Eye Floaters: When to Consult a Neurologist

The mysterious eye abnormalities and issues related to neurology?

Hello Doctor: I have floaters, and after a car accident, I felt that my condition worsened, so I immediately went to the hospital's ophthalmology department to check for any eye-related issues.
After the consultation, the ophthalmologist conducted various functional tests and emphasized that there were no problems with my retina, suggesting that it might be a neurological issue, and recommended that I see a neurologist.
However, although I have issues with migraines, I do not always experience headaches when I notice strange phenomena in my eyes, and I am unsure if this indicates another condition.
My symptoms are as follows: after reading for a long time, I see wavy patterns and flickering lights around my eyes, and sometimes I experience a whole area of flashing or bright light, with occasional headaches that do not necessarily occur after the flashes or may be completely absent.
Could you please explain why this is happening? Should I go to a medical center with the relevant equipment and instruments, or is a general hospital sufficient? Can I expect improvement or even a cure through medical treatment? Thank you for your response!

Mu Di, 20~29 year old female. Ask Date: 2020/02/28

Dr. Jiang Junyi reply Neurology

Hello, based on your description, what could be the reason for this? If the ophthalmologist has ruled out floaters or papilledema, a common possibility is a migraine with aura, which typically presents with visual disturbances before the headache occurs.
Additionally, abnormal electrical discharges in the brain can produce similar symptoms.
Should I go to a medical center with the necessary equipment and instruments, or is a general hospital sufficient? It is advisable to visit a healthcare facility with an emergency department, as they can at least perform a CT scan of the brain.
Other tests may include EEG, visual evoked potentials, MRI, etc.
Can I expect improvement or even a cure through medical treatment? For neurological conditions, it is important to identify the underlying cause and receive appropriate treatment.
Generally, maintaining a regular lifestyle and supplementing with B vitamins can enhance the body's natural healing abilities.
I recommend consulting a neurologist to discuss testing and treatment options.
However, due to the recent surge in COVID-19 cases, it is advisable to wait until the situation stabilizes before going to the hospital for examinations, or to implement self-protection measures and maintain cleanliness and disinfection.
Wishing you good health and peace.
Dr.
Jiang from Taoyuan Medical Center cares about you.

Reply Date: 2020/02/28

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your eye floaters and the associated symptoms you are experiencing. Based on your description, it seems that you are dealing with a complex interplay of visual disturbances and potential neurological issues. Let’s break down your symptoms and the appropriate steps you should take.

Eye floaters, or "myodesopsia," are common and often benign. They typically appear as small spots, threads, or cobweb-like shapes that drift across your field of vision. They are usually caused by changes in the vitreous gel that fills the eye as we age. However, in your case, you mentioned that your floaters have worsened following a car accident, which raises some concerns.

The symptoms you describe—seeing water-like waves, flickering lights, and flashes—could indicate a few different conditions. While the ophthalmologist has ruled out retinal issues, it is wise to consider neurological factors, especially since you have a history of migraines. Migraines can sometimes cause visual disturbances known as "aura," which can include flickering lights or zigzag patterns. However, the fact that these symptoms do not consistently coincide with your headaches suggests that there may be another underlying issue at play.

Given that your symptoms have escalated after a traumatic event, it is crucial to consult a neurologist. They can perform a thorough evaluation, which may include imaging studies such as an MRI or CT scan, to rule out any neurological conditions that could be contributing to your visual disturbances. Conditions such as posterior vitreous detachment, retinal tears, or even more serious neurological disorders could manifest in similar ways, and a neurologist is well-equipped to assess these possibilities.

As for your question about whether you should visit a specialized medical center or a general hospital, it would be advisable to seek care at a facility that has a comprehensive neurology department. This will ensure that you have access to the necessary diagnostic tools and specialists who can provide a thorough evaluation of your symptoms.

In terms of treatment and management, the prognosis for floaters and associated visual disturbances can vary. Many people find that their floaters become less noticeable over time, and while they may not completely disappear, they often learn to adapt to their presence. If a neurological cause is identified, treatment will depend on the specific diagnosis. For instance, if migraines are confirmed, managing triggers and possibly using preventive medications may help alleviate your symptoms.

In summary, your symptoms warrant further investigation by a neurologist, especially considering the recent trauma and the nature of your visual disturbances. It is essential to address these concerns promptly to rule out any serious conditions and to explore potential treatment options. I encourage you to seek an appointment with a neurologist as soon as possible.

Take care, and I wish you the best in your journey toward understanding and managing your symptoms.

Sincerely,
Doctor Q&A Teams

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