Eye Flashes and Floaters in High Myopia Patients

Q: Eye Flashes and Floaters in High Myopia Patients

Hello： Based on your description, you have high myopia and floaters, and you have recently experienced occasional flashes of light. <br>These conditions do require special attention, as individuals with high myopia are more prone to retinal issues. <br><br>1. <br>Floaters and Fla

Eye twitching

Hello Doctor: I am severely myopic (approximately -1100 diopters in both eyes).
In January of this year, I began experiencing floaters (transparent strands, occasionally with small black dots).
Later, I occasionally noticed flashes of light, mostly resembling flickering light bulbs, and once I saw a white arc-shaped flash.
I subsequently visited an ophthalmologist in Marshall, who noted a grid-like lesion in the upper left area of my retina, which appeared thinner, while the rest of the retina looked healthy.
They did not perform any laser treatment and advised regular follow-ups every six months to a year.

In early July, I visited a doctor for eye allergies and asked if I could undergo a dilated fundus examination (I had just had one in early May).
However, I was quite anxious about the possibility of retinal tears or detachment due to my high myopia.
The doctor reassured me that occasional flashes without other symptoms were not concerning and emphasized that it is unlikely for a tear to occur suddenly in a short period.
Therefore, the doctor advised against frequent dilations.
A few days ago, while using the restroom, I experienced flashes again for a few minutes.
I confirmed that the restroom light was flickering, but I noticed a flash again after leaving.
Should I return to the doctor for a dilated examination immediately, or can I continue to observe? Also, is it too frequent to have a dilated exam every three months for someone with high myopia? Since I discovered the floaters, I have been experiencing occasional light bulb-like flashes, which has made me anxious and led to frequent visits to the ophthalmologist for dilation.
Thank you, Doctor.

Zhang, 20~29 year old female. Ask Date: 2024/07/23

Dr. Gao Pilin reply Ophthalmology

Hello: Based on your description, you have high myopia and floaters, and you have recently experienced occasional flashes of light.
These conditions do require special attention, as individuals with high myopia are more prone to retinal issues.

1.
Floaters and Flashes:
- Floaters are caused by changes in the vitreous body and are particularly common in individuals with high myopia.
While most floaters are benign, they can also be early signs of retinal tears or detachment.
- Flashes are caused by the vitreous pulling on the retina and should also be monitored closely.
2.
Retinal Examination:
- You mentioned that the examination results from January showed a lattice degeneration in the upper left retina, which may indicate retinal thinning or small tears.
Regular follow-up is the correct approach.
- If you experience new symptoms, such as an increase in flashes or a sudden decline in vision, it is advisable to seek immediate medical attention and undergo a dilated eye examination.
3.
Frequency of Flashes and Emergency Response:
- Occasional flashes may be due to vitreous traction and do not necessarily indicate a serious problem.
However, if the frequency of flashes increases or is accompanied by changes in vision, you should seek immediate medical attention.
- You mentioned experiencing flashes recently while in the restroom; it is recommended that you see an ophthalmologist promptly to ensure there are no retinal tears or detachments.
4.
Frequency of Examinations:
- Individuals with high myopia have a higher risk of retinal problems, and having a dilated eye examination every three months is not considered excessive, especially when symptoms are pronounced or changing.
- A dilated examination allows for a clearer view of the retinal condition, which is particularly important for those with high myopia.
Finally, your anxiety is understandable.
It is advisable to have regular eye examinations and maintain communication with your physician to detect and address any potential issues early.
Wishing you a speedy recovery.

Reply Date: 2024/07/23

More Info

Understanding eye flashes and floaters, particularly in patients with high myopia, is crucial for maintaining eye health and addressing any potential complications. High myopia, defined as a refractive error greater than -6.00 diopters, can lead to various ocular issues, including retinal degeneration, retinal detachment, and the development of floaters and flashes.

Floaters are typically caused by changes in the vitreous humor, the gel-like substance filling the eye. In high myopia, the vitreous can undergo liquefaction and posterior vitreous detachment, leading to the perception of floaters. These floaters can appear as transparent strands or dark spots, which you have described. They are generally benign but can be alarming, especially when accompanied by flashes of light.

Flashes, or photopsia, occur when the retina is stimulated by mechanical forces, often due to the vitreous pulling on the retina. This can happen during normal eye movements or when the vitreous is undergoing changes. The flashes you describe, such as the "light bulb" effect, are common in individuals with high myopia and can be related to the vitreous tugging on the retina. The white arc-shaped flashes you mentioned could also be a result of this vitreous traction.

Your recent evaluations by eye care professionals, which indicated that your retina is generally healthy despite some thinning and the presence of lattice degeneration, are reassuring. Lattice degeneration is a common finding in high myopia and is usually monitored unless it shows signs of progression or associated complications, such as retinal tears or detachments.

Regarding your concerns about the frequency of your follow-up appointments and the need for dilation, it is essential to balance vigilance with the understanding that not every symptom necessitates immediate intervention. The recommendation to avoid frequent dilated exams is based on the understanding that while vigilance is necessary, excessive anxiety can lead to unnecessary stress. If your flashes are infrequent and not accompanied by other symptoms such as a sudden increase in floaters, loss of vision, or a shadow in your peripheral vision, it may be reasonable to continue monitoring your symptoms.

However, if you experience a significant increase in the frequency or intensity of the flashes, or if new symptoms arise, it would be prudent to return to your eye care provider for a thorough examination. The general guideline is to seek immediate care if you notice a sudden increase in floaters or flashes, or if you experience any changes in your vision.

As for your question about the relationship between eye strain and your symptoms, while excessive screen time and inadequate breaks can contribute to eye discomfort, they are less likely to directly cause flashes or floaters. However, managing eye strain through proper rest and following the 20-20-20 rule (taking a 20-second break to look at something 20 feet away every 20 minutes) can help alleviate overall eye discomfort.

In summary, while your symptoms warrant attention, the current findings suggest a stable condition. Regular follow-ups as advised by your eye care provider are essential, and you should feel empowered to reach out if you notice any changes or if your anxiety about your symptoms increases. Your eye health is paramount, and maintaining open communication with your healthcare provider will help ensure that you receive the appropriate care and support.

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