling on the retina, but since there were no tears, no further laser treatment was performed.
Almost a month later, I noticed flashes on the right side of my right eye (described as flashes, but they feel more like ripples), and the frequency of flashes in my left eye increased, prompting a third visit.
However, the doctor still stated there were no tears, but the pulling in both eyes was significant, so I underwent preventive laser treatment again.
After the third laser treatment, I continue to experience flashes in both eyes.
1.
Is it normal to see flashes due to vitreous pulling on the retina when there are no retinal tears? (I found online that seeing flashes or ripples is a sign of retinal detachment, but I couldn't find information about cases like mine where there are no tears but persistent flashes and ripples.)
2.
Are there any methods to stabilize the vitreous and prevent it from continuously pulling on the retina? (I have asked the doctor, but he said there is no solution, and I just have to adapt.
However, I fear that continuous pulling may eventually lead to tears.)
3.
The doctor mentioned that I might have a naturally thicker adhesion between the vitreous and the retina, causing stronger pulling.
Are there others like me?
4.
Are there any foods that can benefit the retina and vitreous?
Thank you for addressing my questions.
I have consulted with doctors and researched extensively, but I haven't found much help...

A Ya, 10~19 year old female. Ask Date: 2018/11/07

Dr. He Jianxian reply Ophthalmology

Flashes of light are caused by the vitreous pulling on the retina, and they do not necessarily lead to a tear, nor is there an absolute correlation with retinal detachment.
When the pulling force diminishes (which may occur if the vitreous separates from the retina, but could also result in a tear), the flashes will naturally subside.
It is recommended that if the frequency of flashes increases rapidly or is accompanied by a significant increase in floaters, one should seek medical attention for a dilated eye examination as soon as possible.
Currently, there are no specific methods to prevent vitreous liquefaction and traction.

Reply Date: 2018/11/07

More Info

Hello! Thank you for reaching out with your concerns regarding your eye health, particularly in relation to your high myopia and the symptoms of floaters and flashes you are experiencing. I understand that this can be a very anxious time for you, especially given the complexity of your condition. Let’s address your questions one by one.

1. Flashes and Floaters Without Retinal Tears: It is indeed possible to experience flashes of light and floaters without having any retinal tears or holes. In your case, the vitreous gel inside your eye is likely undergoing changes due to the high myopia, which can lead to a phenomenon known as vitreous traction. This occurs when the vitreous pulls on the retina, causing the perception of flashes or light streaks. While many resources may indicate that flashes are a sign of retinal detachment, it’s important to note that not all flashes are indicative of a tear. Your ophthalmologist’s assessment that there are no retinal tears is reassuring, but it’s crucial to monitor these symptoms closely.

2. Stabilizing the Vitreous: Unfortunately, there are no specific treatments available to stabilize the vitreous gel or prevent it from pulling on the retina. This is a natural aging process that can be exacerbated by high myopia. Your doctor is correct in stating that adaptation is often the best approach. Regular follow-ups with your ophthalmologist are essential to monitor any changes in your condition. If you notice any sudden changes in your vision, such as an increase in the number of flashes or floaters, or a shadow or curtain over your vision, you should seek immediate medical attention.

3. Increased Vitreous Adhesion: It is not uncommon for individuals with high myopia to have a more adherent vitreous gel, which can lead to stronger traction on the retina. This can vary from person to person, and while some may experience significant traction without any issues, others may develop complications. Your experience is not unique, and many individuals with high myopia report similar symptoms. It’s essential to maintain open communication with your eye care provider about your symptoms and any changes you experience.

4. Diet and Eye Health: While there is no specific diet that can reverse vitreous changes or prevent traction, a healthy diet rich in antioxidants can support overall eye health. Foods high in vitamins C and E, omega-3 fatty acids, and lutein (found in leafy greens) are beneficial for retinal health. Staying hydrated is also important for maintaining the health of the vitreous. Regular eye exams and protecting your eyes from UV light by wearing sunglasses can further support your eye health.

In conclusion, while your symptoms can be concerning, it’s important to remember that many individuals with high myopia experience similar issues without developing serious complications. Regular monitoring by your ophthalmologist is key to managing your condition. If you have further questions or if your symptoms change, don’t hesitate to reach out to your eye care provider. They are your best resource for personalized advice and treatment options. Take care of yourself, and remember that maintaining a healthy lifestyle can positively impact your overall well-being.

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