Advice for sudden eye issue
June 6, 2015 1:03 PM   Subscribe

My eyes have always been a problem. I had a partial retinal tear 20 years ago. I have tons of floaters. I am extremely nearsighted. I have "dry holes" in the back of my eyes from histoplasmosis. All of these things have been stable forever. Today, something new happened. It's in one eye only. It's like there's a black worm with a long tail dancing across my eye. It seems to be fixed in the center of my eye and it's swimming back and forth from that fixed place. What's going on?

I am supposed to head out of town in a few hours. While the trip isn't URGENT urgent, it's important - it's to help someone else, and they're depending on me. All of a sudden, about 4 hours ago, I had bright flashes of light in kind of a C shape in the corner of my eye. now, I'm getting this weird black thing in the center of my eye. It's as if you pinned an earthworm by one end to a board, and the thing writhed and twisted from that fixed position. That's what I'm seeing. There's no pain.

I've had eye problems all my life. I had a partial retinal tear years ago. It was not like this. I have dry holes in the backs of my eyes. I've had lots of floaters. This seems like something different, but is it just a different kind of floater? It's different because it's so bright and one end seems to be fixed. Should I be alarmed? Is this the start of something bigger?

What I was told in the past is that chunks of the vitreous tear loose - but in a good way, not in the "will make you blind" way. If you see clouds of floaters, get help right away. This isn't a cloud. It's one twisty thing. I know YANMD or my ophthalmologist.

If I need to see someone urgently, where would I go, since it's the weekend? No ophthalmologists here are open on the weekend. Yes, I have health insurance.

Thank you!
posted by clarkstonian to Health & Fitness (22 answers total) 5 users marked this as a favorite
 
Hospital, emergency room, immediately.
posted by parki at 1:09 PM on June 6, 2015 [13 favorites]


Go to the emergency room. Right now.
posted by thomas j wise at 1:10 PM on June 6, 2015 [4 favorites]


emergency room!

You can call a friend and offer to pay them money (or post on craigslist, etc) to help your other friend if you feel terrible about it.
posted by tintexas at 1:13 PM on June 6, 2015 [1 favorite]


Get checked ASAP, even if you have to go to the ER. Concur with all. This can be serious.
posted by kschang at 1:15 PM on June 6, 2015


Agreed, ER now.
posted by Elsie at 1:17 PM on June 6, 2015


Can someone elaborate on why he should go to the ER immediately?
posted by the webmistress at 1:20 PM on June 6, 2015 [4 favorites]


I'm not a doctor or experienced with retinal tears/detachment, so all I can do is google it- but adding a voice to the choir, I'd say emergency room. It sounds like it could be warning signs of something serious like retinal detachment, and if you were to put this visit off, you could lose vision permanently. The sudden onset and bright flashes especially make it sound like something new that needs immediate attention.
posted by Secretariat at 1:23 PM on June 6, 2015


webmistress: Depending on the exact nature of the flashes this could be a tear in the retina
posted by rmhsinc at 1:24 PM on June 6, 2015 [3 favorites]


Possible retinal tear, webmistress. I had a large retinal detachment a couple years ago, and I noticed because of an increased number of floaters in one eye. The things I was told to look our for were flashes of light, and a 'shadow' falling over part of vision. I was told that if I saw either of these (or a lot more floaters all of a sudden) to bolt to the ER.
posted by parki at 1:29 PM on June 6, 2015 [4 favorites]


So here's my reasoning. I read through these two links, and thought that although floaters are normal in this case, the sudden change in vision and the bright flashes, along with existing eye problems that may make retinal detachment more likely, made it sound like something more serious was possible- and that the worst case scenario, loss of vision, is serious enough to cancel on the friend for.

http://www.webmd.com/eye-health/eye-health-retinal-detachment
http://www.mayoclinic.org/diseases-conditions/retinal-detachment/basics/symptoms/con-20022595
posted by Secretariat at 1:30 PM on June 6, 2015 [1 favorite]


Jesus, this question gave me chills just reading it. Clarkstonian, hopefully you have already gone to the emergency room and cancelled your trip out of town. I am at moderately high risk for retinal detachment, and the symptoms you've described are among those that my eye doctor has emphasized I must go to the ER for.

I know two people who have had retinal detachment, and both got to the ER quickly enough that the doctors were able to save their sight. If they had waited any longer, they'd have lost their vision in that eye.
posted by hurdy gurdy girl at 1:36 PM on June 6, 2015 [2 favorites]


If you're still reading this it better be in a cab on the way to the ER.

The ER doc told me mom: "We're so glad you came. That's what we like because if you wait and you come in later it could be too late." He said without treatment she could have been blind in that eye in 24 hours.

Be sure to go to a hospital that's strong in ophthalmology if you have such a hospital in your area.
posted by If only I had a penguin... at 1:38 PM on June 6, 2015


As I'm sure you know, all the nerve fibers which carry signals from the retina back to the brain do not attach to the retina from behind, they are instead attached from the front of the retina and come together at the 'blind spot' near but not at the center of the retina.

I would say that the nerve fibers which were attached to the "kind of a C shape in the corner of my eye" which had "bright flashes of light in the corner of my eye" about "4 hours ago" have ripped free of the retina and are now whipping back and forth in the vitreous humor and casting shadows on the retina.

It sounds like some kind of mechanical stress on the nerve fibers caused this, and I think you should not travel or exert yourself in any way, and should see an ophthalmolgist as soon as possible.
posted by jamjam at 1:42 PM on June 6, 2015


If you're not already at an ER and you have a regular ophthalmologist, you may be able to get through to an after-hours line. I see a doctor affiliated with a major university hospital and the magic phrase is "I'd like to speak with the ophthalmology resident on call, please." This has gotten me attention much faster than just going through the ER, so might even be worth trying if they've left you waiting somewhere. However, it probably will not be particularly effective if you aren't already someone's patient.
posted by teremala at 2:16 PM on June 6, 2015 [3 favorites]


Bright c-shaped light for me was a central retinal vein occlusion in my right eye a few years back - effectively a small blood clot in the vein draining the back of the eye. I left it for a few days - ended up with four years of visits every six months to the eye clinic at the local hospital. The sight is not as good as in my left eye (though my sight is dreadful anyway) but I was very lucky not to lose a great deal more sight.

I know it's going to feel awful to let your friend down, but as they are a friend they will surely understand that this is an emergency and not something you have any control over. Is there anyone you could get to go in your stead?
posted by Martha My Dear Prudence at 3:43 PM on June 6, 2015


No time to elaborate but please do go to nearest university ER right away. Most community hospitals struggle with ophthalmology coverage. At a teaching hospital you will usually be seen expeditiously by ophtho 24/7.
posted by treehorn+bunny at 3:54 PM on June 6, 2015 [6 favorites]


The "one twisty thing" was described by my old ophthalmologist years ago to me with "like when a hair gets stuck on a film reel, but slower" and yes, they told me this was one huge thing to watch out for. Luckily it hasn't happened to me but I leave this comment in the hopes that someone googling weird search terms to self-diagnose their eye problem might see it. I hope a doctor is seeing you right now!
posted by Mizu at 4:49 PM on June 6, 2015 [2 favorites]


Am a doctor but not your doctor. If you were my mother, you would already be in the ED of whatever major teaching hospital is easiest to access.
posted by honeybee413 at 7:06 PM on June 6, 2015 [2 favorites]


A bright, flashy light in a 'C' shape sounds like an ocular migraine, which I suffer on occasion. I hope it's just that an not a retinal tear.
posted by mal de coucou at 7:48 PM on June 6, 2015


Please update. Hopefully from an er.
posted by pearlybob at 8:50 PM on June 6, 2015 [6 favorites]


I've been warned I'm at risk for retinal detachment, and seeing stuff like you're seeing would send me right to the ER. This is exactly the kind of stuff I was told to look out for. Seriously drop EVERYTHING else and please get this looked at right now.

On the bright side, this kind of thing should be treatable. You don't have to go blind from it. But the way you avoid going blind is you go to the ER ASAP.

(There is the possibility this is a migraine, or something else ultimately harmless. But don't risk it.)
posted by Ursula Hitler at 3:38 AM on June 7, 2015 [1 favorite]


Please let us know what happened.
posted by yclipse at 4:38 PM on June 7, 2015 [1 favorite]


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