Visual Disturbances: Flashes, Floaters, and Eye Health Concerns

Frequent fixed bright spots or black dots in the eyes, along with flashes of light, may indicate enhanced scintillating scotoma?

Hello Dr.
Gao, I apologize for disturbing you during your busy schedule.
I have read many of your responses to different patients and noticed that you are truly very patient; thank you.
Since I developed floaters in January, I have recently felt that my symptoms of visual snow are gradually worsening.
I see bright spots in areas of bright light, including sunlit asphalt roads and illuminated books.
These bright spots seem to move along a fixed path (they are not very dense, resembling white blood cells in blood vessels).
I also occasionally experience the sensation described online as visual snow.
Additionally, I see a fixed black spot in my left eye, especially when looking at shadows or dark objects, but it disappears with a blink or a quick glance.

I have fixed bright spots that are very bright and feel like they emit strong light or have an electric sensation, but they also disappear with a blink.
These bright spots are extremely small, approximately less than 0.5 mm in size, and last less than one second.
When looking at distant black objects (like a black car or tree shadow) in bright light, I notice an unusual deep black shape (not very noticeable) flickering around my central vision.
This symptom occurs in both eyes when I close them in the dark.

When my left eye is exposed to bright light at a specific angle, I see a jagged bright light near the bridge of my nose, but it is not like lightning; it resembles the way light looks through water.
Is it possible that this is due to vitreous condensation affecting the angle of light?
I would also like to ask Dr.
Gao if the small fixed black spots or bright spots that disappear with a blink could be a sign of mild macular degeneration.
I visited Beirong and Renai hospitals this week, where I underwent dilated fundus examinations—one with a slit lamp and the other while lying down.
However, they both said my eye structure is normal and there are no issues.
They suggested seeing a neurologist if I am still concerned, and they did not recommend an OCT.
However, I am still worried.
Can mild macular degeneration be missed during a fundus examination? Is an OCT necessary to detect it? Are there any risks associated with OCT?
Additionally, during my examination at Beirong, the doctor mentioned that I had something resembling bugs on my eyelashes and recommended that I use cleansing pads.
However, I am unclear about how long I need to use them to eliminate these bugs.
Last year, out of curiosity, I intermittently used a mobile VR headset for two months and pressed on my eyeballs once, with each VR session lasting no more than 10 minutes, but I developed floaters in January.
I am nearsighted, with both eyes around 400 degrees and astigmatism of 100-200 degrees.
I usually do not wear glasses.
Could my lack of glasses and the resulting focal confusion be causing the bright spots? Or could my newly prescribed glasses be creating a visual illusion?
Since floaters are a sign of vitreous degeneration, do you recommend that I continue jogging? I am really afraid that even moving my eyes might strain my retina.
Additionally, I have been experiencing a sensation of flickering darkness, particularly when exposed to specific dim fluorescent lights, but it does not flicker when I close my eyes in complete darkness.
Could this be a sign of optic nerve inflammation?
I love playing the piano and singing.
Could this increase in brain pressure affect my eyes in any way?
Lastly, I am unsure if I have dry eye syndrome.
Sometimes, I feel a foreign body sensation in specific areas of my eyes, but they are quite moist.
It’s very strange.
Thank you so much for reading this, Dr.
Gao.
I apologize for my anxious thoughts; I am just a very worried university student.

Xuan, 20~29 year old female. Ask Date: 2021/04/28

Dr. Gao Pilin reply Ophthalmology

Hello,
1.
It could be vitreous floaters.

2.
It might be photopsia.

3.
Under strong light, this can happen.

4.
It could be vitreous degeneration.

5.
Macular degeneration does not go away, so it is not that; if the examination is normal, there is no need to worry too much.

6.
You may need to go for further examination to see if there are any other issues.

7.
VR and vitreous floaters should not be related.

8.
It should not be related.

9.
You can go for a light jog.

10.
It is unlikely to be optic neuritis.

11.
It will not affect intracranial pressure.

12.
You can undergo a dry eye test.
Sometimes, dry eyes can cause discomfort and tearing.

Taiwan E-Hospital Puzi Hospital Ophthalmology:
Monday, Tuesday, Thursday, Friday from 8:00 AM to 12:00 PM
Wednesday from 2:00 PM to 4:30 PM
Online responses can only serve as a reference; if necessary, it is still important to seek medical attention at a healthcare facility.
I hope to have the opportunity to serve you.

Dr.
Gao Pilin

Reply Date: 2021/04/28

More Info

Dear Patient,
Thank you for your detailed inquiry regarding your visual disturbances, including flashes, floaters, and other eye health concerns. I appreciate your patience and willingness to seek clarification on these issues, as they can indeed be quite distressing.

1. Understanding Your Symptoms: The symptoms you describe, such as seeing bright spots or flashes of light, especially in bright environments, can be associated with several conditions, including floaters and photopsia (flashes of light). Floaters are often caused by changes in the vitreous gel of the eye, which can become more common with age or due to other factors such as trauma or myopia (nearsightedness). The bright spots you see may be related to the way light interacts with the vitreous or the retina.

2. Potential Causes: The fixed black spots and bright points that disappear with blinking could be related to the vitreous pulling on the retina, which is not uncommon. However, if you have had a thorough examination and your retina is healthy, this is generally less concerning. The symptoms you describe, including the zigzag patterns and flashes, could also be indicative of a migraine aura, even if you do not have a history of migraines.

3. Concerns About Macular Degeneration: You mentioned concerns about mild macular changes. While a standard eye examination can reveal many issues, Optical Coherence Tomography (OCT) is a more advanced imaging technique that can provide detailed images of the retina and help detect subtle changes that may not be visible during a regular exam. It is a non-invasive procedure with no significant risks, and it can be very helpful in assessing the health of your macula.

4. Impact of Eyewear: Not wearing corrective lenses when needed can lead to visual strain and may exacerbate symptoms like flashes or floaters. If you have recently received new glasses, ensure they are properly prescribed and fitted. Incorrect prescriptions can lead to visual distortions and discomfort.

5. Physical Activity and Eye Health: Regarding your question about running and the risk of retinal detachment, while it is important to be cautious, moderate exercise is generally safe for individuals with floaters, provided there are no other underlying retinal issues. However, if you experience any sudden changes in vision, such as an increase in floaters or flashes, you should seek immediate medical attention.

6. Flashes in Low Light: The flashes you experience in dim lighting could be related to the way your eyes adapt to changes in light. If these symptoms persist or worsen, it may be worth discussing further with your eye care provider.

7. Eye Pressure and Activities: Playing instruments or singing does not typically cause increased intracranial pressure unless there are underlying health issues. However, if you have concerns about your eye health or symptoms, it is always best to consult with a healthcare professional.

8. Dry Eye Symptoms: The sensation of having something in your eye, despite adequate moisture, could indicate dry eye syndrome or other conditions. It may be beneficial to discuss this with your eye doctor, who can recommend appropriate treatments, such as artificial tears or other therapies.

9. Managing Anxiety: It’s understandable to feel anxious about your symptoms, especially when they are persistent. Consider discussing your concerns with a mental health professional or a counselor who can help you manage anxiety related to your health.

In conclusion, while many of your symptoms can be benign, it is crucial to maintain regular check-ups with your eye care provider. If you continue to experience significant changes in your vision or if your symptoms worsen, do not hesitate to seek further evaluation. Your eye health is important, and addressing these concerns with a professional can provide peace of mind.

Best wishes for your health and well-being.

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