the Worsening of Floaters: Symptoms and Concerns Explained

Q: the Worsening of Floaters: Symptoms and Concerns Explained

Hello Sabina： 1. These are all phenomena associated with floaters. 2. This is also a manifestation of vitreous degeneration. 3. This may also be a sign of vitreous degeneration; however, it can also occur before a migraine attack. 4. No, it will not. <

Worsening of floaters?

Dear Dr.
Gao,
I have congenital myopia.
During a check-up in first grade, my left eye was diagnosed with -500 diopters of myopia, while my right eye was normal.
However, due to long-term reliance on my right eye, it has now progressed to -1300 diopters, and my left eye to -1800 diopters.
I have been engaged in text-related work for many years, using my eyes frequently, but aside from severe myopia, I have not experienced any other issues.
Two years ago, I began to notice floaters.
Initially, I was alarmed, but later realized that it was just a small circle about 2 millimeters in my upper right visual field, so I didn't pay much attention to it.
Around the same time, I felt discomfort when wearing contact lenses for extended periods; my eyes would feel dry and sometimes itchy, even experiencing sudden sharp pain, so I switched back to glasses.

However, since June of last year, the floaters in my right eye have worsened, with the small circle resembling branched tree limbs, measuring at least three centimeters, and sometimes moving rapidly in front of my eyes, which is quite bothersome.
The semicircular floater in my left eye has also increased in size but appears less frequently.

My questions are as follows:
1.
After the worsening of my floaters, I seem to experience strange visual phenomena at night, seeing many small light points or beams dancing in the dark.
When I close my eyes in the dark, I sometimes see a group of small black dots, sometimes shadows flowing like ink, and sometimes white mist moving.
I also see these phenomena when my eyes are open in the dark.
Is this a common occurrence with floaters? However, during the day, when I wear glasses, I can see clearly and do not notice these strange phenomena.
2.
Recently, I experienced flashes in both eyes (appearing around and above the eyes), but they have become less frequent.
However, sometimes in the morning, I feel light shadows around my eyes, like a faulty light bulb flickering, which disappears after three minutes.
Is this also related to the floaters?
3.
Once, at 3 AM while watching TV in the living room, I suddenly noticed jagged flashes in my right eye when closed, and when I opened my eyes, I saw the same flashes looking at the wall.
This lasted for at least ten minutes before disappearing.
This has only happened once; what could be the cause?
4.
I had a dilated fundus examination last August, and the doctor said there were no retinal tears or detachments, only vitreous opacities along with dry eye syndrome.
Can dry eye syndrome accelerate the worsening of floaters?
5.
Does vitreous opacity indicate severe liquefaction? Once liquefaction reaches a certain level, could it lead to blindness? I am really worried.

I apologize for the lengthy message.
I kindly ask for your clarification on these matters.
Thank you!

Shabina, 40~49 year old female. Ask Date: 2021/01/16

Dr. Gao Pilin reply Ophthalmology

Hello Sabina: 1.
These are all phenomena associated with floaters.
2.
This is also a manifestation of vitreous degeneration.
3.
This may also be a sign of vitreous degeneration; however, it can also occur before a migraine attack.
4.
No, it will not.
5.
Vitreous opacities are a result of vitreous aging, which causes liquefaction of the vitreous body, leading to the aggregation of proteins into opaque spots or lines, or causing vitreous detachment, resulting in small circular opacities.
These opacities float within the vitreous, blocking light and projecting shadows onto the retina, which is what we perceive as dark spots.
Vitreous liquefaction is a normal degenerative process and will not lead to blindness.
For more information, you can visit the ophthalmology department at Puzi Hospital in Taiwan: Monday, Tuesday, Thursday, and Friday from 8:00 AM to 12:00 PM, and Wednesday from 2:00 PM to 4:30 PM.
Online responses are for reference only; it is necessary to seek medical attention at a healthcare facility if needed.
I hope to have the opportunity to serve you.
Gao Pilin

Reply Date: 2021/01/16

More Info

Hello! Thank you for sharing your concerns about your eye health. It sounds like you have been experiencing a range of symptoms related to your vision, particularly with floaters and other visual disturbances. Let’s break down your questions and concerns regarding floaters, their potential causes, and what you should consider moving forward.

1. Floaters and Visual Disturbances: Floaters are small spots or lines that appear in your field of vision, often described as "cobwebs" or "strings." They are typically caused by changes in the vitreous humor, the gel-like substance that fills the eye. As we age or due to conditions like high myopia (nearsightedness), the vitreous can become more liquid, leading to the formation of floaters. The fact that you notice more floaters in low light or when your eyes are closed could be related to how your eyes are processing light and shadows in those conditions. It is not uncommon for floaters to appear more pronounced in dim lighting.

2. Flashes of Light: The flashes of light you describe, especially the zigzag patterns, can be concerning. These are often referred to as "photopsia" and can occur when the vitreous pulls on the retina. While they can be benign, they can also indicate more serious conditions, such as retinal tears or detachment. Since you mentioned that these flashes have decreased in frequency, it may not be an immediate concern, but it is essential to monitor them closely.

3. Vitreous Changes and Retinal Health: Your previous eye examination indicated no retinal tears or detachment, which is reassuring. However, the presence of zigzag flashes, especially if they occur again, warrants immediate attention from an eye care professional. It’s crucial to have regular check-ups, especially given your history of high myopia and the changes in your vision.

4. Dry Eye Syndrome: Dry eye can indeed exacerbate discomfort and may contribute to visual disturbances. While it may not directly cause floaters to worsen, the discomfort from dry eyes can lead to increased awareness of floaters and other visual phenomena. Managing dry eye through artificial tears or other treatments can help improve your overall comfort and visual clarity.

5. Vitreous Liquefaction: Vitreous liquefaction is a natural part of aging and can lead to more floaters as the gel-like substance becomes more liquid. While it is generally not a direct cause of blindness, significant changes in the vitreous can lead to complications, such as retinal detachment. It’s essential to maintain regular eye exams to monitor these changes and ensure that your retina remains healthy.

In conclusion, while floaters and visual disturbances can be common, especially in individuals with high myopia, it’s crucial to remain vigilant about any new or worsening symptoms. I recommend scheduling a follow-up appointment with your eye care provider to discuss your symptoms in detail. They may suggest further testing or monitoring to ensure that your eye health remains stable. Remember, early detection and intervention are key to maintaining good vision and preventing complications. Take care of your eyes, and don’t hesitate to seek help when you notice changes in your vision!

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