Colorful Spots in Vision: Is It Visual Afterimage or Floaters?

Seeing colored spots intermittently in the eyes?

Hello, doctor.
I've been experiencing this issue for the past 1 to 2 months, and it's quite bothersome.
At the end of last year, I got a new pair of glasses (one lens is 600 and the other is 800) because I was having trouble seeing clearly and experiencing dry eyes.
The new glasses are quite heavy and keep sliding down my face, even falling off when I look down.
I also see a pinkish reflection through the lenses.
After getting these glasses, I sometimes see what looks like visual persistence, which moves with my vision, appearing as irregularly shaped and colored spots (each time they appear, the shapes and sizes are different), and I can't even tell which eye they come from before they disappear.
Sometimes, I notice a small colored dot even in dim lighting.
I went back to the place where I got my glasses (an optical shop affiliated with an ophthalmology clinic) and they suggested it might be lens reflection.
However, I couldn't tolerate the heavy glasses, so I got a lighter pair, which eliminated the lens reflection, but I still occasionally see the aforementioned spots that resemble visual persistence.
I have had several eye examinations due to discomfort at the end of last year, and before getting the second pair of new glasses this year, I underwent an eye examination and dilated fundus examination at a major hospital, where I explained the symptoms I was experiencing.
The doctor said my eyes were just a bit dry, with some astigmatism and floaters.
I would like to ask the doctor what these spots might indicate.
Am I mistaken in thinking they are visual persistence, or could they actually be a type of floaters?

NN, 20~29 year old female. Ask Date: 2023/03/25

Dr. Cai Wenyuan reply Ophthalmology

It may be vitreous floaters.

Reply Date: 2023/03/25

More Info

The symptoms you are experiencing, particularly the colorful spots in your vision, can indeed be perplexing and concerning. Based on your description, it seems that you are dealing with a combination of visual phenomena that may include both floaters and visual afterimages. Let's break down these concepts and their potential causes.

Floaters vs. Visual Afterimages
Floaters are small, shadowy shapes that can appear in your field of vision. They are often described as spots, threads, or cobwebs that drift around as you move your eyes. Floaters are typically caused by changes in the vitreous gel that fills the eye, which can become more liquid and allow tiny fibers to clump together, casting shadows on the retina. This phenomenon is common, especially in individuals with myopia (nearsightedness) or those who have experienced changes in their eye structure due to age or other factors.

Visual afterimages, on the other hand, occur when you look at a bright light source and then look away. The cells in your retina can continue to send signals to your brain for a brief period, creating a lingering image. This can sometimes manifest as colorful spots or shapes, particularly if you are looking at a bright or contrasting background.

Your Symptoms
Given your recent experiences, it seems that you may be encountering both floaters and visual afterimages. The colorful, irregular spots you see could be attributed to floaters, especially since they can vary in shape and size and may not be consistently present. The fact that these spots can appear even without bright light suggests that they are likely floaters rather than afterimages.

Additionally, your mention of seeing these spots more frequently after switching to a new pair of glasses could indicate that the new lenses are affecting your visual perception. Heavy glasses that do not fit well can cause discomfort and may lead to visual fatigue, which can exacerbate the perception of floaters or afterimages. If the lenses are not properly aligned with your line of sight, this misalignment can also lead to visual distortions.

Other Considerations
You also mentioned that you have experienced dry eyes and have been diagnosed with mild myopia and astigmatism. Dry eyes can contribute to visual discomfort and may make you more aware of floaters or other visual disturbances. It’s essential to manage dry eye symptoms, as they can significantly impact your overall visual clarity.

Furthermore, if you have undergone comprehensive eye examinations, including OCT (Optical Coherence Tomography) and dilated fundus examinations, and your eye doctor has ruled out serious conditions, it is likely that your symptoms are benign. However, it is crucial to maintain regular follow-ups with your eye care provider, especially if your symptoms change or worsen.

Recommendations
1. Consult Your Eye Care Provider: If you continue to experience these symptoms, or if they become more bothersome, it is advisable to return to your eye care provider for further evaluation. They may consider additional tests to ensure that there are no underlying issues.

2. Manage Dry Eyes: Use artificial tears or other treatments recommended by your eye doctor to alleviate dry eye symptoms, which may help improve your overall visual comfort.

3. Monitor Your Symptoms: Keep a journal of when these colorful spots appear and any associated activities (like prolonged screen time or exposure to bright lights). This information can be helpful for your eye care provider.

4. Consider Lens Options: If your current glasses are heavy and uncomfortable, discuss lighter lens options or different frame styles with your optician. Properly fitted glasses can reduce visual strain.

In conclusion, while your symptoms may be concerning, they are often benign and related to common visual phenomena such as floaters and afterimages. Regular monitoring and communication with your eye care provider will help ensure that your vision remains healthy and that any potential issues are addressed promptly.

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