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Medical Forum / General / Vision / August 2006

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Major floater attack -- does this mean anything?

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jhill524@hotmail.com - 11 Aug 2006 23:40 GMT
I'm a 28-year-old nearsighted male, and I've had floaters for as long
as I can remember.  I never found them too annoying; they were just
little translucent threads (maybe three different shapes) and I never
really noticed them unless I was really paying attention.

However, last night I had a terrible floater experience that I can not
ignore.

It began as I was lying in bed, looking at the ceiling.  The light was
off, and I noticed a sqiggly, spider-like object that seemed to be
dangling from the ceiling.  At first I wondered if a spider was in the
room or a bug was flying around, so I swatted at it.  Nothing seemed to
happen, so I got up and turned on the light.  There was nothing there.

I turned the light off and went back to bed, and I soon saw it again.
I turned my head around, and soon saw something a bit different...a
giant scribbley mess that seemed to turn and twist around in several
different ways.

Later on, I closed my eyes, and instead of the usual black background,
it was a deep reddish color -- and near the bottom of my field of
vision was a bunch of black, grass-like threads that swayed back and
forth, and sometimes bent and quiverred.

Just when I thought things couldn't get any weirder, I saw in the
center of my vision, a giant oval-shaped object with a bunch of tiny
hairs around it -- sort of like a giant paramecium.  The hairs wiggled
and curled just like the grassy stuff had before.

In the morning when the room was light, I looked at my white wall, and
saw what appeared to be a shadow of a tree branch.  But I soon realized
that it looked just like the grassy threads I had seen at night...and
soon afterward, the oval-shaped object returned and seemed to crawl
along the wall.  When I looked at another wall, I saw the same thing.

Throughout the day, these images gradually became dimmer and dimmer --
and at the present, they seem to have gone away.  But I'm still
concerned about this experience and what may have happened in my eye to
spur it on.  I NEVER want to see this horrid stuff again.

Like I said, I've had floaters in the past, but there were differences
between the former ones and the recent ones:

- My usual floaters are small and translucent -- these were big, black
and ugly.  They even seemed to be three-dimensional.

- My usual floaters are seen in daylight, but these I saw most vividly
in the dark and/or when my eyes were closed,  though I could still see
faint shadows of them with my eyes open.

I've read about things like vitreous/retinal detachment that can occur
after an increase of floaters, but I don't seem to have any of the
other symptoms (no light flashes, and my "normal" floaters haven't
increased.)

Still, I want to know if anyone else has experienced something like
this, and what may have happened in my eyes to cause it.  I'd also like
to know if I should get medical help for this, even if they seem to
have faded away.

(And for the record, no, I wasn't on any drugs last night, and I'm
pretty sure I wasn't dreaming it.)

Jeff
Scott Seidman - 12 Aug 2006 00:00 GMT
jhill524@hotmail.com wrote in news:1155336059.460746.164990
@m73g2000cwd.googlegroups.com:

> I'm a 28-year-old nearsighted male, and I've had floaters for as long
> as I can remember.  I never found them too annoying; they were just
[quoted text clipped - 60 lines]
>
> Jeff

Even if they are floaters, its probaby a good idea, like with any sudden
change, to bounce this off your eye doctor.

Signature

Scott
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marcia_jay - 12 Aug 2006 00:21 GMT
I know this is not what you want to hear, but drop everything and RUN
SCREAMIN to an optholmologist immediately.  

I had this happen to me and it is called something like a "vitreal
detachment" or some other scary name.  It can lead to nothing but it could
also involve your retinas.  Please don't wait!!  I have heard some bad
stories about this.

For something like this, you need to not look to the board and get medical
attention.

>I'm a 28-year-old nearsighted male, and I've had floaters for as long
>as I can remember.  I never found them too annoying; they were just
[quoted text clipped - 60 lines]
>
>Jeff
jhill524@hotmail.com - 12 Aug 2006 01:09 GMT
> I know this is not what you want to hear, but drop everything and RUN
> SCREAMIN to an optholmologist immediately.
[quoted text clipped - 3 lines]
> also involve your retinas.  Please don't wait!!  I have heard some bad
> stories about this.

I just called my optometrist.  He asked if I had any of the other
symptoms of detachment (flashing lights, reduced peripheral vision,
etc.) and I said no.  He said that in cases of actual detachment, such
symptoms would occur and the floaters would persist or get worse.  Mine
didn't.

He said that it may have just been the result of a minor
illness/fatigue.  I do recall feeling a bit dizzy with a headache that
night, so that may have contributed.  Plus, the fact that I was
sleeping may have caused by brain to intensify the experience.

Still, he did say that if anything like that happened in the future, I
should call him immediately and not wait.  I'll remember that.

Jeff
marcia_jay - 12 Aug 2006 01:52 GMT
Good. It was still the right thing to do, calling him.

You're lucky you got off the hook. I have to say, the examination and the
implements used for this particular diagnosis when I RAN SCREAMIN to an
opthol that I didn't know, were not a very pleasant experience, let me tell
you!

I have floaters too.  In fact, it's "a jungle in there."

>> I know this is not what you want to hear, but drop everything and RUN
>> SCREAMIN to an optholmologist immediately.
[quoted text clipped - 17 lines]
>
>Jeff
ashlin@hotmail.com - 12 Aug 2006 03:45 GMT
Hi,
I'm undergoing chelation treatment for toxic heavy metals and read
that this treatment improves vitreous floaters. You may like to reseach
or investigate it. here is a starting point.
http://www.abct.info
Richard
David Robins, MD - 12 Aug 2006 07:05 GMT
On 8/11/06 5:09 PM, in article
1155341343.807239.310600@b28g2000cwb.googlegroups.com,

>> I know this is not what you want to hear, but drop everything and RUN
>> SCREAMIN to an optholmologist immediately.
[quoted text clipped - 19 lines]
>
> Jeff

You don't wait to see the signs of a retinal detachment as above. That is
already too late.

Sudden onset of new floaters, with or without flashes or peripheral vision
loss, REQUIRES a retinal examination to PREVENT a retinal detachment. If a
retinal tear is found, it can be treated (laser, cryo) BEFORE it becomes a
detachment. While it could have been an illness, that is a matter of
conjecture, and at the bottom of the list relative to eye symptoms.

I disagree with the optometrist's answer that you did not need a dilated
exam ASAP. My colleagues all agree and we recommend the exam within 48 hrs.
max after onset of symptoms.


David Robins, MD
Board certified Ophthalmologist
Pediatric ophthalmology and adult strabismus subspecialty
Anon E. Muss - 12 Aug 2006 16:59 GMT
>On 8/11/06 5:09 PM, in article
>1155341343.807239.310600@b28g2000cwb.googlegroups.com,

[snip]

>> I just called my optometrist.  He asked if I had any of the other
>> symptoms of detachment (flashing lights, reduced peripheral vision,
[quoted text clipped - 9 lines]
>> Still, he did say that if anything like that happened in the future, I
>> should call him immediately and not wait.  I'll remember that.

[snip]

>You don't wait to see the signs of a retinal detachment as above. That is
>already too late.
[quoted text clipped - 8 lines]
>exam ASAP. My colleagues all agree and we recommend the exam within 48 hrs.
>max after onset of symptoms.

I agree with Dr. Robbins assessment here.

There are NO reliable symptoms that can distinguish a posterior
vitreous detachment (PVD) without an associated retinal break (benign)
from a PVD with an associated retinal break (requires surgical
intervention) or retinal detachment (requires surgical intervention).

If the above patient ends up suffering visual loss from a retinal
detachment, the optometrist would be clearly liable for medical
negligence.

What I have found, and the literature supports this, is that
approximately 90-95% of such patients with those symptoms have a
benign PVD.  IOW, 5-10% of those patients DO have a retinal break.

So the optometrist is either uninformed regarding the standard of care
for acute onset of floaters or playing a numbers game (90-95% likely
it's a benign PVD); either is bad patient care.

For some reasons I hear a lot of anecdotal stories like this; many ODs
(maybe OMDs too -- I don't talk to them as much) would rather diagnose
over the phone than have all these patients come in when they have
these complaints.  I think it comes from "misguided compassion" -- not
wanting to "inconvenience" a patient by having them come in when it is
probably only a PVD

It's misguided for at least 3 reasons:

1.  If the patient suffers visual loss, it's medical negligence (aka
"malpractice") because it is SUBSTANDARD care.
2.  It's financially beneficial for the practice.
3.  It's good patient care.

I can only conjecture here, but I think the reason such eye care
practitioners give such "only come in if it gets worse" advice for
such patients is that those doctors have never seen or diagnosed such
patients that have had what sounded like from the history a benign PVD
but found a rhegmatogenous retinal detachment on fundus examination.  

I've seen a lot of these patients and know better.

Finally, while this may be an isolated OD, such stories do not reflect
good on the professions as Optometry continues to push for scope of
expansion legislation.
Salmon Egg - 12 Aug 2006 02:16 GMT
On 8/11/06 3:40 PM, in article
1155336059.460746.164990@m73g2000cwd.googlegroups.com,

> I'm a 28-year-old nearsighted male, and I've had floaters for as long
> as I can remember.  I never found them too annoying; they were just
[quoted text clipped - 3 lines]
> However, last night I had a terrible floater experience that I can not
> ignore.
<snip>

I am not a health professional. What you describe sounds like ocular
migraine. Go to an ophthalmologist or better yet a ophthalmological
neurologist.

Bill
-- Ferme le Bush
David Robins, MD - 12 Aug 2006 07:08 GMT
On 8/11/06 6:16 PM, in article C10279E9.38C8D%salmonegg@sbcglobal.net,

> On 8/11/06 3:40 PM, in article
> 1155336059.460746.164990@m73g2000cwd.googlegroups.com,
[quoted text clipped - 14 lines]
> Bill
> -- Ferme le Bush

Visua; migraine symptoms do not generally have formed objects. They are
usually flashes, colored flashes, and zig-zag neon-like lines, and scotomas
(absences of vision).

The description given is really what you see with floaters.

Going to a neuro-ophtalmologist for new visual symptoms, in any case, is
tremendous overkill unless the ophthalmologist can't figure it out.
jhill524@hotmail.com - 12 Aug 2006 11:13 GMT
> Visua; migraine symptoms do not generally have formed objects. They are
> usually flashes, colored flashes, and zig-zag neon-like lines, and scotomas
> (absences of vision).
>
> The description given is really what you see with floaters.

I'm starting to wonder if they really were floaters.  The common
definition I've seen is that they appear usually in light -- these were
actually seen most clearly in the dark, or when my eyes were closed.
They didn't float in the same way as my "daytime" floaters do (and I
haven't seen any increase in my "daytime" floaters.)

I actually was very tired and stressed out that night.  I hadn't slept
in a long time and I had been working long hours...my doctor seemed to
think that's what brought it on.

Jeff
retinula - 12 Aug 2006 12:35 GMT
you should quit reasoning and rationalizing about this situation and
get a dilated fundus exam.  sudden-onset of floaters can be a serious
problem.  it may not be but it could be a vision-threatening problem.
just get your eyes checked (with dilation) immediately.  what do you
have to lose?  you are playing with fire!

===============

> > Visua; migraine symptoms do not generally have formed objects. They are
> > usually flashes, colored flashes, and zig-zag neon-like lines, and scotomas
[quoted text clipped - 13 lines]
>
> Jeff
Salmon Egg - 13 Aug 2006 06:32 GMT
On 8/11/06 11:08 PM, in article C102BE5B.81D09%trashadd5@bigfoot.com, "David
Robins, MD" <trashadd5@bigfoot.com> wrote:

> Visua; migraine symptoms do not generally have formed objects. They are
> usually flashes, colored flashes, and zig-zag neon-like lines, and scotomas
> (absences of vision).

To me, the zig-zag lines did have some resemblance to floaters. It is very
difficult to tell what a person actually sees by the descriptions usually
given.

Bill
-- Ferme le Bush
Mike Tyner - 13 Aug 2006 18:40 GMT
> On 8/11/06 11:08 PM, in article C102BE5B.81D09%trashadd5@bigfoot.com,
> "David
[quoted text clipped - 11 lines]
> Bill
> -- Ferme le Bush
Mike Tyner - 13 Aug 2006 19:08 GMT
> To me, the zig-zag lines did have some resemblance to floaters. It is very
> difficult to tell what a person actually sees by the descriptions usually
> given.

There are variants, but typical aura is always binocular and it respects the
midline.

There's an excellent description at
http://www.migraine-aura.org/EN/index.html especially the animated gif on
that page.

The "migraine art" on that site is interpretive and it seldom illustrates
the precise behavior of aura. For a good technical illustration, look at
netterimages.com - search for "migraine scotoma".

Other reliable characterizations of migraine aura:

http://www.dizziness-and-balance.com/disorders/central/migraine/migraine_scotoma
_odc.jpg

http://www.dizziness-and-balance.com/disorders/central/migraine/migraine_aura_odc.jpg
http://www.tju.edu/headache/info/images/aura2.jpg

-MT

> Bill
> -- Ferme le Bush
 
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