Floaters: When to Worry and How Often to Check - Ophthalmology

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Floaters are very bothersome to me?


Hello Doctor: I started experiencing floaters around the age of 22, and I am now 25.
I have been undergoing regular dilated eye examinations, with the last one conducted at the end of July this year, and my retina was still normal.
Since I am quite concerned about it, I tend to pay close attention to the floaters.
My job requires frequent use of my eyes, so I often feel like the floaters have increased.
Recently, I've noticed some additional black spots that are quite bothersome; they appear and disappear intermittently, unlike the linear ones that are always present.
I am constantly worried about retinal tears or retinal detachment, but since I just had a dilated exam at the end of July, do you think I need to follow up soon? I feel like I am caught in an endless cycle of examinations, as the clinics suggest checking every six months to a year, but I find myself wanting to have dilated exams every few months.
However, I am aware that dilation can cause an increase in intraocular pressure, so is it advisable to have dilated examinations this frequently? Currently, my myopia is approximately -4.25 diopters in the right eye and -3.75 diopters in the left eye, and I often feel like my vision fluctuates between good and poor.
I frequently consider getting my prescription checked...
Thank you, Doctor.

Kang, 20~29 year old female. Ask Date: 2021/11/22

Dr. Gao Pilin reply Ophthalmology


Hello, if the examination shows no issues, you can feel at ease.
There is no need for frequent check-ups unless there are noticeable changes.
Once a year is sufficient.
If you are still concerned, it is fine to have another check-up.
Generally, intraocular pressure should not be a concern; if you are worried about it increasing, you can measure it again after dilation.
Dilation examinations are harmless to the eyes, so please rest assured.

Reply Date: 2021/11/22

More Info


Floaters, or "flying spots," are common visual phenomena that many people experience, especially as they age. They are typically harmless and are caused by tiny clumps of gel or cells within the vitreous humor of the eye casting shadows on the retina. However, your concerns about the potential for retinal issues, such as retinal tears or detachments, are valid, especially given your history of myopia (nearsightedness), which can increase the risk of such conditions.

From your description, it seems that you have been proactive about your eye health by regularly undergoing dilated eye examinations. This is crucial, as these exams allow an eye care professional to thoroughly assess the health of your retina and vitreous. Since your last examination in July showed normal retinal health, it is reassuring. However, the emergence of new floaters or changes in their appearance can understandably cause anxiety.


When to Worry About Floaters
While floaters are usually benign, certain symptoms warrant immediate attention:
1. Sudden Increase in Floaters: If you notice a sudden increase in the number of floaters, especially if accompanied by flashes of light or a shadow in your peripheral vision, you should seek medical attention promptly. These could be signs of a retinal tear or detachment.

2. Changes in Vision: If you experience any sudden changes in your vision, such as blurriness, loss of peripheral vision, or a curtain-like shadow, these are serious symptoms that require immediate evaluation.

3. Persistent Anxiety: If your anxiety about your floaters is affecting your daily life or causing you significant distress, it may be beneficial to discuss these feelings with a healthcare professional. Sometimes, the psychological burden of worrying about health can be as impactful as the physical symptoms themselves.


How Often to Check
The general recommendation for individuals with stable floaters and no other symptoms is to have a comprehensive eye exam every 6 to 12 months. However, since you have a history of myopia and are experiencing changes in your floaters, it might be reasonable to have more frequent check-ups, especially if you feel that your symptoms are worsening.

Concerns About Frequent Dilated Exams
You mentioned concerns about the frequency of dilated exams and the potential for increased intraocular pressure. While it is true that dilation can temporarily raise eye pressure, for most individuals, this is not a significant concern. However, if you have a history of glaucoma or other eye conditions that affect pressure, it is essential to discuss this with your eye care provider. They can help determine the best schedule for your exams and whether alternative methods of examination (like non-dilated exams) are appropriate for you.


Managing Anxiety
It’s also important to address the anxiety surrounding your floaters and vision changes. Here are some strategies that may help:
1. Education: Understanding that floaters are common and often harmless can help reduce anxiety. Knowing what symptoms to watch for can empower you to seek help when necessary without feeling the need to check constantly.

2. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, deep breathing exercises, or yoga can help manage anxiety. These techniques can help you focus on the present moment rather than worrying about potential future problems.

3. Limit Eye Strain: Since your work requires extensive use of your eyes, ensure you take regular breaks to reduce eye strain. The 20-20-20 rule is a good guideline: every 20 minutes, look at something 20 feet away for at least 20 seconds.

4. Professional Support: If your anxiety about your vision is overwhelming, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) can be particularly effective in managing health-related anxiety.

In conclusion, while your concerns about floaters and potential retinal issues are valid, maintaining a balance between vigilance and anxiety is crucial. Regular check-ups, understanding when to seek help, and employing strategies to manage anxiety can help you navigate this situation more comfortably. Always feel empowered to reach out to your eye care provider with any new symptoms or concerns.

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