floater, migraine or retinal detachment?

[cranium]

I occasionally would notice a very bright, small spot in the visual field of one eye. It would suddenly occur, and appears to be moving in an intermittent manner along a horizontal line. It's not an entire line that is bright, but just a small spot that's moving. It persists for 2-3 seconds and then disappears.
Although I have no objective evidence to say so, it gives me the impression like a blood cell moving through a capillary.

After reading about symptoms of retinal detachment, I'm concerned whether this indicates something I need to pay attention to. I'm a high myope (-9.25D in both eyes), with floaters in the eye. I see an ophthalmologist once per year and each time he says my retina looks OK, with no holes or tears or anything. My visual field test was normal and IOP is ~ 17 mmHg in the past 2 years.

I do sometimes have a migraine-like feeling (mostly headache with  nausea that persists for 1-2 hours, which gets better by itself), usually occurring when I'm tired. For once or twice I saw bright "zig-zag" lines prior to the migraine feeling. But this moving bright spot thing occurred without any other symptom.

I would like to have an expert's idea on what it is likely to be and what I need to do. Thank you very much.

[John C Hagan III, MD, FACS, FAAO]

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[AnnaE]

I meant to say "detachment" in the first line of paragraph 2, not "attachment."

[AnnaE]

Remember that I am NOT an expert. I have had several retinal detachments. I also have PVD, which is part of the eye ageing process. The vitreous separates from the retina, and this causes light flashes. I have a light flash in one eye. It is like a series of light flashes along a line, in the lower left region of my eye. This is not a worry for me, because right eye has been lasered all around, to protect it from detaching, as my left one did.The flash appears 10-20 times a day.

The doc is the expert here, but PVD provoked the attachment in my other eye, so I might suggest that you see the MD early. I went to the doctor two days before my retina detached, and he said he could see nothing.Two days later there were skyrockets in my eye, as well as big swirling black dots. If your retina were detaching now, there would be drama like this. However, it is worth a lot to get reassurance, and as much knowledge as you can arm yourself with, to protect that precious vision.

I also have the migraine lights, BTW. Those occur in both eyes at once even thought it does not at first appear like that.

I hope that all continues to be fine for you.

[John C Hagan III, MD, FACS, FAAO]

Well it's not at all characteristic of the flashes seen with a retinal detachment, (like a flashbulb going off in the eye), not really typical of a migraine type light (zig-zags are classic).  It could be a entopic phenomena, could be a mini-migraine.

As long as it does not get worse, nothing new develops and you see a Eye MD yearly and your health is good and you have an annual physical I would not be concerned.

Although I am unable to account for symptoms like yours they are quite common in practice and rarely lead to something serious if they stay stable.

JCH IIIMD