Floaters: When to Worry About Retinal Detachment Risks

Floaters and retinal detachment?

I remember having floaters since elementary school, but I wasn't very aware of them and there weren't many.
Currently, my myopia is less than -1.00 diopters.
Recently, due to frequent studying and tutoring, I feel that the floaters have become more noticeable and their shapes have slightly changed (though the number hasn't changed much).
I would like to ask the doctor: 1.
If it is vitreous degeneration, is it too early for that? 2.
Should I get an examination if the shape of the floaters has changed? 3.
At such a young age, will I experience a lot of floaters when I reach middle age? 4.
I have read that if there are flashes and lightning, it may indicate a risk of retinal detachment.
Recently, I have occasionally seen small bright spots, which makes me a bit anxious.
How can I distinguish between the so-called flashes and typical visual afterimages? 5.
Does having floaters always lead to pathological floaters that cause retinal issues? 6.
Does worsening myopia exacerbate floaters? I apologize for asking so many questions and hope the doctor can provide answers.

Kunrao de xuesheng, 10~19 year old female. Ask Date: 2022/09/14

Dr. Gao Pilin reply Ophthalmology

Dear Concerned Student,
1.
It may be a bit early to worry.
2.
You can observe it on your own.
3.
The occurrence of floaters (myodesopsia) does not increase indefinitely; sometimes they may decrease over time, so there is no need to be overly concerned.
4.
Bright spots are usually not like that; for example, lightning flashes are typically long and flickering, and they do not disappear over time, whereas visual persistence lasts only for a brief moment.
5.
Most of the time, this is not the case.
It is a normal physiological phenomenon.
6.
It can lead to premature degeneration of the vitreous body, increasing the likelihood of floaters.
In summary, it is still advisable to have an examination and then continue to observe on your own.

Reply Date: 2022/09/14

More Info

When it comes to floaters and the potential risks associated with retinal detachment, it's essential to understand the underlying mechanisms and when to seek medical attention. Floaters are small specks or strands that drift through your field of vision, often more noticeable against bright backgrounds. They are typically caused by changes in the vitreous gel that fills the eye, particularly as it ages or undergoes changes such as liquefaction or detachment.

1. Is it too early for vitreous degeneration?
While vitreous degeneration is often associated with aging, it can occur at any age, especially in individuals who are nearsighted (myopic). In your case, having floaters since childhood is not uncommon, and their presence does not necessarily indicate a problem. However, if you notice changes in the floaters' appearance or frequency, it may warrant further investigation.

2. Should I get checked if the floaters change?
Yes, any noticeable change in the pattern, shape, or frequency of floaters should prompt a visit to an eye care professional. Changes could indicate that the vitreous is pulling away from the retina, which can sometimes lead to retinal tears or detachment. A comprehensive eye exam, including a dilated fundus examination, will help assess the health of your retina and vitreous.

3. Will floaters worsen with age?
It's possible that as you age, you may experience more floaters, but this varies from person to person. Some individuals may notice an increase in floaters, while others may not. The presence of floaters does not necessarily correlate with a decline in vision, but it can be bothersome.

4. How to distinguish between flashes and afterimages?
Flashes of light, often described as "lightning streaks" or "flashes," occur when the vitreous pulls on the retina, stimulating it. These are different from afterimages, which are visual impressions that linger after looking away from a bright light. If you experience frequent flashes, especially if they are new or accompanied by an increase in floaters, it is crucial to seek medical attention promptly.

5. Do floaters always lead to pathological changes?
Not all floaters lead to pathological conditions. Many people live with floaters without any significant issues. However, if floaters are accompanied by flashes of light, a sudden increase in floaters, or a shadow or curtain effect in your vision, these could be signs of retinal detachment, and immediate evaluation is necessary.

6. Does worsening myopia increase floaters?
Yes, as myopia progresses, the risk of developing floaters may increase. High myopia can lead to more significant changes in the vitreous and retina, increasing the likelihood of retinal tears or detachment. Regular eye examinations are essential for monitoring eye health, especially if you have myopia.

In conclusion, while floaters are common and often benign, any changes in their appearance or the presence of flashes should be taken seriously. Regular eye check-ups are vital, especially if you have myopia or notice any new symptoms. Always consult with an eye care professional if you have concerns about your vision or eye health.

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