Managing Eye Anxiety: When to Seek Help for Visual Disturbances

Q: Managing Eye Anxiety: When to Seek Help for Visual Disturbances

Hello： 1. <br>Regarding the recommendation to have a follow-up examination in one month, if you experience any new symptoms or if your existing symptoms worsen during this period, it is advisable to seek medical advice promptly. <br>If you are concerned about retinal detachment,

Feeling anxious about the current situation and unsure whether to schedule an earlier follow-up appointment or if I'm overreacting?

Hello Doctor, I have myopia of -6.00 in one eye and -8.00 in the other, with astigmatism of about -0.50 in one eye.
My work requires frequent computer use.
My right eye was diagnosed with lacrimal duct obstruction in childhood, which causes excessive tearing.
I also suffer from dry eyes and eye allergies.
Earlier this year, I underwent surgery for ingrown eyelashes that had scratched my cornea.
About two months later, I started seeing a colorful dot in my vision that moves with my gaze or disappears quickly.
Initially, I thought it was just a normal visual afterimage, but I later noticed it appears even in non-reflective areas.
Additionally, I have been experiencing intermittent flashes of white light at the outer and lower parts of my eyes.
Therefore, I visited a major hospital in March, and the doctor said my eyes looked fine and diagnosed me with floaters.
Starting in May, I continued to have issues with ingrown eyelashes, returning to a general clinic once a month for removal.
I also felt that the frequency of the colorful dot's appearance seemed to increase (though the number remained at one), which prompted me to seek further consultation.
The doctor did not mention anything specific after the examination and suggested I return for a follow-up next month, advising me to come in earlier if the number of dots increased.

The colorful dot suddenly appears in my field of vision and sometimes disappears before I even realize it; at other times, it lingers for a few seconds and moves with my gaze.
However, I feel like the color and shape are not consistent each time, and I can even see it with my eyes closed, which makes me anxious.
Sometimes, when I focus on a specific spot, I feel like a small black mark appears, but when I try to look for it, it vanishes.
I wonder if this is just my imagination or if it could be due to insufficient light reflecting off something that is already there.
I also feel a bit anxious when trying to sleep, as I find myself unconsciously wanting to look at my eyelids, which leads to seeing what looks like shimmering light patterns.
Yesterday, in a half-awake state, I thought I saw several black dots, which startled me, but when I opened my eyes, everything seemed fine.
After that, I felt like my left eye flashed with white light.
Before my follow-up appointment, I have a few questions for the doctor:
1.
The outpatient department wants me to return in a month for a check-up, advising me to come in sooner if the symptoms increase.
Is it possible that I have a retinal detachment? What should I do during this period?
2.
I am very afraid of retinal detachment, but I don't know how to distinguish when I should rush to see a doctor.
Is my current situation dangerous?
3.
I usually understand that floaters are fixed shapes like black dots or white lines, but can they also be irregular and colorful?
4.
Is it okay to practice the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds) for eye care?
5.
Given my condition, should I apply heat or cold compresses during rest, or should I do both? Thank you.

Jiao Lv, 20~29 year old female. Ask Date: 2023/08/03

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
Regarding the recommendation to have a follow-up examination in one month, if you experience any new symptoms or if your existing symptoms worsen during this period, it is advisable to seek medical advice promptly.
If you are concerned about retinal detachment, it is best to stay vigilant for the following symptoms: sudden noticeable flashes of light, dark spots or loss of vision in your field of view, and a sudden significant decrease in vision.
These symptoms may indicate retinal detachment.
2.
Current symptoms alone cannot confirm the presence of retinal detachment; further evaluation by a physician is necessary.
If you have concerns, it is best to schedule a follow-up appointment with your doctor as soon as possible and provide them with a detailed account of all your symptoms.
3.
The presentation of floaters can vary from person to person, typically appearing as black dots or lines, but they can also be irregular and colored, which requires assessment by a physician for confirmation.
4.
The 20-20-20 rule is a good method for eye care, but please ensure that you remain comfortable while using the computer and take breaks as needed.
5.
As for hot or cold compresses, it is best to confirm with your physician first.
The condition of the retina or other eye diseases needs to be determined before appropriate treatment recommendations can be given.

Reply Date: 2023/08/03

More Info

Managing eye anxiety, especially when experiencing visual disturbances, can be quite challenging. Based on your detailed description, it seems you are dealing with a combination of refractive errors, dry eye syndrome, and possibly some psychological factors related to your visual symptoms. Here’s a comprehensive response to your concerns:
1. Potential for Retinal Detachment: Your anxiety about retinal detachment is understandable, especially given your symptoms. Retinal detachment can present with sudden flashes of light, a sudden increase in floaters, or a shadow or curtain over your vision. However, since your recent examinations have not indicated any significant issues, it is likely that your symptoms are related to other factors, such as anxiety or visual fatigue. If you notice a sudden increase in floaters or flashes, or if your vision changes significantly, you should seek immediate medical attention.

2. When to Seek Help: It’s crucial to monitor your symptoms closely. If you experience sudden changes in your vision, such as a significant increase in the number of floaters, flashes of light, or any loss of vision, you should contact your eye care provider immediately. Your current symptoms, while concerning, do not necessarily indicate a dangerous condition, especially since your previous examinations have shown no significant problems.

3. Understanding Floaters: Floaters can indeed appear as colored spots or irregular shapes, especially if they are related to changes in the vitreous gel of the eye. While traditional floaters are often described as black or gray, colored floaters can occur, particularly if they are related to the light reflecting off the vitreous or other structures in the eye. It’s important to differentiate between typical floaters and new visual phenomena that may require further investigation.

4. 20-20-20 Rule: The 20-20-20 rule is an excellent practice for reducing eye strain, especially for those who spend long hours in front of screens. Every 20 minutes, take a 20-second break to look at something 20 feet away. This helps relax the eye muscles and can alleviate some of the discomfort associated with prolonged screen time.

5. Warm or Cold Compresses: The choice between warm and cold compresses can depend on your specific symptoms. Warm compresses can help with dry eyes and promote tear production, while cold compresses can reduce inflammation and discomfort. You might find it beneficial to alternate between the two, depending on how your eyes feel at the moment.

In addition to these points, it’s essential to address the psychological aspect of your anxiety. Anxiety can exacerbate the perception of visual disturbances, leading to a cycle of worry and increased symptoms. Consider discussing your feelings with a mental health professional who can help you develop coping strategies to manage your anxiety.

Lastly, ensure that you maintain regular follow-ups with your eye care provider. Keeping an open line of communication about your symptoms and any changes you notice will help them provide the best care possible. If your symptoms persist or worsen, don’t hesitate to seek a second opinion or request more immediate evaluations.

In summary, while your symptoms are understandably concerning, they do not necessarily indicate a severe underlying condition at this time. By following the recommendations above and maintaining regular check-ups, you can manage your eye health effectively while addressing your anxiety.

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