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Over the past 6 months I have been experiencing a "bleary"

Hi over the past 6...
Hi over the past 6 months I have been experiencing a "bleary" right eye with things that seem to float in front of my eye. "like I want to wipe my eye". However, wiping does not clear it. Seems like eye strain. Sometimes I also experience a slight tension in my head. There is no pain. It's just annoying. It does not get worse with exercise but I am generally less aware of it while playing sports etc. I have a lazy eye and wore classes and a patch in childhood. Only reading glasses now. Seemed to start after I experienced an optic migraine (flashing lights etc). I have seen my GP and a neurologist 3 months ago. Also I have had my eyes tested x2 in the last year including the eye die. No reasons identified. Neurologist not even sure it was optic migraine. Possibly stress. However, I don't feel stressed. Although I was quite stressed a few months back. I am a CBT therapist and don't recognise my symptoms as anxiety related. I had a great aunt with glaucoma but have been checked for this. I saw an Opthamologist in 2009 who diagnosed optic migraine. No medicine. But I had experienced flashing lights then. This seems different. I am 49 years. Any ideas?
Thanks
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Answered in 17 minutes by:
8/10/2013
Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3,343
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
Verified
Dr. Dan B. : Hello and thanks for your question. Is it the whole of your visual field in that eye that seems to float around or are you seeing discrete objects floating around in the visual field of that eye with the remaining objects in that eye's visual field being clear?
Customer:

Not whole of my visual field. More like tiny blurry blotches (like a small smear on my glasses) that are stationary but sometimes move slowly across my field of vision. I sometimes also get like a quick flicker in my vision. They/or it usually moves from right to left across my 'good eye (right eye)'. No change to left eye. I have also noticed the outside (eye lid area) of the affected eye sometimes seems a little smaller than my my left. Not the pupil - but the outside. Similar to when I have an allergic reaction such as hay fever. However, I usually get breathless & wheezy with allergy. I am not currently experiencing this. I think the symptoms are there most of the time but I am less aware when busy or distracted. There are times when they are worse but no real pattern to this. Thanks

Dr. Dan B. : So this is happening in one eye only? In other words you can cover the right eye and these blurry patches will go away and then you can alternately cover the left eye and they are still there? Does this change with blinking?
Customer:

Yes, left eye is very blurry and I don't wear glasses to correct this anymore. Seems only to be in my 'right' good eye! If in the left I am not aware of it

Customer:

Sorry not much change with blinking. Sometimes makes the blotch move a bit

Dr. Dan B. : And how often do you notice this blob? How about the flicker?
Customer:

There seems to be times when I am more aware of it. Obviously when I become conscious of it - it is there. Some days seems like it has been there all day others less so. Never a day without it. The flicker is just occasional.

Customer:

Feels a bit like there is slight pressure on the eye. Better when eyes closed. If I think about my eye the flicker and the movement are interchangeable. However, the flicker is very fleeting. Interestingly, none of this seems to affect my performance say on the squash court. Sometimes it is distracting when at work and trying to focus

Customer:

sorry popping out 15 mins will pick up when I return. Thanks

Dr. Dan B. : To be honest with you, this sounds like something that should be identifiable on an exam by an ophthalmologist. I know you said that you have seen one, but I think you would be best served to get a second opinion from another ophthalmologist. If you had your choice, a retina specialist would probably be the best ophthalmologist to see. This sounds like that you have some floaters in the vitreous jelly and the occasional flicker of light is part of the process. Does this make sense?
Customer:

Yes, can I use your notes to share with my GP. Is this dangerous in anyway to my sight. Eg do I need an urgent appointment. If you are correct what would the Ophthamologist suggest? Is there anything else it could be?

Customer:

Many thanks

Dr. Dan B. : These floating spots or lines or cobwebs (they can come in many shapes and sizes) as some people call them, are tiny pieces of the vitreous jelly that occupies a large amount of the volume of the back of the eye. This vitreous jelly, when we're born, is the consistency of a jello jiggler (thick jello). As we age age, the vitreous gel inevitably liquifies and becomes more fibrous bands and water. Because of this liquification and the resultant fibrous bands that are left, there becomes more points of traction that the jelly exerts on the back of the eye where it is attached. As we move our eyes in different directions and as our pupils change shape, or even as we rub our eyes, some of these bands can become unattached from the back of the eye and a piece of it floats around, attached still to the rest of the jelly. It is this traction of the vitreous jelly on the retina that can sometimes produce flashes that you may see or may not see, or may see in the future. If you have or develop them, flashes tend to be small, like starbursts and are usually intermittent; they can also appear as an arcing light. One of the most important things to understand about floaters is that the process of a new floater happening can rarely lead to a retinal detachment, so it is important to know the 4 signs of a possible retinal detachment. These are: 1. sudden increase in or new floaters, 2. flashing or arcing lights that are frequent or persistent, 3. a shade/shadow/spot in your vision that you can't see light through, or 4. a large drop in your vision which doesn't improve after a few minutes. For any of these symptoms you must see an ophthalmologist as soon as possible; however, because these symptoms are new I would recommend making an appointment to see your ophthalmologist as soon as you are able.
Dr. Dan B. : By and large, floaters are so common and so frequently associated with aging that they are essentially normal, even though they are common in younger persons as well. While most people do not completely get rid if their floaters (they never completely and permanently go away), they usually get "better" from these floaters through one of more of three different mechanisms: 1. They can sometimes break up to some degree; 2. They may drift more out if your view; and 3. The brain usually learns how to ignore them to a large extent (and then they usually only become "visible" when they get "stirred up" by moving the eyes quickly from side-to-side or rubbing the eyes when looking at high contrast backgrounds such as white paper/walls, a bright sky or a computer monitor). There is really only way to permanently rid yourself of floaters and that is major surgery, so far the most part, most people just learn how to live with them unless they actually interfere with activities of daily living.
Dr. Dan B. : Does this information help address your concerns? Do you have any other questions about this?
Dr. Dan B. : Your feedback is important to me and will help me improve my encounter with future customers. Please rate your encounter with me by providing positive feedback (by pressing the smiley face); any bonus you may feel prompted to provide would be welcomed and is appreciated. If you feel like your concerns are not resolved or you have a problem or issue with anything I have said or haven’t said, please don’t issue a negative feedback rating—My goal is your satisfaction and I would rather work together to solve your concerns, until you are satisfied, than have you leave our encounter unhappy and unsatisfied. 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. Thanks for your inquiry!
Customer:

That's very helpful thanks. Do you still consider these symtoms as new even though I have had them a few months?

Dr. Dan B. : No, I don't. For that reason I don't think you need to rush to the ophthalmologist, just see one soon.
Customer:

Also. Would this account for the slight pressure feeling in my right eye (like something small on my eyelid) and the occasional pressure feeling ob the sides of my head. I think these symptoms are why the GP suggested stress. I wondered if they are like part of an ora linked with optic migraine?

Customer:

Perhaps this is because my eye is a bit strained due to the floater and that is causing a tension??

Dr. Dan B. : Thats difficult to say. It can be associated with this. But it can be also associated with a dry eye or tear film abnormality. I would recommend using artificial tears 3-4x/day for a few weeks to see if that helps this.
Customer:

Many thanks. Finally, I am interested in the point you made about whether it is in both eyes. My left eye sees so poorly it is hard to tell. However, things do seem better when I cover my left eye? Would it make a difference if I have symptoms in both eyes?

Customer:

Would dry eye or tear film abnormality cause a tension feeling in the head and eyelid?

Dr. Dan B. : If the symptoms were present and only one eye, in other words if the symptoms went away the matter which eye was covered or whether both eyes were covered then I would've thought this would have been more likely to have been a persistent migraine phenomenon. However, this does not seem likely to be the case.
Dr. Dan B. : Yes it could.
Customer:

Wonderful. Many thanks for your help. I will return to my GP with the information you have offered and request an appointment with the ophthalmologist as soon as they can fit me in. I will also try the artificial tears as you suggest. I assume these can be brought in a pharmacy over the counter? I will tell the GP that without providing an examination (from your experience) you are suggesting I have some floaters in the vitreous jelly. Is that correct?

Dr. Dan B. : Yes, you are correct on both counts. I hope this has been helpful. Please rate your encounter with me by providing positive feedback (by pressing the smiley face); any bonus you may feel prompted to provide would be welcomed and is appreciated. If you feel like your concerns are not resolved or you have a problem or issue with anything I have said or haven’t said, please don’t issue a negative feedback rating—My goal is your satisfaction and I would rather work together to solve your concerns, until you are satisfied, than have you leave our encounter unhappy and unsatisfied.
Customer:

Great. Will I get a copy of this chat? If so does it come as an email?

Dr. Dan B. : There should be a link on your page that says 'share'. If you hover your cursor over this, it should give you the option to either print out or email the transcript to yourself. If that fails, I would recommend just selecting the text with your mouse cursor, hitting Ctrl+C, and then opening up a word processor document such as Microsoft Word, hitting Ctrl+V (paste) and that will allow you to keep the transcript. Make sense?
Customer:

Yes, great thanks

Dr. Dan B. : You bet. Good luck.
Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3,343
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
Verified
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Customer reply replied 4 years ago

Hi, since our last chat I have been monitoring my symptoms more closely. The eye floaters continue but probably the most uncomfortable symptom is the head tension (like a numbness or band round my head). I think the eye and the head tension are linked. However, while I can have the eye symptoms alone the head tension is only sometimes. The tensions can be several times a day and can be up to about 20 minutes at a time. I am mostly aware of these when I am driving or after work (perhaps stress related). The sensation can be very uncomfortable and makes it hard to focus. These head tensions seem perhaps more in line with the opitc migraines we discussed before. Before I see my GP I thought I would ask if you consider this still links in with floaters in the vitreous jelly of the eye or does this sound like something different? I have tried the artificial tears you suggested but have not noticed a change (perhaps early days). What are they intended to do? Is there anything else I could try?

Thanks

If your symptoms are related to a dry eye or dysfunctional tear film, artificial tears can help this. It does take using them for a week or so before you would rightfully expect to notice a significant difference. While the floaters may be triggering or may be associated with your headache, I suspect that headache has a life of its own and therefore should be treated as any other headache that you normally have. I do not think treating the floaters Is going to change your headache.
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Dr. Dan B.
Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3,343
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Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology

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