Flashing Lights and Floaters: When to Seek Eye Care

Vitreous floaters and flashes

Hello Doctor, I have a prescription of -3.25 for my left eye and -3.00 for my right eye, with both eyes having a reading of +1.00.
Since last week, while studying, I have started to notice a flickering light above my left eye, resembling a fluorescent light.
After seeing a doctor and undergoing a fundus examination, the doctor said everything was fine and that the flickering might be due to the vitreous pulling on the retina, but they couldn't say when it might tear.
I would like to ask the following questions:
1.
After my visit, I have developed a new symptom: I now see a distinct light moving from the upper left to the lower left, and the frequency of the flickering in the upper left has increased (originally, I only noticed it while studying, but now I see it in daily life, though not constantly).
Does this mean my condition has worsened? Should I return for another consultation or go to a larger hospital?
2.
The flickering is due to the vitreous pulling, and I read that once the vitreous completely detaches, the flickering issue will resolve.
After that, will there be any harm or impact on my eyes?
3.
However, the doctor I consulted mentioned that they cannot predict when the retina might tear, implying that this could eventually lead to retinal detachment and blindness.
How long does this process typically take?
4.
Recently, my left eye has been particularly sore and fatigued, while my right eye feels fine.
Is this related to the vitreous pulling?
5.
Currently, I can see without major issues, but I do experience flickering and flashes.
How serious is my condition? Previously, the doctor said that any flickering should be checked promptly, but my examination showed no problems.
Is there a chance that this flickering could disappear?
Thank you, Doctor, for your assistance!

Jie, 20~29 year old female. Ask Date: 2020/06/15

Dr. Gao Pilin reply Ophthalmology

Hello Jie,
1.
After my consultation, I developed a new symptom where I see a distinct flash of light moving from the upper left to the lower left.
Additionally, the frequency of seeing flashes in the upper left has increased (previously, I would only see them while studying, but now I notice them in daily life, though not constantly).
Does this mean my condition has worsened? Should I return for another consultation or go to a larger hospital?
A: This kind of situation can vary.
If the flashes occur only occasionally and not constantly, you can monitor it.
2.
The flashes are caused by the vitreous pulling on the retina, and I read that once the vitreous completely detaches, the flashing issue will resolve.
After this, will there be any harm or impact on my eyes?
A: This is a harmless change.

However, my doctor mentioned that with this condition, it's uncertain when the retina might tear, implying that it could eventually lead to retinal detachment and blindness.
How long does this process usually take?
A: It does not necessarily happen.
If a retinal tear occurs, early treatment can prevent retinal detachment.
Early retinal detachment can also be treated promptly without necessarily leading to blindness.
3.
Recently, my left eye feels particularly sore and fatigued, while my right eye does not.
Is this related to the vitreous pulling?
A: No, it is not related.
It is more associated with eye strain.
4.
I currently have no major issues seeing things, just the flashes and flickering.
How serious is my condition? A previous doctor mentioned that flashes should be checked quickly, but my examination showed no problems.
Is there a chance that these flashes will disappear?
A: If the examination showed no issues, it is not considered serious, and there is a chance that they will disappear.
The flashing problem should resolve once the vitreous completely detaches.
Taiwan E-Hospital Puzi Hospital Ophthalmology: Monday, Tuesday, Thursday, Friday mornings 8:00 AM – 12:00 PM; Wednesday afternoons 2:00 PM – 4:30 PM.
Online responses are for reference only; if necessary, you should visit a medical facility.
I hope to have the opportunity to assist you.
Gao Pi-Lin

Reply Date: 2020/06/15

More Info

When experiencing flashing lights or floaters in your vision, it can be concerning, especially if you have a history of eye issues such as myopia or retinal problems. Based on your description, it seems you are dealing with a few different symptoms that warrant careful consideration.

1. Increased Frequency of Flashing Lights: The fact that you have noticed an increase in the frequency of flashing lights, especially when reading or during daily activities, is something to take seriously. While your doctor has indicated that the flashes may be due to vitreous traction (the vitreous gel pulling away from the retina), any new or worsening symptoms should prompt a follow-up visit. It’s essential to monitor these changes closely, as they could indicate a potential issue with the retina, such as a tear or detachment. If the flashes become more frequent or are accompanied by other symptoms like a sudden increase in floaters or a shadow in your vision, you should seek immediate medical attention.

2. Vitreous Detachment and Retinal Health: You mentioned that your doctor indicated that the flashes might resolve once the vitreous completely detaches from the retina. While vitreous detachment is a common occurrence, particularly in individuals with myopia, it can sometimes lead to complications, including retinal tears or detachment. The timeline for these changes can vary significantly from person to person. Some may experience a gradual detachment without issues, while others may face complications. Regular eye examinations are crucial to ensure that any potential problems are caught early.

3. Eye Strain and Fatigue: The discomfort and fatigue you are experiencing in your left eye could indeed be related to the vitreous traction. When the vitreous pulls on the retina, it can cause discomfort, especially if you are focusing intently on tasks like reading. It’s also possible that your eye strain is exacerbated by prolonged screen time or reading without adequate breaks. Implementing the 20-20-20 rule—taking a 20-second break to look at something 20 feet away every 20 minutes—can help alleviate some of this strain.

4. Severity of Symptoms: The severity of your symptoms can be subjective, but it’s important to remember that any new visual disturbances should be taken seriously. While your previous examinations showed no immediate issues, the presence of flashing lights and increased floaters can indicate underlying changes in the eye that require monitoring. It’s not uncommon for patients to experience anxiety about their symptoms, especially when they are aware of the potential risks associated with vitreous detachment and retinal issues.
In conclusion, while your symptoms may not indicate an immediate crisis, they do warrant careful monitoring and possibly further evaluation. If you notice any significant changes, such as a sudden increase in flashes or floaters, or if you experience any new symptoms like a shadow or curtain over your vision, seek medical attention promptly. Regular follow-ups with your eye care provider are essential to ensure your retinal health remains stable, especially given your history of myopia and previous retinal concerns. Remember, it’s always better to err on the side of caution when it comes to your vision.

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