Eye Trauma and Retina Problems?

[larrye]

6 days ago I managed to hit myself in the right side of the zygomatic or temporal bone of my right eye with the top of the handle to a shovel. I did notice an increase in floaters (had some before) and a small flash in the very right periphery of my eye only in the dark and only sometimes when I move my eyeball to attempt to use my right peripheral vision.

I was dilated and examined by an optometrist and two opthamologists this week (one with over 30 years experience, one with over 40 years of experience). The last exam even consisted of not only the usual instrumentation (light on the doctors head looking in) but he also placed a lens on the surface of my eye and used the machine that they usually use to peer into the eyes and measure the pressure ... against that lens to view my retina. He looked around for a good solid 5-10 minutes. All said that my retina looked perfectly normal. My refraction exam was almost perfect with nothing obstructing my vision. Yet ... I still have the increase in floaters and that one small periodic flash in the right periphery.

They all didn't seem concerned, and told me to go ahead on my upcoming business trip this week ... that I should just be on the lookout if the flashes worsen, I see new flashes, or I see the "curtain" symptom of a retinal detachment. Yet, somehow ... I feel very unnerved traveling like this. I am concerned, of course, about the effects of this trauma on my retina and would prefer to be able to have a simple laser to repair any minor issues before they become serious enough to require surgery.

Can these symptoms that I am experiencing be just "normal" from the trauma ... or perhaps be a PVD that hasn't resulted in a tear or detachment? I imagine that a retinal detachment is pretty obvious to see .... but is a retinal tear easy to miss?

Thanks in advance for your help.

[psuoh]

My past RD experience is that within a month to 3 mo.or so after PVD if it is going to happen you will end up with a retina tear or detachment around that period.  You will notice progression of floaters, flashes and cloudiness of your vision. If these symtoms are stable you have a good chance you won't end up with one.   No rest or being cautious of physical activity will prevent RD.  I recall I rested in bed and avoided physical activity after PVD due to accident and still ended up with RD requiring extensive surgery.  

[larrye]

So it's now been 17 days since the trauma. This past Monday, 14 days after the trauma, I went to see a retina surgeon. Again, he dilated and agreed with the other three that there is no tear and no detachment. He told me to keep an eye out ... not so much for new flashes but for new floaters. Which is easier said than done because I had floaters to begin with, I have more since the trauma, and it's really hard to "quantify" them. I don't want to be running in for an exam every time I think I MAY have new floaters. He said that if you catch it within 24 hours, you can avoid the OR. He also said that he thinks that the flash I have been seeing is likely due to traction.  

Anyway, I still have the peripheral flashes and increased floaters 17 days later as I did one day after. The floaters are very distracting. I also just have a general feeling of irritation in that eye ... sometimes just feel like something's in my eye. I'm guessing that there's nothing that can be done about this short of a vitrectomy ... which I wouldn't want to do unless I had to?

[Timothy D McGarity, M.D.]

Retinal tears can be missed, but it sounds as if you had a very thorough retina exam with "scleral depression." You could actually have a PVD which hasn't completely detached (as you suggested). You will be fine to travel. If you began experiencing a "shower" of new floaters or loss of vision, then seek care that same day.

Best wishes,
Timothy D. McGarity, Medical Doctor, Ophthalmologist