[Updated Feb 8]
This year has gotten off to a lousy start. It began with a stomach bug that wouldn’t go away for several weeks. Luckily, I have avoided the flu (so far), and managed to keep all my New Year’s resolutions (so far), so I guess things could be worse.
Wednesday (Jan 14), however, brought something really new to me, and I’ll share it here because therein is a caution for all of you — especially those with a little bit of “advanced wisdom” that signifies a bit more age.
Over the last few weeks, I have been mildly annoyed by a new “floater” in my left (and dominant) eye. This is something that many people experience, and is generally only an annoyance. They are caused by a little collagen tissue that has worked loose inside the eye, or perhaps a few blood cells leaking into the vitreous humor. They are inside the eye so you can’t focus on them to see them, but they block some of the incoming light so they make a shadow on what you do see. If you have yet to experience one of these, it is (in my experience) as if you have a smudge on your glasses (if you wear them) or a slight shadow that obscures something in your field of vision in brighter light.
Some floaters are absorbed after months or years, but in almost all cases they cease to be an issue because the neural circuitry of the eye/brain “learns” they are there and edits them out. You also learn to move your eye (unconsciously) to pull in a picture from “around” the floater — our visual systems really are quite adaptable and amazing. Thus, the floaters “go away.”
Having a mostly working brain, by Wednesday I had basically adapted to this new addition to my vision.
Sometime that afternoon, I noticed little black specks moving rapidly across my visual field. I don’t recall that I consciously was thinking about them — they matched the behavior of a small fly, so it wasn’t really foreign. I remember idly thinking it was curious that there would be a fly in my office on a cold day in January, but I was inside where it was warm, so maybe? I was busy with visitors, so I dismissed it from my thoughts and focused on what I was doing.
Later, I had to leave to go pick up my car being serviced, and as I left, I noticed some sparkling “things” out of the corner of my eye. When I would turn, whatever it was that I thought was moving wasn’t there. Odd. And then the loaner car I was driving appeared to have some defective windshield glass, with a wavy texture when I was looking at it sort of from my left side. Strange — a BMW shouldn’t have wavy glass, right?
At the dealership, as I waited for my car, I noticed more “bugs” and other strange things, including curved lines, especially as I turned my head. It looked like rather strange artifacts I have seen in bad video. It was now quite clear to me something was wrong. If I covered my left eye, my vision was fine. If I covered my right, I saw the effects. It was definitely my left eye.
There is a range of things that can cause visual phenomena such as this. I knew it wasn’t drugs, because I don’t take any that could cause that and it wasn’t both eyes. It wasn’t a migraine, because it wasn’t the aura/tunnel effect that describes a classic ocular migraine, and I’ve never had one of those. It probably wasn’t a classic stroke, both because it didn’t match what I know about strokes, and I had no other symptoms. (NB: everyone should learn quick triage for if someone else might have a stroke, using FAST.)
However, I wasn’t sure what else it might be. I also knew from my days as an EMT that such phenomena should not be ignored in hopes they disappear. They usually mean something. And it could perhaps be a precursor for something worse, perhaps be a tear in my retina, or bleed in the eye, or some kind of unusual stroke-like incident. I am highly dependent on my vision, so needless to say, I was now deeply concerned.
Of course, my regular optometrist was gone for the day by the time I determined all this, so I cancelled out of a phone conference, called my wife to tell her to hold dinner, and drove to the urgent care clinic on the way home. The place was full of flu patients, so I had to wait over an hour. (Oh, and I kept away from most of the people in the room. I sure hope I kept far enough away!)
The good news from the doc (finally): not a stroke, and not an intraocular bleed. There was something observable in my eye, but the doctor on call didn’t know what it was. He didn’t think the retina was involved. He urged me to see an ophthalmologist ASAP the next day. I went home, and left a message for my optometrist; he called me a little later, and after hearing me describe the symptoms, he reassured me that it was probably not damage to my retina, but he would arrange for me to be seen by a specialist the next day.
Yesterday (Thursday), I spent 3 hours at the eye clinic, mostly waiting. Pictures, dilation, exam, and testing. Then more exam.
The diagnosis is something called posterior vitreous detachment, or PVD. This is not uncommon in people after about age 50 (me), and more common in people with severe myopia (also me). It is when the vitreous pulls away from the retina, and bits of connective tissue and other cells get into the gel. The increase in material, and the physical changes, lead to an increase in floaters, visual distortion, and phantom flashes of light. Apparently, I am now more likely to have it in my right eye, too — not as a result of it happening to the left, but simply because it shows I have a tendency for it.
The good news is that I have no damage to my retina, but I have to watch it (figuratively) carefully for the next few weeks for symptoms of a tear developing. I also got a clean bill of health for several other issues, such as macular degeneration and glaucoma — also good. My vision is going to be poor for a while, however, so reading and working at the computer may be a bit more of a chore.
Here, however, is where the warning for you comes in, dear reader: In about 10% of these cases, the separation also results in a tear of the retina, with about 40% of those being a complete separation of the retina. This is bad news, and can lead to permanent loss of sight. The good news is that most of these tears and separations can be fixed with a laser or a cryoprobe — but the longer it goes unfixed, the less likely it can be fixed: diagnosis and treatment are optimal if in the first 24 hours!
So, I had an adventure (I seem to have many of those), but in the end I merely have an inconvenience. I’m writing this up because many of my friends and relatives are adding to their accumulated wisdom and laugh lines, and that translates into older eyes. I urge you — if you see a sudden increase in floaters, something that looks like a big curtain or cobweb suddenly over your vision in one eye, or flashing lights and wavy lines in what you look at — see an ophthalmologist ASAP! The exam doesn’t hurt, and if there is underlying damage, a quick response may save your vision. No matter what you see on TV, there are no artificial eyes or transplants: take care of the eyes you have, so if nothing else you can continue to read my occasional blog posts. 🙂
Updated Feb 8
It appears that I had another detachment event yesterday, as I had a big increase in the number of floaters. My vision in my left eye is now full of cloudy things moving around.
Over the last few weeks I have been challenged with this in a major way. Most of what I do during my regular day is read — either papers, or online. Even before yesterday, this was a huge challenge. I read for 30-45 minutes and develop a headache from trying to focus my eye. I also find my concentration affected, because I keep noticing movement that I don’t expect to be there. I tried covering my left eye, but my right eye is my weakest eye, and that resulted in significant fatigue as well.
I’m going to put up an autoresponder on my email to let people know there may be a delay in getting back to them — I am operating at only a fraction of my usual capacity. However, it is difficult to be too upset about this — I can still see (sort of), and I am thankful for that.
Oh, and this doesn’t unduly affect my driving, so you don’t need to avoid me on the roads…unless you did so before this happened. 🙂 I can see well enough to drive. It is only when I want to focus on type or small things that the effects are most noticeable.
Updated Feb 3, 2016
One year on, and now I have new floaters in my right eye. Probably a small PVD. And just as I was nearly recovered from the incident, above. Oh well, at least nothing really serious.