flickering

I had a slit lamp examination with dilated pupils around 6 months ago.  I had a pressure test and a general check up. I also saw an optician who also did a slit lamp test. All these tests did not find retinal detachment or holes or anything else wrong. But the reason I went to them was because I was experiencing a range of symptoms, mainly pin sized flashes from time to time.

Is it really worth requesting ANOTHER slit lamp test only after 6 months?

My vision itself hasn't changed but the symptoms have persisted and in fact have worsened.

What do you recommend I request to be done if I goto the eye specialist?

Thanks for any advice.

[Flavius G Pernoud III, MD]

Flickering,

I'm not sure of the "range of symptoms" you are talking about but a slit lamp exam basically is looking at the front 1/3 of the eye. Flickering usually is a retinal symptom which originates from the back of the eye. A special lens with a mirror placed on the eye can be used with a slit lamp to give the doctor a greatly magnified look at the peripheral retina but usually the doctor will look at the retina with a headlamp called an indirect ophthalmoscope while holding a separate lens in his or her hand. This gives a panoramic view of large areas of the retina. He or she may use a "depressor" which is an instrument to indent the outside of the eye so that more of the retina is visible. Traction from the vitreous gel inside the eye on the retina can cause flickering and can be tugging on the retina. Sometimes this tugging can tear the retina leading to a retinal detachment. Commonly, "floaters" or small dots and strings can be seen in the vision at the same time. In the vast majority of these cases, the flickering stops on its own but the floaters may not go away completely.  If you think that the symptoms have worsened, return to see the doctor soon for another look.

[jim509]

Is it just a matter of luck whether this tugging on the retina leads to retinal detachment?

Well I am sure the doctor did look at the back of the eye, and found no holes or detachment at the time. Hence is it too soon to check the back of the eye again?

I want to know what else can be done to find out what my symptoms are and if they are serious.

My symptoms which concern me are the occasional flash of pin sized white light sometimes purple.

Also when I close my eyes in complete darkness I dont see pitch black, I see some 'pattern'. What is and is not normal when the eyes are closed in complete dark?

(I also have itchiness/redness/irritation for 6 months.)

[russell903]

Great explanation on the extent of viewing with a slit lamp.  I've been treated for macular edema, and the retina specialist has not used the indirect ophthalmoscope, just the slit lamp for exams.  He's also used an OCT test for macula shape changes.  it seems to me from your explanation that the use of a slit lamp alone does not satisfy the need to examine the retina surface directly.  I've been having increasing floaters, and the retina specialist has never used the ophthalmoscope.  Might be a time for a change in retina people.  Russell903  

[jim509]

please can a doctor respond to my questions?

Thanks.