Retinal detachment - A curtain coming down on your vision

Have you ever heard of a condition called retinal detachment?

We hope so, but if you're like most people you probably haven't. Even if you have heard of it, do you know what the symptoms are? Most people don't know but much like a heart attack, retinal detachments are considered medical emergencies and require immediate treatment to prevent permanent vision loss so let's make sure you know what to watch for!

"... a retinal detachment happens when a part of the retina pulls away from the underlying tissue. It can happen to anyone"

Let's start by understanding what a retinal detachment really is. Essentially, a retinal detachment happens when a part of the retina pulls away from the underlying tissue. Fairly quickly, that tissue dies since it is unable to get the oxygen and other nutrients it needs to survive. If left untreated it will usually spread and the entire retina will detach. Since we need our retina to see, if it fully detaches we lose the ability to see with that eye and unfortunately can't get it back. Caught early, it can be treated and stop the vision loss in its tracks

Who is at risk for a retinal detachment? Unfortunately, everyone. Some people have a higher risk, such as people with high nearsighted prescriptions or people with a family history of retinal detachment, but anyone with eyes can have their retina detach. Your retina may detach after an eye injury or accident but that's not required for a retinal detachment to occur.

This is what a detached retina looks like when your doctor looks inside your eye. It's not something we want to see!

So how do you catch and stop a retinal detachment? Well, the main thing is to have regular, dilated eye examinations. That helps your doctor of optometry check your peripheral retina for any problems like thin areas or retinal holes. Sometimes though your retina will look perfect and you still end up with a retinal detachment! So what then?

"Retinal detachments cause flashing lights, floating spots, curtains waving in your vision or a combination of all three!"

Most retinal detachments are highly symptomatic. People experience flashing lights, floating spots, a curtain waving in their vision or a combination of all three! There are many eye disorders that have similar symptoms including things that are relatively harmless like posterior vitreous detachment and ocular migraines but because a retinal detachment is so serious (meaning you can go totally blind)  it's important to have your doctor confirm the diagnosis. Don't try to make that judgment yourself. It's not worth the risk

If you have questions about retinal detachments or anything else feel free to contact us on Twitter, Facebook, Google +, via our website or phone us at (403) 474-6744.

Floaters - Those annoying spots moving around in your vision

One of the most commonly asked questions I get asked  is "What are those things I see floating around in my vision." Most people don't think my answer of 'annoying' is nearly as funny as I do and usually would like a real answer about what is happening. So let's address a problem almost everyone experiences at some point in their life, the visual phenomenon known as floaters.

First of all, what are they? To understand that you need to know a bit about the vitreous jelly, which fills most of the eye and is where floaters form. The vitreous jelly is almost entirely water but it does have a matrix of 'stuff' (collagen and hyaluronic acid to be exact) that gives it a jelly like consistency. Don't think of it as jello though, it's more like an egg white. When we're really young the vitreous is really clear and everything is pretty much perfect. Over time though the jelly starts to break down and water leaks away. The collagen and hyaluronic acid are left behind and they clump forming the black or clear jelly blobs that we see moving around in our vision. What we are seeing is really just a shadow caused by these clumps. Floaters are easiest to see when the lighting is bright and the background is a light colour (so a bright sunny day with a blue sky or a brightly lit, white computer screen).

Floaters sort of look like this... but not really.

So, what can be done about a floater? Honestly, not much. The most effective therapy is something called a vitrectomy where they literally remove the entire jelly from your eye and replace it with a silicone oil or a saline solution. This is an extremely risky solution and I don't know a single retinal specialist that is willing to do this surgery on someone for floaters. There is a laser procedure as well that blasts the floaters.  This is a better solution than a vitrectomy but doesn't work as well. Many patients report that instead of having a few large floaters they now have a lot of small ones.

Why should we care about floaters? Often we don't. The odd floater moving around in your vision is certainly annoying but it isn't harmful. There are situations though where floaters are a huge concern:

  • You get a large number of new floaters all at once,
  • With those new floaters you also experience a flashing light in your peripheral (side) vision like a camera or lightning flash AND/OR
  • With those new floaters you notice a curtain waving in and out of your vision.

Any of those could mean that your retina has a tear or has detached. Retinal detachments are medical emergencies and can lead to complete loss of vision in hours. Retinal tears aren't quite as urgent but usually lead to a retinal detachment so you don't really want to mess around with them either.

Really, it's best to play it safe. If you have floaters and aren't sure if they were there before or you aren't sure if they're normal floaters come in for a dilated eye exam. We'll put drops in your eyes for this type of exam (which is fully covered by Alberta Health Care) to have the best possible look at the very far outer edges of your retina to make sure there aren't any problems. If something is wrong we will get you to a retinal specialist as quickly as possible and keep your vision safe.

If you have any questions about this or anything else feel free to contact us on Twitter, Facebook, Google +, via our website or phone us at (403) 474-6744.

For more information check out these links:

All About Vision - Floaters

Ask a Doctor of Optometry - Floaters

Psychedelic, surreal, multi-coloured shapes in my vision!

Alberta is a land of ups and downs when it comes to weather (you may have noticed this recently with our ‘spring’ weather). +20C in December? -10C in July? -40C on Tuesday and +20C on Wednesday? These are just normal weather patterns here and as anyone who gets migraines can tell you it’s not fun. The wild temperature swings wreak havoc on our systems and can cause some funny things to happen.

You’re busy doing your thing when suddenly your vision goes a little funny. You may notice shapes or colours or motion in your vision, not right in the middle but just off to the side. The effect may get larger or smaller. It may move faster or slower or not at all. Sections of your vision may simply vanish and go dark or you may still be able to ‘see’ but things you know should be there just aren’t visible to you anymore (like whatever is supposed to be there pulled a chameleon on you and has become invisible). You may have never had this happen but if these symptoms sound familiar you’re not alone. If you had this happen and didn’t panic at least a little I’m impressed. I’m an optometrist and when this happened to me even though I fully recognized my symptoms and knew what was happening my heart rate bumped up a few notches. This event is known as an ocular migraine.

I know what you're thinking... what the heck did I eat? No, you aren't having a psychedelic trip, this is an example of an ocular migraine. Everyone experiences them differently though so if yours doesn't look exactly like this don't panic.

The term ocular migraine implies that you should get a headache afterwards. That’s not always the case. Some people do have migraine headaches after seeing these images in their vision but not everyone. You may have heard of people getting an aura that tells them they’re about to get a migraine. That’s essentially what this is. Auras or 'ocular migraines' usually last about 20 minutes and are followed by a return to normal vision and depending on the person a headache, a migraine, or absolutely no pain.

So, what the heck is going on? It’s not certain but what is believed to happen is that for some reason the blood vessels in the visual cortex (the very back of your brain… about as far from your eyes as you can get and still be in your head) shrink way down and not as much blood is getting through as before. This lack of blood flow means your brain can’t function the way it would like and you start to experience really bizarre things in your vision. It takes your brain, usually, about 20 minutes to figure out this isn’t normal at which point the blood vessels do one of two things. They either return to their normal size, blood flow returns to normal levels and you stop feeling like you ate a brownie you shouldn’t have OR the blood vessels expand to their maximum size stretching themselves to be as big as they can. It’s that extreme stretch that causes the horrible pain people experience with migraines. In some cases the vision changes can last longer than 20 minutes. This usually occurs if someone completely panics causing an adrenaline surge. The resulting stress levels can cause the visual changes to linger for about an hour.

Here’s the real kicker. There’s not much you can do about this. We think that all those blood vessel antics are caused by the same things that cause migraines… so, almost anything (certain smells or foods, weather patterns, stress, lack of sleep. The list goes on and on). Migraine medication can be helpful if a person is getting ocular migraines all the time and it’s seriously interfering with their life but otherwise we just recommend that a person sit back and enjoy the show for 20 minutes.  If you’re driving it is strongly recommended to pull over and wait it out. These vision changes are temporary and do not cause any damage to your eyes or your brain.

So rest assured that if you have been properly diagnosed with an ocular migraine your eyes are safe and sound. I would love to leave it at that but there is one more thing. Not all flashes in your eyes are harmless. Retinal holes, tears and detachments can cause symptoms including flashing lights in your vision, floaters and a curtain moving in and out of your vision. These flashes do not go away in 20 minutes and generally are noticed at the very edge of your vision. Retinal detachments are extremely serious and cause permanent loss of vision. If you experience flashing lights in your vision of any kind it is best to have it properly checked by an optometrist.  These visits are considered medically necessary and are fully covered by Alberta Health Care. I would advise against taking a risk. If you see flashing let an optometrist have a look at your retina to confirm everything is normal.

For more information feel free to contact us on Twitter, Facebook, Google +, via our website, phone us at (403) 474-6744 or come in anytime. You can also read more at the links below.

All About Vision - Ocular Migraine

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