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Suggest treatment for seeing floaters in both eyes and increased power

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Posted on Tue, 15 Jul 2014
Question: I have been wearing contact lens for the last 14 years now. I made a big mistake of not going for a regular check up for 10 years(2001-2011). When i went in 2011 my doctor told me my power has increased to -4 (glasses) in both eyes. Before this i used to wear contact lens of -2.75 for 10 years. Since changing my power to -4, i have been seeing floaters in both eyes, more prominent in my right eye. In 2012 again my power change to -4.50 and is stable till now and recently I have observed my right eye power is little bit less, maybe it need to be change again. I dont know but I'm very stress because my power is maybe changing again. I'm 34 years old now and I cant understand why it is not stable at least for my right eye. Recently i saw some purple spots on both my left and right peripheral on both eyes ie left peripheral of my left eye and right peripheral of right eye. I can see them out of the corner of my eye only when i move my head sideways otherwise they dissapear. Can you tell what are these and whether should i go for check up? Also those floaters on my right eye , I can see 3 spots instead of one when I first saw them. The left still looks ok ie no increase in floaters. During my last eye exam, which is 3 months back, the doctor said everyhing is fine. Till now I havent done a dilation exam.
doctor
Answered by Dr. Dadapeer K (1 hour later)
Brief Answer:
You require to undergo dilated fundus examination.

Detailed Answer:
Hello
Welcome to Health care magic.

I am Dr. Dadapeer K, an Ophthalmologist and I answer health problems related to eye.

It seems from the history that you are having refractive error in the form of myopia and you are using contact lenses for correction of refractive error.
The increase in refractive error from -2.75 to -4.5 dioptres is expected in myopia. The refractive error will get stabilized as the growth of the eye ball stops in case of myopia caused by axial length by the age of 20-21 years.
However in myopia caused by curvature the increase in the refractive error can occur. Since it is still increasing in right eye this requires examination of the curvature of the cornea which can be done by corneal topography or orbscan. This test result will be able to detect the cause for increase in the refractive error.

The presence of moving black spots called as floaters. These are caused by opacities in the vitreous, a gel like liquid layer which lies behind the lens infront of the retina.These are commonly seen in refractive errors like myopia or following injuries to the eye or age related degenerations of the vitreous. In your case these are probably because of myopia.
Though most of the times floaters does not cause any problem, it requires examination of the retina and vitreous after dilatation of the pupil by indirect ophthalmoscopy. Since the floaters have increased in number in right eye this requires examination by indirect ophthalmoscopy.

In case of refractive errors like myopia the eye examination including dilated fundus examination has to be done at least once in 1-2 years to find out the status of the posterior retina. In myopia it is common to see few retinal degenerations like retinal thinning and treatment of them is necessary to prevent complications.

Hence I advice you to consult your ophthalmologist for refraction testing, corneal topography of left eye and dilated fundus examination.

Hope the information is helpful to you.

Thank you
With regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dadapeer K (3 days later)
Hello Dr Dadapeer,
I forgot to gave you my full prescription which is -4.5 sph, -1 cyl, 180 deg since 2012.

I have done the dilated examination and the Dr told me everything is normal. There are no holes or tears yet. However he said my right eye retina is thinner at the peripheral compare to left eye. He advised me against carrying heavy things and be gentle while coughing. Is this true? since I'm used to carry heavy things everyday. I' ve enclosed herewith the ultrasound report also which also came out normal.

Regarding my refraction test he said I can continue with the current prescription. He said the decrease in my right eye might be due to the thinning of retina.
doctor
Answered by Dr. Dadapeer K (2 hours later)
Brief Answer:
With retinal thinning, better to avoid exertion.

Detailed Answer:
Hello
Welcome to Health care magic

Thank you for the follow up question.

Your dilated fundus examination showing retinal thinning in the periphery. This is seen in high myopia and when associated with symptoms like floaters barrage laser can be considered prophylactically to prevent development of retinal tears or retinal holes.
The ultrasound report attached with the question is normal and no need to worry about it.
Retinal thinning in the periphery of the retina is associated with increased risk of development of retinal tears and retinal detachment and this can be precipitated by exertion hence your doctor has advised you to avoid exertion and lifting heavy weights. You can undergo barrage laser to prevent any complications from occurring in retinal thinning.
Regarding the refraction testing and prescription, you can continue the same refractive power spectacles or contact lenses.

Hope the information is helpful to you.

Thank you
with regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dadapeer K (43 minutes later)
Thank you Dr for your suggestion. But there is still that problem that I have asked you also and whether you can help me, ie regarding that purple like spots that I saw on both my left and right side. I can see them only while moving my head sideway and looking out of the corner of my eye. And this spot seem to appear and dissapear. Even my Dr couldnt explain, at first he said it might be blood vessel I'm seeing on my retina.But since the test came out normal he dont know what I'm seeing. I saw this just last friday only.
doctor
Answered by Dr. Dadapeer K (1 hour later)
Brief Answer:
Purple spots are not related to eye condition.

Detailed Answer:
Hello
Thank you for the follow up question.

The purple spots which you saw for a transient period of time may not be related to the retinal thinning and refractive error. But the floaters are because of retinal thinning and since the examination of retina and vitreous is normal need to worry about them.

These can occur as a part of migraine aura or as a part of transient ischemia. Hence if it is one episode lasting only for few minutes, then you need to worry.
If these episodes recur then evaluation may be required to rule out causes like migraine, hypotension, hypoglycemia...

Hope the information is helpful to you.

Thank you
With regards
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Dadapeer K (54 minutes later)
Thank you once again Dr . I have one more enquiry. I have been wearing contact lens for the last 14 years now because I just dont like glasses. I was too much self- conscious then. I found contact lens very comfortable. I started out with power -1.25 in 2000 and now it has gone up to -4.5, -1 cyl.
So my question is "Are contact lens as effective as glasses in correcting refractive error?". Can I continue to wear them? I keep glasses now only as backup
doctor
Answered by Dr. Dadapeer K (46 minutes later)
Brief Answer:
Contact lenses are effective as glasses.

Detailed Answer:
Hello
Thank you for the follow up question.

Contact lenses are equally effective as spectacles for correction of refractive error.
The increase in refractive error will occur even with correction by spectacles or by contact lenses.
The only long term problem of use of contact lenses is contact lens intolerance as a result of allergy caused by constant use of contact lenses.
If you are not having any intolerance with use of contact lenses, you can continue the use of contact lenses.

Hope the information is helpful to you.

Thank you
Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Dadapeer K

Ophthalmologist

Practicing since :2003

Answered : 5709 Questions

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Suggest treatment for seeing floaters in both eyes and increased power

Brief Answer: You require to undergo dilated fundus examination. Detailed Answer: Hello Welcome to Health care magic. I am Dr. Dadapeer K, an Ophthalmologist and I answer health problems related to eye. It seems from the history that you are having refractive error in the form of myopia and you are using contact lenses for correction of refractive error. The increase in refractive error from -2.75 to -4.5 dioptres is expected in myopia. The refractive error will get stabilized as the growth of the eye ball stops in case of myopia caused by axial length by the age of 20-21 years. However in myopia caused by curvature the increase in the refractive error can occur. Since it is still increasing in right eye this requires examination of the curvature of the cornea which can be done by corneal topography or orbscan. This test result will be able to detect the cause for increase in the refractive error. The presence of moving black spots called as floaters. These are caused by opacities in the vitreous, a gel like liquid layer which lies behind the lens infront of the retina.These are commonly seen in refractive errors like myopia or following injuries to the eye or age related degenerations of the vitreous. In your case these are probably because of myopia. Though most of the times floaters does not cause any problem, it requires examination of the retina and vitreous after dilatation of the pupil by indirect ophthalmoscopy. Since the floaters have increased in number in right eye this requires examination by indirect ophthalmoscopy. In case of refractive errors like myopia the eye examination including dilated fundus examination has to be done at least once in 1-2 years to find out the status of the posterior retina. In myopia it is common to see few retinal degenerations like retinal thinning and treatment of them is necessary to prevent complications. Hence I advice you to consult your ophthalmologist for refraction testing, corneal topography of left eye and dilated fundus examination. Hope the information is helpful to you. Thank you With regards