Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.
It sounds like you may have two things going on. The first is myokymia and the second is a posterior vitreous
detachment. Let me give you a bit of information on these two issues:
1. Myokymia is an involuntary, local twitching of a few muscle fibers in the body of a muscle. This twitching, if it occurs in a limb, is not strong enough to actually move a joint but can be felt and sometimes seen as an area of quivering.
Myokymia commonly involves the eyelids and muscles around the orbit
. It often appears and resolves for no apparent reason and has not been linked to any underlying significant pathology. What causes myokymia? Studies have shown that it is associated with anxiety, stress, lack of good sleep, high caffeine intake and the use of some drugs.
The best way to treat myokymia is to get more sleep, decrease caffeine intake and decrease stress. The good news is that myokymia is not a sign of serious underlying pathology and often resolves on its own.
Here is an excellent article on this topic:
2. 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:
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.
From what you have posted I do not believe you have Oscilopsia nor is this a sign of something terrible, like a brain tumor.
And, of course, your overlying anxiety just makes things worse :(
Does this make sense to you?
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Thanks in advance,
Dr. Rick MD FACS