Eye Flashes and Floaters: When to Seek Help

Occasional flashes of light in the eyes?

Hello, doctor.
Since I was young, I have noticed some gray strands floating in my right eye (possibly floaters).
Later, I developed myopia, which is now around -800 diopters (with over -100 diopters of astigmatism).
The symptoms persist, and now my left eye has also started to show some thread-like objects.
Two years ago, I suddenly noticed that the lower corner of my left eye sometimes flashes like "lightning," and I also perceive flashes of light when I close my eyes.
What kind of condition could this be? I have been wearing contact lenses for many years, and for the past two years, I have worn them daily for about 12 hours.
I later discovered I had dry eye syndrome, so I reduced my wear to once a week for less than 5 hours.
I have regular retinal examinations at the ophthalmologist every year, and there have been no significant issues.
The most recent check-up was in June of this year, where the ophthalmologist noted a pulling mark in the upper outer part of my right eye and advised me to return if I noticed any lightning phenomena.
However, I am experiencing the flashes in my left eye.
I mentioned to her that my left eye occasionally has flashes, but the doctor did not indicate any issues with that eye.
Why am I experiencing these flashes? Could it be a side effect of wearing rimless and diamond-cut glasses? Or could it be something like a tumor? Should I consider consulting another ophthalmologist for a second opinion?

Junfang, 20~29 year old female. Ask Date: 2005/08/28

Dr. Zhang Yanrui reply Ophthalmology

Actually, if there is a detailed examination after dilation, it is not necessarily required to change doctors.
However, if there are "lightning" type visual disturbances, it may be necessary to have follow-up appointments every one to two weeks, as this indicates that the retina is being pulled.
It is uncertain when it might tear, so close monitoring is absolutely essential.

Reply Date: 2005/08/28

More Info

Understanding eye flashes and floaters is crucial for maintaining eye health, especially for individuals with a history of visual disturbances. Based on your description, it seems you are experiencing a combination of floaters and flashes of light, which can be concerning but are not uncommon.

Floaters are small specks or strands that drift through your field of vision, often described as gray or black lines. They are typically caused by changes in the vitreous gel that fills the eye, which can become more liquid and pull away from the retina as we age. This is known as vitreous detachment and is generally a benign condition. However, if you notice a sudden increase in floaters, especially if accompanied by flashes of light, it is essential to seek medical attention promptly, as these can be signs of retinal tears or detachment.

Flashes of light, often described as "lightning" or "flashes," occur when the vitreous gel pulls on the retina. This can happen during normal aging or due to trauma. The fact that you experience these flashes when closing your eyes or in specific positions can indicate that the vitreous is exerting pressure on the retina. While your previous eye examinations have shown no significant issues, the presence of flashes warrants careful monitoring.

You mentioned that your eye doctor noted a "pulling mark" in your right eye. This could suggest that the vitreous is indeed pulling away from the retina, which is a common occurrence but can lead to complications if not monitored. The fact that you also experience flashes in your left eye, despite your doctor not indicating any issues with that eye, is worth discussing further with your healthcare provider. It’s possible that the left eye is experiencing similar changes, and it’s essential to ensure that both eyes are evaluated thoroughly.

Regarding your concerns about wearing contact lenses, especially if you have developed dry eye syndrome, it’s advisable to limit their use, as prolonged wear can exacerbate dryness and discomfort. Switching to glasses, especially if you have a high prescription, can help alleviate some symptoms associated with dry eyes.

In terms of seeking a second opinion, if you feel uncertain about your current eye care provider's assessments or if your symptoms persist or worsen, it is entirely reasonable to consult another ophthalmologist. A fresh perspective can provide reassurance or highlight any potential issues that may need addressing.

To summarize, while floaters and flashes can be benign, they require careful monitoring, especially given your history of high myopia and previous eye examinations. Regular check-ups with an eye care professional, especially if you notice changes in your symptoms, are essential. Maintaining good eye health through proper lens care, managing dry eye symptoms, and ensuring regular eye exams will help you preserve your vision and address any potential issues early on. Remember, your comfort and peace of mind regarding your eye health are paramount, so don’t hesitate to seek further evaluation if needed.

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