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Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2436
Experience:  MS Ophthalmology with 13 years of surgical expereince
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I am 62 in excellent health, only taking lisinopril 5mg/day.

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Hi! I am 62 in excellent health, only taking lisinopril 5mg/day. No other problems. Last wk I briefly noticed a smudge-like spot in the vision field of my right eye. This occurred twice last wk, so I dismissed it. Late this afternoon this small blurry area returned to @ 5 o'clock in my R eye- not really a floater, as it does not bounce around, but is more noticeable if I look down. Could this be a retinal tear? Should I just make an appointment with an opholmolgist asap or does this need immediate attention? Thank you.

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A retinal tear resulting in a retinal detachment(RD) surely would have been more constant and not intermittent ( twice or thrice a week). Moreover it would not have been obvious only on looking down ( irrespective of the direction of gaze , it should have manifested with the visual blur). Even though the blurred spot does not float, the very fact that it appeared and then disappeared points towards a possibility of a floater( slightly larger floaters may not show the characteristic bounce due to the sheer size of it). There is higher possibility of your symptom being due to posterior vitreous detachment(PVD) rather than RD.

In PVD the thick gel at the back of the eye( called vitreous) gets detached from its surrounding retina . This results in retinal traction which results in the symptom of flashes of light and includes color distortion. Flashes of light may not be prominent in some individuals. Once the vitreous gets detached completely , it may form clumps or strands and cause symptom of floaters such as dark spots, cobweb or thread like strands in the visual field.

More often it is not a serious issue and does not require any specific treatment. A routine retina examination needs to be done by an ophthalmologist just to check for the intactness of the retina and to look for any peripheral retinal tears or holes, which if found, can be sealed by lasers.

The symptoms which require urgent treatment by a retina specialist are those of a RD- characterised by a sudden shower of floaters, flashes of light and blurring of vision as if looking through a veil or curtain ( this would be more or less constant).RD is very unlikey to occur in case of a healthy intact retina. It is more often seen in those with high myopia(short sightedness), diabetic retinapathy, trauma, ocular inflammatory diseases.

Thank you and best wishes.

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Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist

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