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Life Issues, Medicine

Eye emergency: Floaters and Flashes

MEDICAL WARNING! (From a doctor who became a patient.) (On vacation.) (In England.)
If you have a sudden visual change including increased “floaters” (spots, threads or rings in what you see, that usually move around) flashes of lights or -especially! – a loss of part of your vision, including a “curtain coming down”over one or both eyes, get to the ER! It could be a retinal detachment! You need evaluation and urgent, if not emergency, treatment to save your eye!
The biggest risk factors are aging – over 50 years old – and nearsightedness, followed by direct trauma to the eye.
After 50 years old, the vitreous will deteriorate, becoming liquid like water, instead of its usual jelly-like consistency. The vitreous collagen fibers can pull on the retina and create a tear, fluid from the vitreous can ooze behind the tear, pulling the delicate tissue of the retina away from its nourishing bed. The retinal cells will soon die, taking your vision on that eye.
The good news is that sometimes, the symptoms are (like mine were) only due to aging and the pulling by the vitreous. They will eventually resolve on their own. (Even these can carry an increased risk of a tear in the first month, accompanied by a sudden visual change, as described above.)
We can save most of, if not all, of your vision with out-patient Laser therapy, *if* you get care early on. If you wait days, the dead cells can’t be replaced or repaired. Even with the best outcome, the treatment is much more complicated as time goes on, requiring surgery and carrying a greater risk of lost vision and an increased risk of cataract development.

While “on holiday” in England, I got to learn this lesson better than any medical textbook could teach me.

I first had the flashes and thought it was a painless migraine and that I was simply more aware of the floaters because of the flashes.
All of the symptoms were variable throughout the day, seemed to get better and even went away over the next few days. And who wants to go to an ER on vacation, especially in another country?
Then a week after the first flashes, I had a real scare: a sudden increase in the number of floaters and a very short time when it seemed as though I was looking through bad glass. I remembered a patient who had a retinal detachment who told me about seeing through “cracked” glass.
So, on a Saturday afternoon, I visited the local “A&E” at the hospital, followed on Monday by a trip to the Urgent and Emergency walk in clinic at the eye hospital in Oxford.
At the ER visit, I received a quick exam by the ER doc and, after reassuring me that there didn’t appear to be a detachment, I was given warnings about what to watch out for and the need to follow up with an opthalmologist for a dilated exam of the eye.

At the eye hospital, I had a visual fields test and a dilated retinal exam by an opthalmologist. There was no tear or obvious defect in my retina. I was reassured that I was experiencing “a normal process of aging,” but the warnings to return for new visual loss were repeated.
I met wonderful, kind and cheerful at both facilities and wasn’t charged a fee at all. I was told that “the first one is free!”
The waiting times were actually shorter than I expected, since neither department was very busy when I visited. (That must have been the slowest Monday morning clinic I’ve ever seen.)
My vision is fine, with a few more “floaters” than before. They’re more like strings or half rings at the the outside of my eye, and there’s one dot that floats past the middle of my vision occasionally.
(This is a re-write of a Facebook post.)

About bnuckols

Conservative Christian Family Doctor, promoting conservative news and views. (Hot Air under the right wing!)

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