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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3193
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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Can fentanyl patch (50 mcg) cause eye floaters Or could it

Customer Question

Can fentanyl patch (50 mcg) cause eye floaters? Or could it be my breakthru med, oxycodone-acetaminophen 10-315. Was just switched from dilaudid (hydromorphone 4mg) to oxy. Also use tizanadine 4 mg for muscle spasms.
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 3 years ago.

Doctor DanB : Hello and thanks for your question. Are you available to chat?
Doctor DanB : No, fentanyl is not known to cause floaters. This is a coincidental event to starting the fentanyl patch. Does that make sense?
Doctor DanB : A floater tends to follow your eye movements, floating behind and then catching up to the same position they occupied. These floating spots or "bugs" or cobwebs (they can come in many shapes and sizes) as some people call them, are tiny pieces of the vitreous jelly that occupies a large amount of the volume of the back of the eye.  This vitreous jelly, when we're born, is the consistency of a jello jiggler (thick jello). As we age it liquifies and becomes more fibrous bands and water. Because of this liquification and the resultant fibrous bands that are left, there becomes more points of traction that the jelly exerts on the back of the eye where it is attached. As we move our eyes in different directions and as our pupils change shape, or even as we rub our eyes, some of these bands can become unattached from the back of the eye and a piece of it floats around, attached still to the rest of the jelly. It is this traction of the vitreous jelly on the retina that can sometimes produce flashes that you may see or may not see, or may see in the future.  If you have or develop them, these flashes tend to be small, like starbursts and are usually intermittent; they can also appear as an arcing light. One of the most important things to understand about floaters is that the process of a new floater happening can rarely lead to a retinal detachment, so it is important to know the 4 signs of a possible retinal detachment. These are: 1. sudden increase in or new floaters, 2. flashing or arcing lights that are persistent and not going away, 3. a shade/shadow/spot in your vision that you can't see light through, or 4. a large drop in your vision which doesn't improve after a few minutes. For any of these symptoms you must see an ophthalmologist as soon as possible. 
Doctor DanB : Does this information help address your concerns? Does this make sense? Do you have any other concerns about this that we haven't addressed? It appears you are momentarily offline  I am happy to be able to help you today. I will also be happy to answer any other questions until you have the information you need; please just respond with any further needs and I will address them then.  If not, Please help me get credit for my efforts in answering your questions and press the ACCEPT button for this encounter; this allows part of the funds that you have deposited to the website to be released for my efforts to assist you. This does not end our conversation, however-we can continue to discuss any of your concerns without further charges until you are satisfied. Any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. Thanks for your inquiry! My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.
Customer:

Yes, I'm available to chat...was just reading e-mail when your answer came in. Mind if I read the rest of your answer?

Doctor DanB : Go right ahead I'll wait for you.
Customer:

I was also taking seroquil (very small dose--approximately 20 mg per night, for sleep. After I read all the side effects, I immediately stopped that drug, but I am on such a list of drugs due to the back pain (failed back fusion surgery with hardware and artificial disks-L3-L5). The pain clinic upped my dose of tizanadine (Zanaflex for spasms is the brand name, but I use the generic tizanadine), and that was the day the floaters began suddenly while I was removing eye makeup. I saw my optometrist who is really knowledgeable and has a lot of new equipment that he used to look into the eye. He said there was no retinal tear that he could see but there were some spots that looked like blood and he wants me to get a second opinion from a retinal specialist, which I will get either tomorrow or Tuesday. They will do tests to confirm his dx. Still, I wonder if it is due to some drug I am taking or what. I know they come with age, but I understand they never really go away, but my optometrist said they will eventually (in about a month or so) drop down out of the line of vision and will only be bothersome if I suddenly move from a lying to standing position, sort of like the "snow" in one of those old snow globes I know of from childhood (don't know if you are familiar with them?)

Customer:

Also, that was the same day that I was switched from dilaudid 4 mg to oxycodone-acetaminophen 10-325.

Customer:

And my fentanyl was upped from 25 plus 12 patch to 50 mcg patch.

Doctor DanB : Yes, I am familiar with them and his description is accurate. I also agree with his assessment that you should see a retinal specialist because anytime a new onset of floaters is associated with hemorrhage, the chances that something is wring or could go wrong with the retina increases significantly. One thing I can tell you most assuredly is these medicines (and all medicines for that matter) do not cause spontaneous vitreous hemorrhages.
Customer:

So, you agree the floaters should drop down out of the line of vision in about a month? Also, if they do find a tear in the retina or if the hemorrhage (my op didn't call it that, tho--at least I don't think--was very nervous and scared), how successful is surgery, which I understand is usually laser and is there a big chance I'll lose vision?

Doctor DanB :

Sorry this chat feature is behaving rather oddly today... Let me reply to your questions.

Customer:

I'm here and BTW will press accept as soon our chat is over!

Doctor DanB :

For most people these floaters do eventually drift out of the view, but for some people it can take more than a month. If there is a tear or hole in the retina, or if one does develop, as long as the retina does not detach significantly from that hole, a laser is very successful at stopping this process and you should not expect to lose vision.

Customer:

Thanks for the reassurance. If I have more questions, will you be available all day today? And, if so, how do I "reach" you? You have been most helpful!

Customer:

My optometrist said that about 99% of the time, the floaters "drop." out of the line of vision.

Customer:

I do keep getting flashes, but yesterday only had two.

Doctor DanB : I will be here and you can just return to this thread and I'll be happy to continue with you.
Doctor DanB : Do you have any other concerns about this that we haven't addressed?
Customer:

B4 I sign off, do you agree withthe 99% figure? Are the continuing but lessening flashes a concern? These are my last questions that I can think of.

Customer:

I have never used this site b4. How do I get back to you in particular? Do I choose you from the doctors available for chat?

Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3193
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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