Seeing the Flashing Light

[Waydwnsouth1]

I went to my opthamologist today. At the end of our visit I asked why I was seeing bright flashing light in my side field of vision. I told her it only happens at night and not every night. As I was telling the story she quickly looked at her assistant. She asked how long this had been happening. I told her it started out just a few times very now and then. Now it has been happening more frequently and the lights seem to be brighter and flashing in greater numbers.

So now I have an appoinment next Monday with a Retina Specialist.

It turns out to be Posterior Vitreous Detachment. To keep this short I would ask that you Google it if you want more info. But basically PVD ios very common once we reach 50. As I underand it the flashing lights are caused by the Vitreous gel attaching to the retina and pulling on it. But, it can also cause a hole in your retina and if the gel breaks away with enough force it can cause a detached retina. Everything is treatable with meds until the retina detaches. That is only treatable with surgery and a detached retina can cause blindness.

I know I have seen a few posts on here about the flashig lights we all attributed to MS. According to my Optho this is has nothing to do with MS.

[Redwings]

That's right! Posterior vitreous detachment has nothing to do with MS and everything to do with aging and gravity. I've already had an uneventful PVD in both eyes. The worst part for me is the resulting monster-size floaters. On the other hand, my significant other was one of the unlucky ones who had a retinal detachment. So it really is important to get flashes and floaters checked out.

However, I'm not clear on what you mean by, "Everything is treatable with meds until the retina detaches." I have a feeling that a couple of concepts got jumbled together in translation. Can you be more specific about what "everythng" and "treatable" mean, and which meds are involved?

[MarkLavelle]

My wife got that dx just a few months ago, and your explanation matches what she told me.

Bottom line: everyone should think ophthalmologist first when weird vision things happen...

[Waydwnsouth1]

Redwings,

I was merely para-phrasing what the brouchure I read was saying. From as near as I can determine I believe they were meaning even if the retina had a hole it it could be treated with meds. I also believe there are some meds that can keep the vitreous from attaching to the retina. Therefore you would not have a hole in the retina and best yet no detached retina. Now I am not certain but I do believe that is what I understood. There is also a large possibility I could be wrong too. It was just my understanding.

I hope this does not confuse people.

[JerryD]

I had the flashes and the floaters at Thanksgiving 4 years ago. I saw my cousin the optometrist, my other cousin the opthalmologist and the chief retina guy at Wills Eye hospital, Dr. Tasman. After all the check ups and tests, some with dye in my veins, the dx was Macular Degeneration. I can't remember if its dry or wet, but its the kind that has no treatment. Just my luck !! And then, guess what ? i was dx'd with primary progressive MS ! Another dx with no treatment !!

You know what I did ? i started taking the vitamins called 'Ocuvite'. I don't know what good it did but it seems that the flashing has decreased or stopped altogether. I strongly suggest you use nutrition supplements in your treatment regime. Along with whatever the doctors prescribe, if anything. Do the research and try to find out what you can do for yourself ! You are your own best advocate ! Don't wait for anyone to 'play God' with you !

[Shashi]

About five years ago, when I was 44, I started having flashing lights and really bad floaters. I was also diagnosed with PVD. It hasn't really caused me any problems, except that the floaters never went away. I wasn't ever given meds for it or any other treatment though.

[Redwings]

Hi Waydwnsouth:
As I suspected, a couple of things got garbled in translation.

Developmentally, and in a younger eye, the vitreous humor is a semisolid gelatinous body that is normally attached to the retina. The attachment is strongest at the anterior vitreous base, less strongly around the optic nerve head, and weaker everywhere else (posterior to the anterior base). With age, the vitreous becomes more liquid and, with the help of gravity, it naturally detaches posteriorly. Hence the name, posterior vitreous detachment (PVD). (Trauma can also cause a PVD, but that's outside the scope of this discussion.) Somehow, you interpreted the description backwards, with the vitreous being normally unconnected to the retina, then having it somehow attach abnormally, and then pulling on the retina. This is where I'm going to send you to Google.

In its normal state, the vitreous is loosely adhered to most of the retina. In a typical PVD, as the vitreous peels away from the retina, there can be enough traction to mechanically stimulate the associated parts of the retina. And it's the mechanical stimulation that causes the retinal cells to fire, causing the perception of light flashes. In a typical PVD, the whole scenario is relatively brief. I had no unusual flashes in either eye with my PVDs. What got my attention both times was the resultant MONSTER floaters.

Since vitreal attachment is the normal state, there are no medications (nor a need for any) to prevent the vitreous from attaching to the retina.

Problems occur when the otherwise normal attachment of the vitreous to the retina is abnormally strong. That's when the traction can cause a hole or tear in the retina. Your ophthalmologist apparently is sending you to a retinal specialist because the continuing flashing indicates that the traction between the retina and posterior vitreous isn't releasing normally, which puts you at risk for a retinal hole or tear posteriorly, which could led to a retinal detachment.

The other place where abnormal vitreoretinal traction causes problems is at the macula. The macula is the part of the retinal where vision is sharpest. If the abnormal traction causes a hole there (a macular hole), the consequences to visual acuity can be significant. From your description, your traction isn't macular.

I can't imagine what you could have read that gave you the impression that retinal holes are treated with medications. There are no medications that "treat" retinal holes or tears. Peripheral holes or tears are sealed with laser burns or cryotherapy. Large retinal detachments are treated surgically.

Macular holes are treated surgically, which relieves the abnormally strong vitreoretinal traction there.

That all disproves your interpretation that "everything is treatable with meds until the retina detaches." You can Google all of this, and I doubt you'll find anything that supports what you think you read in that brochure.

With one possible exception. What got my attention about your post is that there is a medication that's awaiting FDA approval that can pharmacologically -- instead of surgically -- break abnormal vitreoretinal traction. By breaking the traction, it can prevent retinal holes or tears, which can prevent macular holes and retinal detachments. I'm wondering if the brochure you read might have been about this med. Although I can't figure out how a brochure could have been published in advance of FDA approval...

But there still aren't any meds that treat retinal holes or tears.

All of these issues can undoubtedly be clarified by your visit to the retinal specialist. (And you might want to ask whether vitreoretinal traction is a nutritional issue.) If you find out any information from your retinal specialist to the contrary, I -- and I'm sure some other folks -- would be most appreciative if you'd share it with us. I hope your retinal visit goes well.

[kryptonite]

Same problem

I am seeing light flashes and floaters also. I just logged in to ask if this had anything to do with the MS but I saw this post first. I have not seen a dr about it yet. Thanks for all of the info.

[Redwings]

Hi kryptonite:
Floaters are never directly, and virtually never indirectly, caused by MS, and most flashes aren't caused by MS. There's no way for most people to tell what's causing them, so all new onsets of flashes and floaters need to be checked out by an eye doctor. Could be nothing, could be something, and the something might be serious. So make an appointment with your ophthalmologist -- not your neurologist or GP, unless you need a referral and that's the only way to get one.