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Ask Dr. A.S. Desai Your Own Question

Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2368
Experience:  MS Ophthalmology with 11 years of surgical expereince
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I am a 64 yr old artist. Saturday I suddenly had arc shaped

Customer Question

I am a 64 yr old artist. Saturday I suddenly had arc shaped bright, bright flashes around the perifery of my vision in my right eye. They were and are intermittent and very distracting. The arc flash would get big enough to be a "C" shape. Today it isn't arcing quite that big. I also have floaters that are more numerous and black, not opaque as in the past. These symptoms affect my vision.

When arriving home that evening the things I read said get it checked out immediately. So I went to ER. The Dr there did some eye tests and an ultrasound and determined it was not a retinal detachment but thought it could possibly be a tear. If so, I need it to be looked at. She mentioned PVD, which I never heard of. She said to watch my activity level until I saw my Ophthalmologist, which she wanted me to do ASAP.

I went to my regular board certified Opthamalogist Monday. He is very cocky young fellow with a good reputation as doctor and a surgeon. He first berated me for going to the ER. He assumed they did a CT scan, and was surprised she did not order one because "they usually do". He said they normally order the uneccessary test. He obviously had no respect for the ER doctors.

His office did an eye chart exam, they dilated my eyes and he looked at them. He then showed good photos of PVD to my husband and me. I did understand PVD much better then.

He eluded to the fact virtually ALL of us older citizens develop this condition (that I have never heard of, even though I was a care-giver to 2 elderly parents).

He has scheduled a recheck in a month. My only restriction, when I asked, was "no jumping jacks" which he thought was quite funny. He made it known as we left and he talked to his assistant about how many patients he had to squeeze into the schedule that day, obviously feeling I was a needless one.

While I am greatly relieved, and I have put up with his attitude - I don't need him as a friend, I am confused.

1.When DO I check out symptoms like these? Or do I ignor them?

2. Is PVD expected at my age as a right of passage? Because it seems, from what he said, all we older folks have it happen?

3. Does this ever develop into a tear? Or detachment? What would I notice different, if so?

4. My husband has been diagnosed with a "retinal lesion", is that the same as a tear? (He sees a different Opthamalogist and is being sent to a retinal specialist tomorrow.)

Thank you in advance for any insight. Excuse the pun.

Submitted: 2 years ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 2 years ago.

Dr. A.S. Desai : Hello,Thank you for the question.I am Dr.A.S.Desai and I look forward to assisting you .
Dr. A.S. Desai : Are you available for chat now?
Dr. A.S. Desai : Yes, PVD is a very common condition and is expected at your age.
Customer: I am available, thank you.
Dr. A.S. Desai : Sometimes it can lead to peripheral retinal tears. Since you have already been examined by your ophthalmologist who has confirmed that the retina is intact, I guess you need not worry about it . A retinal tear is asymptomatic and can be detected on routine eye exam. Whereas a retina l detachment is characterised by a sudden bout of flashes of light and a shower of floaters along with fogginess of vision as if you were to be looking hrough a curtain or veil.
Dr. A.S. Desai : Did the flashes and floaters begin at the same time? Did the doctor mention the possibility of migraine? Did you experience any headache ?
Customer: Thank you, XXXXX XXXXX This was very sudden and I have some cloudiness in that eye, but main symptoms are flashing arcs and dark floaters. I feel while my doctor did not find a tear, and am confident that there was none there, how do I tell the difference between a serious retinal issue and the symptoms? My husband and I both felt he did not see any reason for my concern. When should I be concerned, if not with these symptoms? Also is a tear and a lesion one and the same?
Dr. A.S. Desai : No, retinal ter and reinal lesion are not the same.
Customer: Should I have ignorred the symptoms?What is the difference?
Customer: Difference between tear and lesion? Sorry, I accidently sent before I finished.
Dr. A.S. Desai : At this stage you can ignore the symptoms as it has been confirmed that the retina is intact
Customer: Should I have ignored the symptoms? As said, I am comfortable with the fact I don't have any tear.
Customer: Where do I look up difference between tear and lesion?
Dr. A.S. Desai : Yes, you can ignore the symptoms now. A retinal lesion could be anything in the retina such as pigment, new vessels, ischemic area, hemorrhage, dystrophy, degeneration and so on.
Dr. A.S. Desai : Your problem of PVD is totally different from a retinal lesion as has been diagnosed in your husband.
Dr. A.S. Desai : I guess you need not worry about having any retinal problem at present. The next eye exam after a month would confirm the above.
Customer: Thank you for explanation of tear versus lesion. I understand that. I was asking what SHOULD i have done, before going to ER? Should I always ignor any symptoms like that if they happen? I also understand PVD and tear and lesion and detachment are different things. As said, I am not worried that my doctor is wrong. I am just trying to understand why I should not have gone to er.
Customer: By the way. While I am not worried about a tear, it is impossible to ignor the symptoms.
Dr. A.S. Desai : I don't think you were wrong in goin to the ER since the symptoms of flashes and floaters is common to both PVD and RD. The only thing is that the person who does the dilated eye exam at the ER is not necessarily an eye specialist. A general doctor may not be the right person to identify these conditions.
Customer: I understan that, also. It was a Saturday night, or I would have called my Opthamologist.
Customer: Have a good evening.
Customer: Mary
Dr. A.S. Desai : Ok. In that case your visit is justified.
Customer: TY
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2368
Experience: MS Ophthalmology with 11 years of surgical expereince
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