PHUKET: We tend to think that if it doesn’t hurt it must be fine, but ignoring irregular eye symptoms is a big mistake. Why? Because there are no pain receptors in the eye, so if you’re seeing things but feel no pain it doesn’t mean you’re okay.
Today, we will talk about “floaters and flashing”. These two are important warning signs which can lead to serious eye diseases. Floaters are tiny black spots, specks, flecks or cobwebs which drift aimlessly in your field of vision. Although they can be annoying, ordinary eye floaters are common and usually aren’t cause for concern. In contrast, flashing, which is the sensation of flickering light or “lighting” triggered by eye movement, will require medical attention.
First we should understand the basic anatomy of our eyes. I usually tell my patients to think of their eye as a ball filled with gel. In medical terms we call this gel vitreous, which is mainly water and accounts for about 60 per cent of the eye’s total mass, giving it form and shape. Lining the inner wall of the eye, like wallpaper, is the nerve tissue membrane called the retina.
As we age the vitreous consistency will liquefy somewhat, contracting and moving the form of the vitreous. It is as the vitreous liquefies which can cause the effect of floaters.
These changes are considered normal with age, and as much as we would like to help; eye professionals can’t help you
FLASHES AND LIGHTNING
In most cases the process described will cause no medical problems. In a small amount of cases, the contracted vitreous can generate a pulling effect on the retina, similar to the resistance of pulling wallpaper from a wall.
This pulling will send electrical impulses to the brain and will be interpreted as flickers or light and cause the person to see flashes, like lightning. When the tugging force is too strong, the retina can tear and blood vessels inside can start bleeding. In this extreme case, the person will see many floaters at the same time.
If you do not consult with your medical professional immediately, the vitreous can pass through the retinal tear and start ripping the retina from the inner-eye wall. If retinal detachment happens then the person’s vision will be seriously impaired.
If left untreated, retinal detachment can lead to permanent blindness in a matter of days or weeks.
Retinal tears can be successfully treated with the help of laser treatment applied to the retina to seal the tear and prevent the progression of disease.
If the condition has gone too far and the retina has already detached, surgery will be required to push the retina back into its original position. The retinal detachment surgery is one of the most complicated eye procedures and requires a retinal sub-specialist ophthalmologist to perform the surgery. It is important to note, that not every patient who receives surgery after a detached retina can regain their full vision.
A study in the Journal of the American Medical Association in late 2009 found that the sudden presence of eye floaters and flashes means that one in seven people with these symptoms will have a retinal tear or detachment. About 50 per cent of people with a retinal tear will have a subsequent detachment.
When should you consult a medical professional?
• If you begin to see floaters in your vision.
• If the number of floaters in your vision significantly increases fast, immediately consult your doctor.
• If you see flashes in your field of vision.
• If black spots obscure your field of vision.
Doctor Captain Wiriyaluppa is an ophthalmologist and retinal consultant in Phuket.
— Dr Captain Wiriyaluppa
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