Floaters: Risks and Symptoms of Vitreous Changes

Bright blue specks and tiny shimmering dots in the field of vision?

I have high myopia and underwent retinal laser treatment six years ago.
I have confirmed that I have vitreous opacities, and I experience brief flashes of white or black specks almost every day, sometimes accompanied by sudden blue specks that last less than a second.
Occasionally, when I look at the sky or a white screen, I see one or two small dots that move with my head.

1.
Can existing floaters cause retinal traction?
2.
If I experience the above symptoms, is the likelihood of developing new retinal tears high?
3.
Are these symptoms considered acute manifestations of vitreous changes?
4.
Can vitreous hemorrhage also present as these black spots?
5.
What methods are available to alleviate vitreous opacities and reduce the traction on the retina?
6.
If there are no acute symptoms, is the risk of retinal tears or detachment very low?

Gao Du Jin Shi Huan Zhe, 30~39 year old female. Ask Date: 2021/12/20

Dr. He Jianxian reply Ophthalmology

1.
Floaters can indeed cause traction on the retina, but it is not the floaters themselves causing the traction; it is the surrounding retina that is being pulled.

2.
It is difficult to determine the probability of a tear forming.

3.
This is not an acute symptom.

4.
The symptoms of vitreous hemorrhage are not like this.

5.
Vitreous opacities cannot be alleviated.

6.
There are no acute symptoms, and the retina can still have tears; however, the likelihood of detachment is relatively lower.
Dr.
He Jianxian, Ophthalmology Department, Nantou Hospital.

Reply Date: 2021/12/20

More Info

Understanding floaters, particularly in the context of vitreous changes, is crucial for individuals with a history of high myopia and previous retinal laser treatments. Floaters are small specks or strands that drift through your field of vision, often described as "cobwebs" or "shadows." They are typically caused by changes in the vitreous gel that fills the eye, which can become more liquid and less gel-like as we age, leading to the formation of clumps or strands that cast shadows on the retina.

1. Do existing floaters cause retinal traction?
Floaters themselves are not directly responsible for causing retinal traction. However, if the vitreous gel is pulling away from the retina, this can lead to traction, which may increase the risk of retinal tears or detachments. In individuals with high myopia, the risk of such complications is heightened due to the elongation of the eyeball, which can lead to a thinner retina that is more susceptible to tears.

2. Is there a high risk of new retinal tears with the described symptoms?
The symptoms you describe, such as sudden flashes of light or new floaters, can indicate a potential retinal tear or detachment, especially in the context of your high myopia and previous laser treatment. While not every new floater or flash results in a tear, the presence of these symptoms warrants immediate evaluation by an eye care professional. They can perform a thorough examination, including a dilated fundus exam, to assess the retina's condition.

3. Are these symptoms considered acute vitreous symptoms?
Yes, the sudden appearance of new floaters or flashes can be classified as acute vitreous symptoms. This is particularly true if these symptoms are new or have changed in character. Acute symptoms often require prompt assessment to rule out serious conditions such as retinal tears or detachments.

4. Can vitreous hemorrhage cause similar black spots?
Yes, vitreous hemorrhage can cause similar visual disturbances, including the appearance of dark spots or floaters. When blood leaks into the vitreous cavity, it can create shadows that may appear as floaters. This condition can occur due to various reasons, including trauma, diabetic retinopathy, or retinal tears.

5. What methods can alleviate vitreous opacities and reduce retinal traction?
Currently, there are no definitive treatments to eliminate floaters or vitreous opacities. However, maintaining regular eye examinations is essential. In some cases, if floaters significantly impair vision, a vitrectomy (surgical removal of the vitreous gel) may be considered, but this procedure carries its own risks, including retinal detachment. Additionally, ensuring good eye health through proper management of underlying conditions (like diabetes) and protecting your eyes from trauma can help minimize risks.

6. If there are no acute symptoms, is the risk of retinal tears or detachments low?
While the absence of acute symptoms may suggest a lower risk of retinal tears or detachments, it does not eliminate the risk entirely, especially in individuals with high myopia. Regular monitoring and eye examinations are crucial to detect any changes early. If you notice any new symptoms, such as an increase in floaters or flashes, it is essential to seek immediate medical attention.

In summary, while floaters are common and often benign, their presence, especially in the context of high myopia and previous retinal treatments, should be taken seriously. Regular eye check-ups and prompt attention to any new symptoms are vital for maintaining eye health and preventing potential complications. Always consult with an ophthalmologist for personalized advice and management based on your specific condition.

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