I was eating dinner at the table when a spark of light similar to a mini thunderbolt flashed in the corner of my eye. The sun was setting outside the window, so I assumed it was just the rays bouncing off the lens of my eyeglasses. Every time I turned my head to the left, the light appeared in my peripheral vision on the right side. I didn't think much of it at first; it had to be the sun's glare. But when it became dark outside and the flashes were still appearing, I began to worry. Thinking that perhaps I'd spent too many hours staring at a computer screen that day, I went to bed early with the hope that the strange light would disappear.
The next morning the flashes of light were gone, but they were replaced by long, squiggly lines that resembled black worms floating across my right eye. After Googling my symptoms, I panicked, convinced that I was going blind from retinal detachment and immediately called my optometrist for an emergency appointment.
Her diagnosis: posterior vitreous detachment (or PVD), a natural, non-sight threatening eye condition that occurs when the vitreous (the clear, gel-like substance that makes up the eyeball) pulls away from the retina.
PVD is a common occurrence in middle-aged adults, especially those near the age of 60. The reason it happens later in life is due to the vitreous losing its firm, gel-like shape as it becomes more liquid with age. This causes it to separate from the retina at the back of the eye and move closer toward the center. Early symptoms include flashes of light (usually peripheral) and floaters — the tiny black specks that are a result of age-related changes in the eye. Floaters occur when tiny fibers in the vitreous stick together and cast a shadow over the retina. They are normal and of little concern, unless there is a sudden increase in spots or if a dark curtain appears on either side of the eye, blocking the peripheral vision.
On its own, PVD does not cause permanent loss of vision or pain, and the symptoms usually subside after three months. Even so, a professional diagnosis with a dilated eye exam is recommended to confirm that the retina has not been compromised.
When PVD occurs, the retina (the light-sensing nerve tissue at the back of the eye) reacts to a vitreous detachment by delivering small electrical signals to the brain, causing flashes of light to appear in the peripheral vision.
In my case, hemorrhaging also had occurred around the area of the vitreous humor (the gel portion of the eye) making it difficult to view the condition of the retina. The floating black lines in my vision were actually the result of blood leaking into the vitreous. My optometrist urged me to see a retina specialist for an extensive exam to rule out the possibility of retinal tears or detachment.
Unfortunately, the specialist found that my vitreous had tugged on the retinal nerve layer hard enough to cause several rips in the tissue and would need immediate care before the retina could separate from the back of the eye cavity (known as retinal detachment, which can affect vision permanently). He assured me that since my retinal tears were diagnosed early, if I sought proper treatment my prognosis for healthy eyesight was good.
The two most common procedures used for retinal tears are laser photocoagulation and cryopexy (a freeze-burn procedure), both of which are safe and effective. Laser therapy involves sealing the leaking blood vessels in the retina by making small burns around the affected area to create a scar. This, in turn, holds the tissue in place and keeps it from further leakage, similar to cauterizing a bleeding wound.
Cryopexy is the process of using a cold probe, known as a cryoprobe, to stimulate fusion of the tissue surrounding the retinal tear.
My retina specialist felt that laser therapy was the best option for my condition, explaining that it needed prompt attention to avoid retinal detachment and that the procedure would take roughly 15 to 20 minutes in the office. His decision did not allow any hesitation on my part, which was probably a good thing since I'm the type of person who would have gone home and Googled every first-person account of laser surgery and psyched myself out.
As promised, the surgery was quick with minimal discomfort after the topical anesthetic drops were applied to the eye. I had to remain perfectly still during the procedure, which felt like Darth Vader and Luke Skywalker were battling it out with laser wands in my eye.
Once it was over, I was told that the floaters would shrink over time and to refrain from strenuous activity for the next two weeks while the eye recovered. I asked my specialist what caused my condition since I hadn't experienced head trauma. He explained that PVD was very common, especially in people over the age of 60 and added that since it had already occurred in one of my eyes, there was a higher chance of it developing in the opposite eye within the year.
There are several other risk factors beyond advanced aging and head trauma for retinal tears and detachment:
- Thinning of the retina
- Myopia (nearsightedness)
- Cataract surgery or any recent interocular surgery
- A family history of retinal tears or detachment
Wrinkles and fatigue I expected with age, but never once did I consider a problem with my eyes other than needing prescription readers for small print. My condition was truly an “eye-opener” and a reminder to anyone over 60 of the importance of having your eyes checked regularly by an optometrist.
From now on if I experience floaters or flashing lights, I won't hesitate to call my specialist for an exam. I plan on living my life to the fullest and seeing it all with 20/20 vision.
