Worried about eye flashes

[spacechimp]

I've had eye floaters for years, but only really notice them when reading - books or computer screens - or looking at the sky. Over the last few months I've also experienced a few instances of very brief flashes of light in the corner of one eye when lying in bed reading on dim light before going to sleep

Last night I had an eye flash which was more in the centre of my eye and so made an appointment with optician today as I was worried about the possibility of a retinal tear/detachment

I've had all the tests, including the dilation tests, photographs, and puffer tests before and after the dilation drops. Optician said he couldn't see anything, though the gel was 'not stationary' in the eye I've been having trouble with

I thought all was ok but he then proceeded to freak me out by telling me to go straight to the Eye hospital emergency if the flashes happen again, so I'm wondering whether there is actually a problem. The flashes are momentary and only happen (or I've only noticed them) late at night.

I should say that I suffer from anxiety so it is hard for me to assess what I'm being told but I'm now wondering whether I should be thinking about going to the eye hospital anyway, even though I've been tested today

Has anyone had something like this which wasn't a retinal tear/detachment, and if I've been checked today and nothing further happens can I assume I am ok?

Google MEWDS, it could be that. (Multiple Evanescing White Dot Syndrome if memory serves.) If it is that it will probably clear up by itself. I would, however, stress the importance of getting anything eye related checked out properly. Mewds is quite rare, so I had to be seen by top guy at Moorfields before mine was diagnosed. Good luck.

I have had two episodes of vitreous detachment,. The first episode where the vitreous detached in my right eye led to floaters. The second, three years later where the vitreous tore away in my left eye caused no lasting problems.

I am not an Optician and therefore can't determine if this is what you are experiencing.

However, the way my situation was explained to me is that sometimes as we get older the vitreous, which is attached to the back of the eye, loses its elasticity and tears away. The process of tearing away causes flashing and usually lasts two - three weeks. It can also cause floaters which are permanant but become less noticeable over time.

This is not the same as retinal detachment, but can in a tiny minority of cases, lead to the retina detaching.

The reason that you have been told to go to A&E if you have any more flashes is because they will need to ensure that you don't end up with any damage to the retina, if you are experiencing a vitreous detachment.

Please don't hesitate to go to A&E if you are worried. I ended up with six visits to the Optician over 6-8 weeks as my vitreous individually detached. Each time they were happy to check all was well and that my retina was not being affected.

what lunenberg has said really

also had a PVD which presented as a quite large arc of wobble in my vision plus the flashing lights effect in low light

the retina is only really attached at the optic disc and it's the vitreous that keeps it in place so once that starts shrinking and pulling there can be issues

I would always present to my optician if I was worried and take it from there, most have cameras and can get a really good look in your eye to assess what is going on and refer on from there.

It helps to try to be objective and quantify your symptoms so you don't end up freaking out over something that really doesn't matter so try and notice how often the flashes are occuring, how intrusive they are, are they getting worse, taking up more space?
Then if you have an obvious pattern you can get a feel of if things are worsening or not and take action if required.

Thanks everyone - really helpful to hear. Have had a look at the description of MEWDS Barabajagal and will bear it in mind

Thank you for sharing re PVD lunenburg and MsHomeSlice. From the tests I've had today do you think the optician would have been able to say if there was any evidence of vitreous detachment going on at the moment?

He did mention that the vitreous in the eye I've had flashes in was 'not stationary' so there could be changes to the vitreous which would explain the flashes, but do you think I don't need to worry about retinal damage at the moment?
He said that flashes in the day were something to seek help for - more so than at night - but didn't say why. The only time I've had flashes (that I've noticed) has been late at night

The advice re being objective and quantifying symptoms is really useful and makes me feel a bit better about monitoring. I guess if the flashes do get more frequent/obtrusive then that's an obvious sign to go to Eye Hospital as an emergency but if it happens again as it has done before - occasional and very brief then not sure what I do

I get something similar. I’ve had it about 5/6 years and have seen various opticians, had dilation etc and even paid privately to see a neurologist but I’ve still not gotten to the bottom of it.
I get a bright blob in my vision as though someone has flashed a camera in my eye. It’s only usually in one eye at a time, changes sometimes right eye, left and the blob can be anywhere in my vision. I notice it when I look at a bright background such as the sky, tv screens or computer screens. Occasionally, it’s a dark/grey blob. Usually the size of a small pin head and they usually only last a few seconds to minutes then gradually fade. I get them almost every week but can go weeks without getting one.
The only real diagnosis I got was from the neurologist who said if he had to give it a name he would say it was silent migraine. I do get migraine from time to time but that’s always in the both eyes at the same time and is like a zig zag prism so a bit different to the blobs. So who knows what it is? I too suffer with anxiety which makes this much worse as I really panic about it!

Yes, as the very enlightened PP have said, it does sound like the start of a PVD (posterior vitreous detachment). The vitreous is the gel at the back of the eye that gives the eye its shape, that's why the Optometrist referred to it as "non-stationary gel"

As you age the vitreous liquifies somewhat and the very back bit that was attached to the retina comes away. As it pulls on the retina it causes you to see little flashes of light. Occasionally it can cause a little tear or hole as it pulls and that why he was advising you to go to A&E if you get many more flashes, you should also watch out for any curtains across your vision or a very sudden increase in the number of floaters you have.

Twoweekcruise - yours sounds like a very unusual kind of entoptic phenomenon (have a google and see if any of the descriptions fit yours).One that seems quite common in young children (especially in little girls) is seeing coloured blobs in their eyes!!

Honestly you should get checked again. No one can tell you for sure what you are experiencing without looking at your eye. Go and get checked again

Thanks for your explanation of PVD underneaththeash - do you think that's what the Optometrist was seeing the start of?
Most of what I've read about PVD mentions peripheral flashes but the one I had the other night was in the middle of my eye and was more like a bright floater if that makes sense. Would that still fit with PVD?
Also, why would it be worse to see flashes in the day than at night, as mentioned by the Optometrist?
I've been taking it easy today and trying to get more sleep - have been sleeping badly the last few days. If I am at the start of a PVD would it be ok to do spin classes? I'm not sure if I should be avoiding strenuous exercise
Sorry for all the questions - am guessing you are have professional experience in this area underneaththeash

I get something very similar which is a stress migraine.

White flashes only in one eye and always the same one. Quite often my peripheral vision is affected and j have had blind spots on occasion. They just came on one day about three months after my son was stillborn and I had them almost constantly for about six months then they gradually got better and went.

Last year dp had a serious health condition and hospital stay and they came back with a vengeance. Thankfully better again now three months on. I had tests at hospital twice and they didn't find anything.

I've had PVDs in both eyes a few months apart.

I have had floaters for years and also flashers at outer corners of my eyes which were mainly seen when it was dark.

Then one day I had l had a shower of little black specks in my vision in one eye when I was out shopping. It was quite startling as it was like a meteor shower.

Went to optician and was referred to the hospital's eye clinic. I was checked out and was told It was a PVD and that I had a weiss ring floater caused by the PVD.

The weiss ring floaters are very annoying as they are in the centre of the vision in each eye and I notice them all the time in all kinds of light. This has been going on for some years.

I have read that the brain learns to ignore floaters so you don't see them, but so far that's not the case for me. I think it's because the weiss rings are large. Also I still occasionally notice the flashes of light at outer edges.

When I am stressed I get optical migraines as well. No headache at all. I just see wavy lines like a heat haze and have patches of obscured vision which makes it difficult to see computer screen if it happens at work. Only lasts for about 10 to 20 mins then I am fine.

I am also a veteran of PVD. I had some laser treatment for it about 15 years ago, with no noticeable symptoms since. I am quite shortsighted (-5, -8), and understand otvis more common in shortsighted people.

OP - yes, I'm an Optometrist. I've seen lots of PVD as it happens to most people eventually, around 85% of people in their 80's will have had them.

Yes, your Optometrist was seeing the start of one - that's what he was referring to.

People often see the flashes more at night, I don't think there is a definite answer for why. Maybe its just the low light conditions that make them more noticeable or maybe its due to the anatomy of the vitreous that makes it pull more when you're lying down?

Sometimes the flashes are in the middle as the vitreous is also attached around the macula which quite central in the eye.

Spin is fine. I wouldn't go bungy jumping though.

Two more things that I should have mentioned before. If you are going to develop a tear or hole in the retina it occurs within 4-6 weeks of you first experiencing the flashing lights.The risk is pretty low though, only 1-3% of people develop a tear or hole and even then most of those don't need treatment.

Also, it will happen to the other eye at some point in the near future and when it does, you just need to go back to the Optometrist as you did this time and get him/her to check the retina. Most holes/tears are detected at this first visit.

@underneaththeash I'm an optometrist too and I'd be quite careful about giving professional advice on a forum. If something goes wrong because they've followed advice read on here, you could be liable. It's too easy to find out who you are on here.
I'd always advise to get checked again if more flashes present like you would in practice

mintich - Thanks for that. That's why I don't give advice unless I'm sure I'm correct.

If you look at the original post, the poster has been advised to go to A&E if she gets further flashes and that's the advice that I re-itterated too in my previous post.

The reason I say that us because you haven't seen it, and listening to what someone was told could still be wrong...misunderstood etc. In practice you wouldn't just say oh if your other optometrist said that then do it, you'd check right? I've just seen cases like this with advice given on social media, so now I worry about it, not just for me but other professionals too!
Not having a go at you, just saying be careful!

Just reading your advice you then gave some reassuring info at the end, which could encourage someone not to get checked....ie saying it's normally picked up at first visit.

I'm really grateful to underneaththeash for answering my specific questions, and it's reassured me in my particular case. I asked additional questions about why I'd been told what I had by the Optometrist I saw because I struggle with anxiety and have been trying to work through how I deal with these symptoms. I take full responsibility for making decisions about my health, though, and will follow the advice I was given by the Optometrist I saw on Monday and go back if I get more flashes. Sorry if I've caused any conflict