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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience:  Eye Physician and Surgeon
20222826
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16 days ago I suffered a PVD in my right eye. My opthalmologist

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16 days ago I suffered a PVD in my right eye. My opthalmologist says was one of worst she's seen. Weiss Ring got worse, and was examined again, not retina detachment. I have continually seen the typical small flashes in the periphery, and a week later went to see a local retina specialist. A small pin hole in retina at bottom center (6 o'clock) was discovered and repaired outpatient with laser. Since then, at nite or low light conditions only, I will sometimes see a small halo ring, sometimes it fills with blue color, and goes away quickly. At first it appeared only in the extreme periphery, but now occasionally appears on top of field of vision. The halo ring fills with blue quickly-then dissipates, and only lasts for a second or so. Sometimes I see it when blinking. I have been re-examined by the retina specialist who sees no signs of retina damage after the laser procedure, but the halo flashes did not appear until after the laser repair of the pin hole. Since they only appear at night or dark I assume they are vitreous related but don't appear to be classic. What/could they be symptoms of?
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. James replied 3 years ago.
Chat Conversation Started
Dr. James :

Hello.

Customer :

Hi.

Dr. James :

Please Note:
JustAnswer is a public forum. Information provided is for educational purposes & does not establish a patient-physician relationship nor substitute for a personal consultation with a physician.

Customer :

I understand.

Dr. James :

With your history of a PVD and retinal hole, the visual disturbances are most likely related to the vitreous pulling away from your retina.

Dr. James :

There are some other conditions with may cause these photopsias, but in this context, less likely.

Dr. James :

Those could be inflammation of the retina, ocular migraines, or abnormal blood flow to the eyes.

Customer :

I assumed such-but the halo type flashes don't appear to be the classic brief flash in the periphery. I have had a very thorough exam 3 times in the last 16 days, with another scheduled for a week from today. I have a relative with a terminal illness in California, and am wary of flying.

Dr. James :

With a PVD, you are safe to fly. It is only with a retinal detachment in which you should be worried because you would have to seek medical attention urgently if it does occur.

Dr. James :

Sigs of a retinal detachment are if you notice a sudden increase in floaters, flashes of light (like a lightening storm), or a shadow/veil in the periphery of your vision.

Customer :

The adjustment to the floaters has been good, but the halo flashes increasing has caused me concern. My vision is 20/20 still with glasses, 20/20 pinhole, and 20/30 w/o glasses. I'mn not seeing any curtain effect, and peripheral vision appears OK. My concern with flying is that I am statistically within the window of suffering a retinal detachment, or a PVD in other eye. I laso have never heard a description of the type of halo flash I see as associated with a PVD. I ave not seen any lightning storm flash either.

Dr. James :

The lights patients see can be varied. In general, they should be very brief, however.

Dr. James :

There is not restriction to flying. Most people with PVDs have no problems. If your retina specialist is OK with you traveling, then it should be OK.

Dr. James :

Hello... are you still online?

Customer :

That is correct, they are brief. In searching I have yet to see a good description or rendering of the types of flashes associated with PVD. I am sure they would easy to re-create by those of us who have those symptoms, and that would be helpful in understanding what one is experiencing. So is there not a "classic" flash? It just seems based on all I've read the "halo" flash is unusual, and it did not occur until immediately after the laser repair. I know there's no flying restriction, my concern is having a problem away from home and being away from the typical support group of family and friends.

Customer :

Apparently the types of halo flashes vary enough to not be definitive in a description or rendering?

Dr. James :

It is best to stay in the area, however, a PVD may take months to be fully complete. If you can postpone your trip easily, then great.

Dr. James :

From patients who come in with "flashes", they usually describe it vaguely. This is usually because it occurs in the peripheral vision, a portion of vision where they are not use to seeing things. Secondly, it is brielf so difficult to see it.

Dr. James :

May I ask what kind of work you do?

Customer :

Yes, I'm aware that the PVD completes in around 3 months, but can take up to a year. It will be necessary at some point, sooner rather than later to make the trip. I will try and make it brief.

Customer :

I am in the automobile business, outdoors a lot, do a lot of wholesale business and appraisal work, some retail. I do spend hours a day on the computer as well. FYI I have been referred to the Doheny Group in California when I travel there, as my retina specialist did his fellowship and was offered there.

Dr. James :

You don't have to answer that question about work. I was just curious because patients who are very analytical tend to be very attuned to their symptoms. These tend to be engineer or PhD type patients.

Customer :

OK-you hit the nail on the head-I am very analytical, and am very attuned to my symptoms.

Dr. James :

The Doheny Eye Institute is top notch in Los Angeles.

Customer :

That's what I understand. I was basically looking for affirmation of what I'm hearing so far, and also some clarity regarding these halo flashes.

Customer :

FYI the halo flashes are not just in the corner periphery-they started out there but I am seeing them move over top of eye also. Can liquid get behind retina and cause something like that?

Dr. James :

From my experiences, the flashes can be so varied that their description is less useful. If the flashes are prolonged and not brief, then that is not typical of a PVD and I would look for other explanations.

Dr. James :

Yes, the vitreous can cast shadows. The laser can cause dispersement of pigment as well. It can be halo like in appearance, spider web -like, worms, fibers...

Customer :

Interesting. That explains the lack of description then. And the fact they occur in low light or dark would then indicate a likelihood they are vitreous/PVD related?

Dr. James :

Yes, because the light is coming from inside your eyes, they are more apparent in low light conditions. In bright conditions, you can confuse them for stimulus coming from the environment. Also, it is harder to different light from inside your eyes with extrinsic light because yours are flooded with stimuli.

Dr. James :

In low light condition, there is less "noise" so the flashes are easier to see.

Customer :

OK-thanks very much. It has been a pleasure "chatting" with you. I really appreciate your time and info. It has been helpful, educational, and reassuring. Perhaps the most difficult aspect of this sudden PVD was the related anxiety and fear associated with the uncertainty and potential for further issues.

Dr. James :

Do you have any other questions I can answer for you?

Customer :

No sir! Thank you very much!

Dr. James :

You're welcome.

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Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience: Eye Physician and Surgeon
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