Eye Flashes and Vitreous Liquefaction in High Myopia

Q: Eye Flashes and Vitreous Liquefaction in High Myopia

Hello： Based on your description, you are indeed facing some challenges related to retinal issues, but in your case, these symptoms are typically classified as part of retinal degeneration. <br>Retinal degeneration is a broader term used to describe changes or deterioration in th

Eye flashes; vitreous liquefaction?

Hello, Doctor: A few days ago, I came to ask you about the sensation of flashing lights in my eyes.
I have high myopia of over 1000 degrees, and I started noticing floaters around January, which led me to frequently visit ophthalmology clinics for dilation, as new symptoms kept appearing.
The number of floaters hasn't increased, but I have been experiencing intermittent flashes of light.
Currently, I have three types of flash symptoms: 1.
Flickering type: I feel that objects in my peripheral vision are moving, occasionally with a wavy appearance.
2.
Light bulb type: I have experienced two instances of a quick flash of darkness, lasting just a moment.
3.
A few days ago, I noticed a white arc flash at the edge of my left visual field, which was also fleeting.
In March, I visited a major hospital's retinal specialist, and the doctor briefly mentioned that my retina was discharging, that my peripheral retina was slightly thinner due to high myopia, and that there was a process of posterior vitreous detachment and liquefaction.
A few days ago, due to the appearance of a noticeable and new symptom of white flashes, I hurried to a nearby ophthalmologist.
They performed an ultra-widefield examination, and the doctor, after dilation, noted that there was "grid-like degeneration" in the upper left corner of my left eye, but the area was small and just needed observation.
They also mentioned that there was no need for preventive laser treatment and did not see any tears or holes.
The peripheral retina was slightly thinner compared to normal individuals, but overall, the retina is currently healthy.
The doctor suggested that the flashes might be caused by certain areas of the vitreous pulling on the retina more forcefully.
I would like to ask the doctor, since other ophthalmologists have simply stated that it is retinal degeneration, what does retinal degeneration encompass? Also, how long might these symptoms persist? The appearance of new symptoms every so often really makes me anxious...
(Although the doctor mentioned during the consultation that I shouldn't be too anxious at the moment, the continuous emergence of new symptoms makes it really hard to judge 🥲).
Currently, I am under regular follow-up, and should I return for a check-up immediately if new flashes appear? Or can I observe for a while longer? I'm really uncertain about how to manage the frequency of follow-ups...
I also want to ask if this is related to eye strain? Because I experience these symptoms even when I’m resting and I maintain a routine of resting for 10 minutes after every 30 minutes of activity.
Additionally, the doctor advised against vigorous exercise; what is the definition of vigorous exercise? I usually jog, brisk walk, do yoga, and Pilates—do these count? Thank you!!!

Hsu, 20~29 year old female. Ask Date: 2024/05/12

Dr. Gao Pilin reply Ophthalmology

Hello: Based on your description, you are indeed facing some challenges related to retinal issues, but in your case, these symptoms are typically classified as part of retinal degeneration.
Retinal degeneration is a broader term used to describe changes or deterioration in the function and structure of certain parts of the retina.
This may be due to factors such as age, high myopia, or the risk of retinal detachment.
Retinal degeneration can include thinning of the retina, surface distortion, holes, or tears.
Regarding the symptoms you described, the flashes may be caused by the vitreous pulling on the retina, which could be a manifestation of retinal degeneration.
These flash symptoms often occur during eye movements or head movements and may appear intermittently.
Although these symptoms may cause you anxiety, in most cases, they do not indicate that you are facing an immediate serious problem.
However, it is advisable to continue regular follow-ups and to return promptly if new symptoms arise or if you feel discomfort.
Regular check-ups are very important as they ensure that your doctor can detect any potential changes or issues in a timely manner.
Additionally, if you feel uncomfortable or concerned, you can always reach out to an ophthalmologist for professional advice.
Regarding the definition of vigorous exercise, it generally refers to high-intensity, high-risk activities that may increase stress on the eyes and body, thereby raising the risk of retinal problems.
This may include weight training, high-intensity aerobic exercises, and intense competitive sports.
The activities you described, such as jogging, brisk walking, yoga, and Pilates, are typically not considered vigorous exercise, but if you feel discomfort or have concerns, it is best to consult your physician.

Reply Date: 2024/05/12

More Info

Understanding eye flashes and vitreous liquefaction, especially in individuals with high myopia, is crucial for maintaining eye health and addressing any potential concerns. High myopia, often defined as a refractive error greater than -6.00 diopters, can lead to various ocular complications, including retinal degeneration, retinal detachment, and changes in the vitreous body.

Eye Flashes and Their Causes
The symptoms you describe—flashes of light, visual disturbances, and the sensation of movement in your peripheral vision—are commonly associated with vitreous changes. In high myopia, the vitreous gel that fills the eye can undergo liquefaction and posterior vitreous detachment (PVD). This process can cause the vitreous to pull on the retina, leading to the perception of flashes of light, often described as "lightning streaks" or "flashes." These flashes occur when the vitreous tugging on the retina stimulates the photoreceptors, creating the sensation of light even in the absence of actual light stimuli.

1. Types of Flashes:
- Flickering or Wavy Flashes: These can occur due to the movement of the vitreous gel and are often transient.

- Sudden Bright Flashes: These may indicate more significant traction on the retina and warrant further investigation.

- Arc-shaped Flashes: As you described, these can be related to specific areas of vitreous traction.

Retinal Degeneration
Retinal degeneration in high myopia can manifest in several ways:
- Thinning of the Retina: This is common in myopic eyes and can increase the risk of retinal tears or detachment.

- Lattice Degeneration: A condition where the retina becomes thin and more susceptible to tears.

- Retinal Holes or Tears: These can occur due to the pulling of the vitreous and may require laser treatment if they pose a risk for detachment.

Duration and Monitoring of Symptoms
The duration of symptoms can vary significantly. Some individuals may experience intermittent flashes for weeks or months, while others may notice a gradual decrease in frequency as the vitreous stabilizes post-detachment. Regular monitoring is essential, especially if new symptoms arise. If you experience sudden increases in flashes, new floaters, or a shadow in your vision, it is crucial to seek immediate evaluation by an eye care professional.

Frequency of Follow-Up Visits
Given your history of high myopia and the recent symptoms, a proactive approach is advisable. Regular follow-ups—typically every 6 to 12 months—are recommended, but you should return sooner if you notice any changes in your symptoms. Your eye care provider can guide you on the appropriate frequency based on your specific condition.

Impact of Eye Strain
While excessive screen time and eye strain can lead to discomfort and exacerbate symptoms like dry eyes, they are not directly linked to the vitreous changes causing flashes. However, maintaining good eye hygiene, such as the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds), can help alleviate discomfort.

Definition of Strenuous Exercise
Strenuous exercise typically refers to activities that significantly elevate your heart rate and exert pressure on your body, such as heavy weightlifting, high-intensity interval training (HIIT), or competitive sports. Activities like jogging, brisk walking, yoga, and Pilates are generally considered moderate and may not pose a significant risk. However, if you experience discomfort during these activities, it is wise to consult your eye care provider.

Conclusion
In summary, while the symptoms you are experiencing can be concerning, they are often associated with the normal aging process of the vitreous, particularly in high myopia. Regular monitoring, understanding the nature of your symptoms, and maintaining open communication with your eye care provider are key to managing your eye health effectively. If you have any further questions or concerns, do not hesitate to reach out to your healthcare professional for personalized advice.

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