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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10792
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I believe am experiencing symptoms of a detached retina (floaters

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I believe am experiencing symptoms of a detached retina (floaters - hairs and strings - and brief flashes of light on the left periphery of my left eye). I am visiting in NY and away from my regular opthomologist who is in Kentucky. I am uncertain if it is safe to wait until I drive back to Kentucky tomorrow and see the doctor the following day, or should I rush to an emergency room in New York today? If it is indeed a detached retina, what exactly could they do for me in an emergency room that would benefit me?

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

I am a retina surgeon and can help you with this issue.

Customer:

Thanks. How dire is the emergency?

Dr. Rick :

You are correct, an ER doc can't help you, unless there is an ophthalmologist on call who can come in and see you. That being said, before you think about running off to the ER let's see if you need to......

Dr. Rick :

In addition to the flashes and floaters, are you seeing a curtain coming across your vision from any direction?

Dr. Rick :

If you wear glasses or contacts, do you know if you are highly nearsighted, say more then minus six?

Customer:

No curtain. I wear glasses mainly for reading.

Dr. Rick :

OK. I do not think you are having a retinal detachment and I do not think you need to seek emergency care. Let me tell you what is going on with your eye:

Customer:

ok.

Dr. Rick :

You are likely experiencing a PVD or posterior vitreous detachment, a common event that happens in many people.

You have a thick gel material in the middle of your eyes called the vitreous. Over time as it liquefies, this gel material collapses on itself, forms little clumps that you can see as dots, lines or bugs. As these clumps form the vitreous pulls away from the wall of the eye. In the process it can stimulate the retina -- causing the flashes that you may see.

It is recommended that you see your ophthalmologist to look at the retina to make sure there are no problems such as a retinal hole or tear. In most cases, there are no problems, but this exam is precautionary and allows for preventative treatment of any lesions that are found.

If you notice a sudden increase in floaters, flashes of light (like a lightning storm), or a shadow/veil in the periphery of your vision, this can be worrisome for a retinal detachment. You would need to contact your ophthalmologist promptly in that case.


 


What can you do about the floaters? Well, floaters don't go away, and they don't really get worse. Over time they tend to "sink" out of your central vision and you brain "filters" them out so you don't notice them so much anymore. They almost never cause significant visual problems except, of course, if they cause a secondary retinal detachment as discussed above. The only way to decrease or remove the floaters is with a major surgery called a vitrectomy. As a retinal specialist for almost 2 decades I've only done this procedure to remove floaters in a handful of cases.


 


Here is a video of the actual surgery to remove floaters:


http://www.retinavitreous.com/video%20files/intro_floaters.html


 


In January 2013 a new drug, called Ocriplasmin, was approved by the FDA to dissolve vitreous strands in a particular eye condition called vitreomacular traction. Perhaps someday this drug could be used to also remove floaters…. Only time will tell.

Dr. Rick :

So. What is the take home message? No need to panic. Enjoy New York and see an ophthalmologist when you get home but no need for an emergency exam.

Dr. Rick :

Does this make sense to you?

Customer:

Makes all the sense in the world and takes a load off my mind. Thanks so much.

Dr. Rick :

My pleasure. Happy Mothers day!

Dr. Rick :

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

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