Dr. Alla Hynes: Floaters annoying, but most not threatening

Reader question: A few years ago I started seeing flashes of light when I went outside around dusk, and wiry spots floating in my left eye. I also got headaches from light - especially fluorescent lights. I thought I might have a partially detached retina, but my doctor said my sinuses caused the problem. I don't really notice the floaters anymore, but I still see flashes of light -- like lightning -- at dusk. What can cause this?

Dr. Alla Hynes: Floaters are small clumps of gel that form in the side of our eyes in the vitreous (gel) cavity as we get older. The older we get, the more we see them. Floaters may be seen as dots, lines, cobwebs or spiders. They are most often noticed when reading, looking at a blank wall or gazing at the clear sky. There are usually five main reasons for the floaters.
1. Floaters are usually a result of aging as the gel in the back of the eye loosens, shrinks and pulls away from the retina. Floaters can be annoying, but are usually not threatening to your sight and do not require treatment.
2. A big floater that suddenly appears should be a cause for concern and especially with flashes of light. Usually it's the result of posterior vitreous detachment, which is caused by shrinkage of the vitreous gel and the gel being pulled away from the retina. This requires an urgent visit to the eye doctor so that he/she can dilate your pupils and check the retina to make sure that during this process gel did not pull too hard on the retina and did not create a retinal hole, which can cause retinal detachment if not treated immediately.
3. Multiple black spots which suddenly developed can be the sign of bleeding inside of the eye, caused by retinal detachment, diabetes, high blood pressure and other medical problems.
4. Floaters can be also seeing as the result of inflammation in the vitreous gel. That can happen if you have multiple sclerosis, sarcoid, Lyme disease and other autoimmune and infectious diseases.

People with migraine headaches may also experience migraine-related flashes that can distort vision for 10 to 20 minutes and appear as jagged lines or heat waves. They may or may not be accompanied by a headache. In some patients, bright light, sun or fluorescent light can precipitate the migraines.

In most of the cases, sinus infections do not cause flashes of lights with floaters. If you are experiencing floaters, flashes or other vision problems, you should be seen by an eye doctor or discuss it with your medical doctor.

January is Glaucoma Awareness Month

The American Academy of Ophthalmology has announced that January is a glaucoma Awareness month. Glaucoma is still one of the leading causes of blindness in the United States and developed countries despite available treatment. Glaucoma is a series of diseases that damage the optic nerve. That damage causes blind spots in your field of vision, and if the entire optic nerve is affected, blindness will occur.

Glaucoma is estimated to affect 1 of every 50 adults. It can occur at any age, and the risk of developing the disease increases significantly after the age of 35, according to the American Academy of Ophthalmology.

One of the main reasons why people may go blind is that a patient gets diagnosed too late, when the disease has advanced to moderate or severe stages and the permanent damage has been done. Chronic opened angle glaucoma, the most common form of glaucoma, does not have any symptoms or signs and the person is not aware about it unless he happens to have an eye exam for unrelated issues or suddenly realizes that his peripheral vision is severely compromised.

How can we prevent blindness from glaucoma? We can do it only by early detection and treatment of glaucoma. If you have a family member or blood-related relative with glaucoma, you should be screened for glaucoma by your eye care provider. Most of the insurance will pay for it and you do not need an eye vision plan for it. If you don't have any insurance, some of the doctors will allow you to pay in monthly installments.

When you are at the eye doctor's office, checking eye pressure, which is one of the risk factors for glaucoma, is not enough. That's because your eye pressure can fluctuate during the day. The doctor should dilate your pupils and check the optic nerve, which connects the eye ball with the brain. Having a normal pressure in the eye does not exclude glaucoma, in some patients pressure never goes outside of the normal limit, but the optic nerve will start showing glaucoma damage.

Dr. Alla Hynes of Eye Care Physicians & Surgeons of Woodstock and Winchester, is a board certified opthalmologist specializing in the treatment of a wide variety of eye diseases.

Email her at info@nvdaily.com if you would like her to answer your questions in her column next month. Read her bio: http://www.nvdaily.com/lifestyle/dr-alla-y-hynes.php.