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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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I just had an eye exam on Monday. I was having a small

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I just had an eye exam on Monday. I was having a small white circle flash a few times & some floaters. The optometrist told me I had a PV, that it should be okay that a retinal detachment wasn't likely. Today my eyes seem more blurry I do have astigmatisms, but I have no glasses to wear til my new ones are ready. I have been without my eyeglasses for almost 3 months. I looked in the mirror & it seems that my left pupil is just a tiny bit smaller than my right pupil. I read online a shower of floaters can mean a retinal detachment I have a few how do you consider it to be a shower? I have one that seems like it's right in the center of my eye. This is all happening in my left eye the one she told me I have a PV. Is this all normal with a PV even a smaller pupil? Another thing she just looked into my eyes with a light, but she didn't dilate them which I thought they always did especially with the problem I was having. I have always had them dilated in the past. My left also seems to be watery not a lot, but usually they never do
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 6 years ago.
Doctor DanB : Hello and thanks for your question. Are you able to chat?
Expert:  Dr. Dan B. replied 6 years ago.
I'll be typing my answer to your question right now.
Expert:  Dr. Dan B. replied 6 years ago.
A shower of floaters generally refers to a whole bunch of floaters with a sudden and stark onset, not one isolated PVD as you have.
When a there is a difference in pupil sizes, this is call anisocoria. Depending on how the pupils react and whether there are other associated signs, this can be caused by several significant medical problems, or it could be just the way you're "wired" so to speak, even if did just come on recently--this is called a physiologic anisocoria, or a difference in pupil sizes that is always less than 2mm, isn't associated with any other signs or symptoms and isn't caused by any significant medical pathology.
For those people who have a physiologic anisocoria, the amount of size disparity can vary from day to day and the "abnormal" pupil can even change sides. But a physiologic anisocoria is also usually the same size disparity in both well-lit and dim environments.
For the most part the pupil size difference is usually not related to the PVD in anyway, but mere coincidence here.
While you can see some central PVDs without dilating the pupils, whenever an exam is done for a new PVD, it is essential that the entire retina be carefully examined  and that cannot be done without dilating the pupils.
I think that the watering of the eye is also an un-associated problem from the PVD and the pupil.
Does this information help address your concerns? Does this make sense? Do you have any other concerns that I haven't addressed?
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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: replied 6 years ago.
when the optometrist examined my eyes & she saw the PVD could she have missed I had a retinal tear, because she did not dilate my eyes? So I could still have more than a PVD? All she did was shine the light in both my eyes & fit me for eye glasses
Expert:  Dr. Dan B. replied 6 years ago.
she very well could've missed a retinal tear. While it is still an uncommon to rare event to have a retinal tear with a new PVD, you are still at risk for it. I would recommend seeing an ophthalmologist to get a thorough exam for this.
Customer: replied 6 years ago.
When I ask her if I had a retinal tear she assured me I did not, she said I had a PVD & there could be a slight chance I could develop a retinal tear. She also told me that quite a few people had been in for light flashing & were worried about retinal tears, she said mine was the mildest & the worst one she saw that day had a hole not a tear. She seemed pretty sure that mine was nothing to worry about now you are telling me she could have missed a RD & it could be more than a PVD?
Expert:  Dr. Dan B. replied 6 years ago.

Without equivocation, if she did not dilate your pupils then she could not have seen the entire extent of your retina, unless your pupils are naturally 10mm in diameter and stay that way. She can also not rule out a retinal tear, hole, or break or even RD on the basis of how big your PVD is. To attempt to do so is a dangerous assumption. Again, it is still a rare event to get a retinal hole, break, or tear or RD from this event, but you are certainly still at risk. As an ophthalmologist (a Medical Doctor and eye surgeon), I would not be sure that you didn't have a retinal problem unless I dilated your pupils and did a comprehensive retinal exam. In addition, a retinal hole can just as easily turn into a retinal detachment as can a retinal tear or break.

Customer: replied 6 years ago.
all this being said to me & the general pubic we go in for an eye exam we are told from the flashes, floaters, etc it's nothing more that a PVD by our optometrist, how would one know any different if we take their word? It's pointless than to go to an optometrist at all if that being the case. I couldn't understand why she never had my eyes dilated, and her nurse said sometimes she doesn't if she can get a clear view.
Expert:  Dr. Dan B. replied 6 years ago.

Please let me explain a fundamental difference between optometrists and ophthalmologists. An optometrist is a person who has a college degree who went to 4 years of optometry school to study the general workings of the eyes, but most specifically the optics of the eyes. Their training qualifies them to prescribe glasses, contact lenses, conduct general, healthy eye exams and to facilitate more complex low vision aids for persons with decreased vision. They are usually adept at general eye health concerns, but they are not medical doctors.

An ophthalmologist, like me, is a medical doctor. I have a four year college degree and then attended four years of medical school and graduated with an M.D.. I am, therefore, trained in every process of disease and physiology in the human body. I am a trained surgeon and understand how the diseases of the body in general affect the health of the eye and vice versa. Ophthalmologists have much more training, experience, and knowledge regarding the medical diseases of the eyes because this is the bulk of our training.

I would not advise seeing an optometrist for an urgent or potentially urgent problem with the eyes because many of them do not know the extent to which they don't know important principles.

Yes, you are correct. The general public trusts everything that is said by an optometrist because, for all they know, this person is an "eye doctor." It is true that their optometry degree is a "doctorate" degree and therefore they are eligible to be called doctors. But they are not medical doctors or physicians. They are doctors of optometry.

If this optometrist has established a practice of not dilating patients who have new onset PVDs just because she can see the PVD when the pupil is not dilated, then she is skirting a dangerous path.

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