Eye Health: Addressing Floaters, Flashes, and Dim Vision

Q: Eye Health: Addressing Floaters, Flashes, and Dim Vision

Hello： If you have already undergone an eye examination and there are no issues, there is no need to feel anxious. <br>Psychological anxiety can lead to other problems. <br>Your sleeping position does not have a significant impact. <br>The frequency of examinations should follow

Regarding issues with the retina, experiencing flashes of light, and feeling that indoor environments are relatively dim?

Hello Doctor: I am 33 years old, and my current vision is 1175 in the left eye and 1200 in the right eye, both with astigmatism of 100.
I have a regular habit of visiting the clinic for dilated eye exams.
My current situation is as follows: 1.
I have noticed an increase in floaters, and they seem to be larger; my left eye appears more blurred (possibly due to insufficient prescription for my contact lenses).
2.
Upon waking in the morning or after a nap, I see flashes of light when I blink, but these flashes disappear after I get up and move around.
3.
My eyes have been feeling more fatigued lately.
4.
Recently, when I am in the living room with friends and family at night, I feel that the lighting is dim, and I want to turn the lights up, but my friends say, "Why make it so bright?"
Regarding points 1 and 2: I visited two different ophthalmology clinics for retinal examinations.
The first clinic used an ophthalmoscope for the exam, which took less than three minutes for both eyes.
They said there were no issues but used rather alarming language to warn me that I might be prone to certain eye diseases in the future.
The quick examination left me feeling anxious afterward.
The second clinic used OCT for the examination and performed scans both before and after dilation.
They confirmed that my retina is still tightly attached, with no edema or cataract issues.
Derived questions: After undergoing two types of retinal examinations, and based on information I found online, the two tests complement each other, so there should be no issues, right? Is the reason for seeing flashes of light upon waking simply due to vitreous detachment, as others have asked? Or could it be caused by my sleeping position, such as lying on my side and putting pressure on my eyeball? Should I change my sleeping position? Should the frequency of retinal examinations change from every six months to quarterly? The serious language from the first doctor has made me afraid to sleep lately, and I keep wanting to visit multiple clinics for repeated checks, feeling mentally unwell and constantly fearing that I might wake up with a retinal detachment.
Regarding point 3: I have made some lifestyle changes: 1.
I have significantly reduced my daily screen time on my phone.
2.
I force myself to look at a distance for a few minutes after using my phone for 20 minutes or after an hour of computer use.
3.
I do warm compresses daily.
4.
I am taking supplements such as lutein, astaxanthin, anthocyanins, and multivitamins.
Derived questions: When resting my eyes while looking at a distance, should I wear glasses or not? If there is nothing to look at in the distance, can I close my eyes for five minutes instead? Sometimes, looking at a distance makes my eyes feel strained; is this normal? Or after looking at a distance for a long time, when I switch to the computer screen, it appears a bit blurry and takes a while to adjust; is this normal? Would you recommend wearing glasses instead of contact lenses regularly? Are warm compresses effective for relaxing the eyes and promoting blood circulation in the retina and other tissues, thereby slowing degeneration and aging? Do supplements (lutein, astaxanthin, anthocyanins, multivitamins, etc.) help maintain eye health and reduce the risk of complications from high myopia (such as retinal tears or detachments)? Recently, after changing my resting habits, I feel that floaters have decreased and there are no clumps, so is it possible that floaters can naturally metabolize?
Regarding point 4: About feeling that the indoor lighting is dim at night, both doctors said there are no issues with my eyes, and my pupils respond to light.
However, I personally feel that I need more light after dilation (or that I need to increase from three to five lights).
I have tried to see the outlines of objects in a dimly lit room within five minutes; could this be due to my eyes being overly fatigued, leading to reduced pupil adjustment ability? It shouldn't be night blindness, right?
Lastly, two off-topic questions: After about nine years of work, my prescription has slightly increased; does this indicate that my eye axial length is continuing to elongate, or could there be other factors contributing to the increase in myopia? I have maintained a gym habit for the past nine years and do push-ups daily; can I continue this exercise routine? Thank you, Doctor.
I apologize for the many questions, but I am really anxious.

Konghuan dao shuibu tai hao de ren, 30~39 year old female. Ask Date: 2021/09/29

Dr. Gao Pilin reply Ophthalmology

Hello: If you have already undergone an eye examination and there are no issues, there is no need to feel anxious.
Psychological anxiety can lead to other problems.
Your sleeping position does not have a significant impact.
The frequency of examinations should follow the recommendations of your eye care provider.
If you feel nervous, you may seek opinions from other doctors.
If your eyes feel tired, take a break; fatigue can cause blurred vision, which can occur when looking at both distant and near objects.
You can remove your glasses if you do not need to see clearly at the moment.
Whether to use frames or contact lenses depends on your needs.
The occurrence of floaters can vary; sometimes they may increase, and other times they may decrease, which is a normal phenomenon.
It is unlikely to be night blindness, as adequate lighting is necessary for clear vision.
There are many reasons for a slight increase in myopia, and sometimes it is simply related to accommodation, which can improve with rest.
If your examination results are normal, you can continue your daily life without letting this affect you.

Reply Date: 2021/09/29

More Info

Hello! Thank you for your detailed inquiry regarding your eye health. It’s understandable to feel anxious about changes in your vision, especially with a history of myopia and floaters. Let’s break down your concerns and provide some clarity based on the information you've shared.

Floaters and Flashes
1. Increased Floaters: Floaters are common, especially in individuals with myopia. They occur due to changes in the vitreous gel inside the eye, which can become more liquid as we age, leading to the formation of clumps or strands that cast shadows on the retina. If you notice an increase in the size or number of floaters, it’s essential to monitor them. Regular eye exams, as you are doing, are crucial to ensure there are no underlying issues, such as retinal tears or detachment.

2. Flashes of Light: The flashes you see upon waking could be related to vitreous traction on the retina, which is common in myopic individuals. This phenomenon is often benign, but if it becomes frequent or is accompanied by a sudden increase in floaters, it warrants immediate attention from an eye care professional.

Eye Fatigue and Vision Changes
3. Eye Fatigue: Your symptoms of fatigue, especially after prolonged screen time, are typical in today’s digital age. Implementing the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds) is an excellent strategy to reduce eye strain. Additionally, ensuring proper lighting while using screens can help alleviate discomfort.

4. Night Vision: Feeling that your living space is dimly lit could be a result of several factors, including your eyes’ adaptation to light. If both doctors have confirmed that your eyes are healthy, it may simply be a matter of personal perception and comfort. However, if you continue to feel that your night vision is impaired, it’s worth discussing further with your eye care provider.

Eye Care Practices
5. Eyewear Choices: Whether to wear glasses or contact lenses depends on your comfort and the specific visual tasks you are performing. Glasses can provide a break from contact lenses, especially during screen time. If you find that your vision is blurry after looking at distant objects, it might be beneficial to wear your glasses when resting your eyes.

6. Hot Compresses: Using warm compresses can indeed help relax the eyes and improve blood circulation, which may alleviate some discomfort. It’s a simple yet effective method to soothe tired eyes.

7. Nutritional Supplements: Supplements like lutein, zeaxanthin, and omega-3 fatty acids can support overall eye health. While they may not directly prevent myopia progression, a balanced diet rich in antioxidants can contribute to long-term eye health.

Monitoring and Follow-Up
8. Frequency of Eye Exams: Given your history and current symptoms, maintaining regular check-ups is essential. If you feel more comfortable with quarterly visits, especially given your anxiety, it may provide peace of mind. However, if your symptoms stabilize, semi-annual visits may suffice.

9. Physical Activity: Regular exercise is beneficial for overall health, including eye health. It can help manage stress and improve circulation. Continue your fitness routine, but ensure you are not straining your eyes during workouts.

Conclusion
Your anxiety regarding your eye health is valid, especially with the complexities of myopia and associated symptoms. It’s crucial to maintain open communication with your eye care professionals and express your concerns. They can provide reassurance and tailored advice based on your specific situation. Remember, while floaters and flashes can be concerning, they are often benign, especially when accompanied by regular monitoring and eye health practices. If you experience any sudden changes in your vision, do not hesitate to seek immediate medical attention. Your proactive approach to your eye health is commendable, and with the right strategies, you can manage your symptoms effectively.

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