Increasing Eye Floaters and Flashing Lights: When to Seek Further Evaluation

The appearance of flashes of light and an increasing incidence of floaters in the eyes over the years?

Hello Doctor, two years ago I was diagnosed with a degenerative retinal tear due to floaters and underwent laser treatment.
For the first one to two years after the treatment, I didn't have any significant issues.
However, now I feel that the floaters seem to be increasing, and when I look at the sky, the elongated floaters appear to be longer.
Occasionally, I also see small flashes of light.
Although I had a dilated eye exam earlier this month and was told everything was fine, I am still very concerned.
Should I undergo another dilated eye exam, or is there any other treatment I should consider? Thank you very much for your response.

Mr. Chen, 20~29 year old female. Ask Date: 2021/08/20

Dr. He Jianxian reply Ophthalmology

Generally, when there is a change in the condition of floaters, a dilated fundus examination is necessary.
However, if no new findings are observed during the dilation, there is usually no need for excessive concern.
Director He Jian-xian, Ophthalmology Department, Nantou Hospital.

Reply Date: 2021/08/20

More Info

When it comes to eye floaters and flashing lights, especially after a history of retinal issues, it is essential to remain vigilant and proactive about your eye health. Your experience with floaters and flashes can be concerning, particularly given your previous diagnosis of a degenerative retinal tear and subsequent laser treatment.
Floaters are typically caused by changes in the vitreous gel that fills the eye. As we age, the vitreous can become more liquid and may pull away from the retina, leading to the perception of floaters. These can appear as small dots, lines, or cobweb-like structures that drift across your field of vision. Flashes, on the other hand, occur when the vitreous pulls on the retina, stimulating it and causing the sensation of light.
Given your history of retinal issues, it is crucial to monitor any changes in your symptoms closely. The increase in floaters and the appearance of new flashes can sometimes indicate a more serious condition, such as retinal detachment or a new tear. While your recent dilated eye exam showed no immediate problems, it is important to understand that symptoms can evolve.
Here are some guidelines on when to seek further evaluation:
1. Increase in Floaters: If you notice a significant increase in the number of floaters, particularly if they are accompanied by flashes of light, this warrants immediate attention.
2. New Flashes: The appearance of new flashes, especially if they are frequent or persistent, should be evaluated by an eye care professional.
3. Changes in Vision: Any changes in your vision, such as blurriness, shadows, or a curtain-like effect, should prompt an urgent visit to your eye doctor.

4. Regular Monitoring: Given your history, regular follow-ups with your ophthalmologist are advisable. Even if your last examination was clear, your symptoms suggest that another evaluation may be prudent.

5. Peace of Mind: If you are feeling anxious about your symptoms, it is always better to err on the side of caution. Requesting another dilated eye exam can provide reassurance and help rule out any potential issues.

In terms of management, if your ophthalmologist determines that your symptoms are benign and not indicative of a serious condition, they may recommend monitoring your symptoms over time. However, if there are any signs of retinal complications, they will discuss appropriate treatment options with you.

Additionally, it is essential to practice good eye health habits. This includes protecting your eyes from excessive strain, ensuring proper lighting when reading or using screens, and taking regular breaks to reduce fatigue.
In summary, while your recent examination showed no immediate concerns, the increase in floaters and the appearance of flashes should not be taken lightly, especially given your medical history. It is advisable to consult your eye care provider for a thorough evaluation to ensure your retinal health remains stable. Regular monitoring and open communication with your ophthalmologist will help you manage your symptoms effectively and maintain your eye health.

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