The verdict - why didn't I know this already??

[dreamshark]

After a night in the emergency room that resulted in nothing more concrete than a 10:50am appointment with an opthamologist....

My eye is okay. It was something called "separation of the vitreous humour," which is not in itself harmful but does occasionally result in a detached retina or other side effects. (carbonel, was that what happened to you?) Apparently, this "separation of vitreous humor" happens to pretty much everybody. The vitreous humor changes consistency and gradually shrinks with age, and somewhere between the ages of 40 and 60 it shrinks enough to pull loose from the retina at the back of the eye. This is normal and doesn't change your eyesight. But it's sort of like a suction cup letting go, and tugs on the retina enough to cause "flashers" and often some residual floaters. You would think from the description that this would be a gradual process, but it commonly happens suddenly like it did with me. And once the process is complete it shouldn't happen again, at least for that eye.

Fortunately in my case it all went smoothly. My eye is pretty much back to normal now except for some cloudy floaters that ophalmologist says will probably disappear gradually. While relieved to find that I am not going to be faced with the choice of eye surgery or losing the sight in one eye, I am wondering why I hadn't been told about this phenomenon earlier. I've been wearing glasses since I was 9 years old, which means I have been visiting optometrists and opthalmologists on a regular basis for 50 years. Wouldn't you think that somewhere along the line (maybe about the time I got bifocals?) one of these optical professionals might have mentioned this set of weird symptoms that was almost certain to happen to me and provide some guidelines on how to tell the difference between the harmless flashers of an uneventful vitreous separation and the serious situation of a detached retina?

Not only has that never happened, I had a hard time pulling that information out of Dr. Kalina. Since I may be going through this again with the left eye, this would be good to know. It boils down to this - if you have a sudden onset of flashers but no loss of vision in the eye, make an appointment with an opthalmologist ASAP to have the eye dilated and examined for retinal damage. However, it is not an emergency unless there is loss of vision - typically loss of peripheral vision, missing spots in the visual field or a dark curtain moving in from the side (or occasionally down from the top).

Here's a Good article about this topic. Do not be alarmed by the appearance of the word "catastrophic." They appear to be using this word in a technical sense to mean "suddenly."

Comments

[quadong.livejournal.com]

This is good to know.

It's not altogether different from the experience I had discovering that I have a completely harmless heart condition -- premature ventricular contractions. The symptoms are very alarming: irregular heartbeat and a pulsing sensation in my chest. But all it is is the ventricle contracting a bit early. It's still empty, so it feels like a missed beat. But the mechanics of it make it impossible for two beats to be missed in a row, 'cause it's certainly full on the second try. The treatment is more or less "don't drink so much coffee".

Only by going to the ER over it did I learn (a) from the doctors that it's very common and not dangerous (b) from my parents that my father has the same thing.

PVCs

[dreamshark.livejournal.com]

Oh, yeah, I have them too! Actually, most people do, but not everybody has enough of them to find alarming (check the Wikipedia article for more detail). In my case, the PVCs appear as occasional skipped beats when my heart is at rest. However when I am using exercise equipment with a heart monitor, the PVCs are picked up by the monitor as EXTRA beats. This has the disturbing effect of causing my pulse rate to jump abruptly back and forth between 123 and the high 140's. I don't notice any sensation from it at all, but the monitors were making me nervous, esp. since it had only started happening in the last few years (apparently you should not only avoid coffee but also perimenopause). I finally scheduled an exercise stress test to find out that it was harmless PVCs.

I'm still puzzling over the question of whether that rather expensive procedure is an example of the "unnecessary tests" that everybody wants to cut out to lower health care costs. It seemed perfectly reasonable to request the test since I am middle-aged, obese and have a family history of heart disease. But ultimately, it turned out to be one of those "problems" that was created out of whole cloth simply by monitoring too many things. If I hadn't been diligently working out on exercise equipment with a heart-rate monitor (which I was doing for my health, of course) I would never have thought there was a problem in the first place.

Re: PVCs

[quadong.livejournal.com]

I think the amount of testing they put me through after my ER visit would qualify. They drew blood from me 4-5 times, did a short ECG in the office *and* put me on a 24 hour ECG, which itched like you wouldn't believe. All the while saying that they didn't really think it was anything serious.

Now, to be fair, some of those blood draws were in response to a high hematocrit on the first several, which really is a totally separate issue. But that also turned out to be nothing, or more precisely, mild dehydration due to always drawing my blood right after I biked in to get my blood drawn.

[vgqn.livejournal.com]

That's fascinating -- thank you!

I too have heard people talk about detached retinas before, but never this. I wonder if it often happens while people are sleeping so they miss all of the excitement and just wake up with more floaters than they used to have.

[dreamshark.livejournal.com]

Hmmm. Interesting point. Seems like it might be set off by REM sleep. I wonder if you'd dream of fireworks all night.

[skylarker.livejournal.com]

I'm so glad to hear that it was nothing worse. And yes, you'd think the optomatrists and opthamologists would be more forthcoming with info on it, especially once we get to an age likely to be affected.

humor... this isn't funny

[minnehaha.livejournal.com]

This is exactly what happened to me in December, deep in Viet Cong territory in the Mekong Delta, about 6 hours from modern medical care (e.g. Saigon). I still have massive and distracting floaters, probably always will. I was utterly thrilled to learn I had it, since the other option, a detached retina, would have meant a) emergency medical evacuation to someplace like Tokyo, or b) having laser surgery in Saigon.

As it happened, I got back to Saigon, went to the French Vietnamese Hospital, got an immediate appointment, was seen early, had all the usual Western eye exams from an English-speaking, French-trained opthamologist and was charged $40. So, pretty lucky. Plus, I had B., who is excellent in these kinds of crises.

K.

Re: humor... this isn't funny

[dreamshark.livejournal.com]

Yikes! One of my major nightmares - getting seriously ill in a foreign country where I don't speak the language. Belated sympathies on that scary experience. I guess I should stop grousing about merely having to spend 7 hours in a waiting room at Methodist Hospital. Doesn't really compare.

Now I'm even MORE annoyed at the strange lack of information about this phenomenon.

[carbonel]

Yes, this is precisely what happened to me. I had the same sort of vitreous separation, and in my case, it caused a retinal hole, which is why I had surgery -- though not all cases of retinal holes require surgery.

Unfortunately, I seem to have sustained permanent damage to my vision as a result (20/50 with correction instead of the previous 20/20), but at least it probably won't get any worse. The retinologist seems happy, anyway.

I'm glad your condition resolved on its own -- apparently that's the more common outcome.

[dreamshark.livejournal.com]

And I'm so sorry that yours didn't. :-( Especially after all the discomfort you went through to have that procedure.

[quility.livejournal.com]

Thank you for the education! I'm glad it's nothing serious and I hope the floaters clear up soon.

[barondave.livejournal.com]

I vaguely recall a discussion of this with a nurse (not the doctor) after an eye an eye exam at Perle. She didn't say much, except that I didn't have the condition... but watch out for floaters.

Glad you're okay.

[pameladean]

This happened to me in, oh, 2004 or 2005, right before Minicon. I posted about it.

My particular eye doctor told me that even absent the loss of vision, it's just as well to be seen so they can determine that the vitreous detached cleanly.

P.

[dreamshark.livejournal.com]

"This happened to me in, oh, 2004 or 2005, right before Minicon. I posted about it."

Gosh, you'd think I'd remember that. This is the kind of medical geekery that usually sticks in my head. Oh well, now we've both done our part to educate the masses. What can you do.

"My particular eye doctor told me that even absent the loss of vision, it's just as well to be seen so they can determine that the vitreous detached cleanly."

Yes, that is pretty much what my guy said as well.

[pameladean]

Well, it was right before Minicon. If you were running Programming, or anything else, that might explain your just plain missing it.

I didn't even wonder why I hadn't heard about it if it's so common, but it's a good question.

P.