Flash and floaters

Hi,

I was seeing floaters and i went to see a retina specialist last week.  He saw my eye  ( dilated exam) and told be my retina looks ok..no problem.

Then after 4 days i saw one flast in my right eye and i went to see him again. He  again dilated me and told no problem. Here is my questios

(1) Does dilutions of eye having any risk for eye? I had 3 dilated exam in one month.  ( my angle between cornea and iris is wide open)

(2) After diluting my eye retina specialist office it stayed 4 days. He told me they use strong eye drop. Blurry vision went away in 12 hrs but my pupil was large for 4 days and it was reducing very slowly. I have black eye. Is this normal?

(3) Can retinal tear occurs in a day or two after a complete eye exam or if this is the case doc will tell u? Is seeing one flash mean i am having a tear? Or i should be more flashes?

Thanks

[John C Hagan]

1. drops used to dilate the eye very rarely cause problems. If problems occur they happen within 24-36 hours and do not linger longer than that. Possible problems include redness, swelling, watering.  Very strong dilation drops (10% neosynephrine) can elevate the blood pressure and raise the pulse. For this reason most of us use 2.5%. Cyclogyl in children and young adults can rarely cause confusion and aggitation.  Of course the drops will make the eye sensitive to light, make it difficult to see at near and if uncorrected farsightedness is present will blur the distance medicine until it wears off. In extremely rare cases in some farsighted individuals dilation can provoke angle closure glaucoma. This isn't a bad thing as these eyes need to be identified and treated with laser iridotomy to prevent future attacks and allow safe dilation.

There are no problems with frequent dilations of the eye in terms of permanent damage, etc.  

2. Some people are very sensitive to the drops, especiall light colored iris (blue, gray, green) and the drops last longer than normal. If you will tell the ophthalmologist (EyeMD) and the staff they will often be willing to use only "half dose" of dilation. (we do this in our office all the time). There are drops to make the dilation wear off sooner but they don't work on everyone, cause the eye to be very red and are so expensive that some practices charge to use them. I feel they are not worth the expense for my patients.

As to your questions about 'black eye' ( I presume you mean bruising of the eyelids) drops will not cause that. When a person has a complaint of flashes and floaters an instrument called a scleral depressor is often used to press on the lids to help see the very hard to see peripheral retina where tears often originate. The pressure from this instrument could cause bruising (but its very infrequent) in people that bruise easily, on blood thinners, steroids, have certain blood disorders. Sometimes it takes a lot of pressure to see certain suspicious areas and the eyelids are "sore" after this examination.

3. Please look at previous posts on the Ophthalmology forum and the patient-to-patient discussion groups and use the search feature on the site to look up "retinal detachments", "vitreous detachments", "floaters and flashes".  Retinal detachments can occure anytime but are very rare compared to the number of people that have flashes, floaters and vitreous detachments. The highest risk is in the first 4-6 weeks after the vitreous starts to peel off the back of the eye.

JCH MD