a lifetime of flashing lights, photopsia!

[Vinny456]

Hi doctor,

After experiencing flashing lights and increased numbers of floaters for ten weeks, I was found to have PVD and three small retinal tears that required laser treatment. Although I was informed that the probability of additional retinal tears and/or detachment was very low, I was also told that I may continue to experience the flashing lights for the remainder of my life! When I asked the surgeon that IF the vitreous did not fully detach and continued to tug and create tension on my retina and/or macula for the rest of my life, in fact wasn't there a greater risk of tears and detachment rather than lower risk, he did not elaborate any further.

I would appreciate your feedback.

[gpackg]

Hi, I had a posterior vitreous detachment in my right eye 11 weeks ago and although the flashes subsided after a few days, I have had persistent black lines and shapes moving constantly in kaleidoscope fashion in my right eye's peripheral vision. Two opthamologists and a retinal specialist have done numerous tests, have never seen this before, and can't figure it out. The first two docs think it may be an unusual PVD symptom, but the specialist doesn't think it's connected, even though it occurred at the same time as the PVD. He suggested I see a neurologist although I'm experiencing no neurological problems, including no migraines or headaches. Have you ever seen this symptom before?

[nelu712]

Sir m dr. neelima, i have underwent barrage laser last year for lattices and holes in my retina..  i am high myopic -18 diopters both eyes. since one month i am observing some light illuminations at the periphery of my viion towards lower eyelid. i went for dilated retinal examination and my retina specialist says that this is vitreous degeneration and pulling but there is no changes in retina so far.i want to know whether PVD in such a early stage will cause any future problem. Will people with higy myopia are able to see life long??m a doctor highly ambitous but worried about future please help

[Vinny456]

Thank you Dr. Hagan.

After writing my previous post, the floaters described above were becoming more noticeable so one of my surgeon's fellows performed a comprehensive retinal exam this afternoon and he indicated that the scar tissue was from the laser intervention was immature but healing and there were no new signs of tears or detachment. He advised me to modulate my physical activity at this stage until the scar tissue becomes more solidified.

The fellow also noted that he observed some lattice degeneration but not to a significant extent. He also indicated that there was a low risk of further tears and/or detachment but they were always possible.

Dr. Hagan, does laser treatment of retinal tears possibly lead to further tears in an eye(s) of a myopic individual with some lattice degeneration?

Due to the fact that I also have pigment dispersia syndrome, if I need cataract surgery in the future will the fact that I had a laser repair of these retinal tears make me more prone to a retinal detachment?

Thank you

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

laser treatment or cryo treatment of laser hole/tear do nothing to reduce floaters or make them go away. The most worrisome floaters are showers of small black "soot" with or without flashes or loss of visual field. Those call for an emergency call to your surgeon.

Small single floaters that you notice are generally not worrisome

JCH MD

[Vinny456]

Dr. Hagan, thanks for your response. Google images was quite helpful in visualizing the images of a vitreous and retinal detachment. Thanks.

I had the laser repair of three small tears last friday and was subsequently examined on Monday. I was informed that "immature" scars have formed and was advised to return next week for a followup visit. However, I noticed that after my most recent exam there is the presence of one or two black dot floaters that intermittently dart across my visual field, especially when I am looking at my computer screen and/or a light colored wall. They seem to move out of my visual path when I attempt to observe them. No curtain or shower of floaters are present.

I contacted my retinal surgeon and spoke with one of his assistants regarding this new "development" and she spoke with the surgeon who in turn thought that this new symptom was not anything to be concerned about and that I should keep my scheduled appointment next week.

It is interesting to note that the flashing lights seems to have decreased significantly since Monday of this week. However, even though my surgeon does not believe that the darting black floater(s) that I am currently perceiving is anything to worry about, and that the chances of a detachment or additional tears are unlikely, in fact I am concerned due to the fact that my previous retinal specialist completely missed the presence of the three retinal tears (in spite of four proximal retinal exams), in spite of my consistently informing him that I was inundated with flashing lights.

So Dr. Hagan, I am very vigilant regarding any new symptoms that emerge and remain quite concerned at this time. However, I don't wish to overreact either and run to the ER each time I see a new floater.

As a clinician, would you be concerned regarding the emergence of a new floater(s) post laser repair of tears or am I in fact overreacting.

Thank you again for your kind assistance.

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

The vitreous rarely complete detaches. It is held firmly around the anterior edge of the retina in an area called the vitreous base. It does often separate from the retina further posterior.

Yes the more that the vitreous peels away from the retina the less chance of a hole/tear/RD.

Yes, I have a few patients that continue to see occassion light flashes for many years however in the great majority the flashes eventually stop usually within several months.

Go to Google Images type in vitreous detachment and get an idea what they look like

JCH MD