Transcript
Are you seeing dots in your vision? They're these little black things which float around. Sometimes people notice them when they're looking at a bright background, like a white sky or blue sky, and sometimes against a computer screen. Now what are they? Is it something that we need to be worried about? How soon do I need to be seen by an optometrist? Well, this is what we're going to talk about in this video, so stay tuned. Hi and welcome. My name is Doctor Dee I'm here to guide you through to better eye health. Welcome to the Natural Eye Doctor community. This is where we're going to learn and share our best ideas to help each other to get better eye health. And you know, ultimately we want to make our eyes last a little bit longer. So there's tips, tricks and techniques that I'll be bringing you to allow us to get there. If you're new to the community, don't forget to hit subscribe and click that bell so you're kept up to date with the latest information and the newest videos that we create. With that being said, let's jump right into it. In this video we're going to be talking about what floaters are and if this is something that needs to be treated straight away, or is it something that you can actually wait before you're seen by a specialist. For your own specific situation i'm going to be asking a series of questions that will allow you to be able to identify where you sit in that scale. There's a different video I've created for those people who want to know how to get rid of floaters or how to just start noticing them less, so I'll put the link up here for you and make your way there for those videos. So you might be seeing these black dots for the first time. So it can be quite worrying. It can be quite concerning. You might be feeling a little bit anxious, but that's OK that's normal. A lot of people do get floaters. In my career, I think probably I've seen 60% of people having some kind of floaters. Some of them are visible to the person, some of them are visible only when an optometrist looks inside the eye. So they are very, very common. Now I'm going to walk you through a video which will describe what floaters are. At the front of the eye we have the cornea and at the back of the eye, we have the retina. Now that back of the eye is attached to the optic nerve, which sends all those nerve impulses from the eye straight to the brain. Also, you've got the lens inside the eye. The lens is normally, again, nice and clear and it allows the light to pass through it. That's also the area where we get cataracts. So I'll do another video about that later on. Now the retina is made of rods and cones and allows us to process the light that we see. And inside the eye you've got the Jelly. Now that Jelly inside the eye is normally made of water and collagen in there as well. Now that Jelly is stuck to that back of the eye. Think of it as being stuck by cells like glue cells and that glue with time unfortunately becomes a little bit weaker, and as it becomes a little bit weaker, it pulls away from the back of the eye. And as it pulls away, it also pulls those glue cells with it. And so now what you've got is as the light enters the eye, that light now comes through through the lens and through the vitreous, but hits those cells and it casts a shadow onto your retina. Now depending on the type of cells that there are in the formation, you'll get all kinds of variations and different kinds of shadows, which is why you'll see them whisp around. And so if you're looking at white tiles or a blue sky or you're looking at a computer screen that's when you're going to notice it. The brighter the light that's coming at you, the more darker that shadow's going to be. Now, unfortunately, that continues. That process of the Jelly shrinking continues, and it pulls on the retina, causing strain and then it can cause a retinal detachment. Now the retinal detachment, if that happens, tiny little dots of cells, little tiny tiny dots come out of that break in the retina and suspend themselves at the front part of the Jelly. That is known as Schaefer sign, which we'll talk about later on. Now, as that retina also flops down from the top or from the bottom or whichever area it is, as that retina flops, it casts an even bigger shadow on the back of the eye. And you get a like a curtain veil coming over. So that's why you'll hear some optometrists ask, have you noticed a curtain over your vision? Now the question to ask is how quickly do I need to be seen by a health professional? How serious is my situation? Now, over my 20 years of practicing, I've realized that patients don't know the answer. Every time they'll ring up and they'll speak to the receptionist at the clinic and the receptionist will say I've got an appointment for you, but it's in three weeks. How do you know if that's OK? Three weeks might be too long. On the contrary, you don't really know what's going on. Equally, you might force them to put you into a clinic which is already super busy, and you're not going to get the best care that you need. You're not going to get the best attention that you need, so you want to just know how serious your situation is and then address it appropriately from there. And yourself and the receptionist and the optometrist can then figure out how soon you need to be seen by them. So what I want to do is give you a tool to help you to navigate around how quickly you need to be seen. So I call this the FINE check. It's very simple Floaters IN Eye check. It's nothing complicated, but it's just something that I have created to allow you to be able to ask yourself a series of questions. Score yourself appropriately. There's a score of five or ten associated to each of the questions that I'm going to ask you and I want you to add those scores together. Have a calculator to hand or a pen and pencil or you're just good at maths and you can do it all in your head. And at the end of this I'm going to get you to add those numbers together and that will give us a scale of "it's not that urgent" all the way to you really need to be seen right now. At this point I just want to put out there that this is for educational purposes only. And don't take this as gospel. This is from my own experience of being an optometrist for 20 years, so if you're unsure or have any doubt, Please remember pick up the phone, Speak to your own health provider. They're the ones who will give you great advice, I'm sure. So the first question to ask yourself is how many are you seeing? Are you seeing just one floater? Or are you seeing more than one? If you're seeing just one floater, give yourself five points. If you're seeing more than one floater, give yourself 10 points. The second question to ask yourself is when did they show up? Did they show up less than two weeks ago or did they show up more than two weeks ago? If they showed up more than two weeks ago, then you give yourself five points. If they showed up just less than two weeks ago, give yourself 10 points. Now number three, are there any other symptoms? For each of these that you are getting? Give yourself 10 points. Have you noticed flashes, So little pinpricks of light which either are little pinpricks or they shoot past your eye, corner of your eye typically, which is like representing lightning bolts. A lot of patients describe it as lightning, but some patients just only get little pinpricks of light. Please note this is not the same as shimmering. Some people get shimmering in their vision. Shimmering that lasts anyway from 5 minutes to 30 minutes. That is different. That is a different scenario and I'll probably create a different video for that. But for now we're talking about pinpricks of light or flashing lightning bolts as they go up and down your vision. And to note, this also happens when your eyes are closed. So while your eyes are closed, if you're still seeing these bright sharp things or pinpricks of light, then that's something to note. The next thing is floaters. If you're seeing lots and lots of hundreds of little black dots floating around in your vision there, that's super important as well. Give yourself 10 points as well for that. And the last one is, are you noticing a curtain that's coming over your vision? So I'll just recap bright flashes. Hundreds of little dots or a curtain coming over your vision. Any of those three, you give yourself 10 points. If you got more than one of those, you give yourself 20 points if you got 2, or 30 points if you got all three. Now the next question, which is question number four, is where are they? Are they located centrally in the middle of the middle of your vision, or are they off to the sides? So if they're in the middle, give yourself five points. If they're off to the side, give yourself 10 points. Now question number five. What colour are they? Are they red? In which case, give yourself 10 points. Or are they colourless? Are they translucent? Are they grey? Are they black? If they are like that, give yourself five points. Now question number six. What do they look like? Do they look like strands or do they look like a spider or a fly in your vision? If so, give yourself five points. Do they look like cobwebs, or do they look like lots of little dots? If so, give yourself 10 points. We're at the end of our questions. I want you to just take a moment and just add those numbers up. Now when you've added those numbers together, that should give you a range of scores. Some people will have a low score, some people will have a higher score. The range should be from about 25 to 80. If you're on the low end if you've got 25, then that's something that we don't need to overly panic about at this very second. If you on the contrast side today, if you've got 80 then you need to actually be seen straight away that's something that actually you do want to get looked at pretty much sooner rather than later. So what's the purpose of doing this? To give you an idea, if you're at 80 that's like same as going to hospital same day. If you're seeing flashes, floaters, a curtain, you're having red coloured dots in your vision. So that's all stuff which is significant. So you do want to get seen that same day either by your own health professional if they are available on that day for you. If not, then you take yourself to an eye emergency somewhere that you that you can access. And this is a point that I wanted to make that not everyone has access to eye care. So again this is something to be aware of that if your nearest point of contact or, how far away you are from, your closest optometrist? Let's say its about 2 hours. You want to know, is it something that you need to go today and drive that two hours and call them? Or can this wait for later in the week for when you can actually book it and plan your week properly and go and see them? So this is to help you a little bit along with that as well. Also, now that you are armed with this information, when you call up the optometrist clinic, now you can talk to them on the phone and say. I've got this, this, this and this because now you know your questions, now you know your answers, so this is something that you can convey over the phone. And if the receptionist is unsure, please ask them to speak to the optometrist. We're always happy to to speak to whoever depending on what the symptoms are. So the gatekeeper is the receptionist, so just make sure you've conveyed all the correct information to them and they will then come over to us and then at least we can handle it from there. So hopefully this gives you a little bit more insight into how to look after your specific situation. Now let's go into the different causes for what these floaters could be. All right, so we've got 5 main things. First one is PVD, posterior vitreous detachment. PVD means that the Jelly in the eye has shrunk and it's come away from the back of the eye, whether it has shrunk or whether it's come away as a result of a rapid eye movement or trauma. But the Jelly has come away from the back of the eye Weiss Ring. This is where the Jelly is attached to the optic nerve. That Jelly, the glue that holds the two things together, is generally like a circle. And that circular glue formation comes away. And as it comes away, that ring floats away as well. And sometimes that ring can twist on itself and it forms different shapes. So Figure 8. Or it could be just a BLOB. So some people see that as a fly, some people see that as a spider. Obviously remember when you were looking for floaters, the best way to look at them is through a dilated fundus examination and that's how you get a good view of what's going on. is where the Jelly inside the eye actually starts to liquefy. It turns into a liquid. So normally that Jelly substance, which is collagen and water, it kind of liquefies, and as it liquefies the collagen bits, they group together. They come and stick together. Now, as they stick together, that forms like a BLOB, and the light that comes in the light hits that BLOB and it casts a shadow. The fourth thing is a vitreous hemorrhage. Now I've seen quite a few of these, unfortunately, and it does depend on the person's general health as well. Vitreous hemorrhage is where the back of the eye the blood vessels. Leak and as they leak, they leak blood into the Jelly of the eye. Because it's leaking and its blood, it's normally red in colour, so these people would notice a red floater. Hence why one of the questions earlier was what color is it? So if it's red, that's most likely going to be blood or plasma related and that's also highly linked with people who don't look after their diabetes well and also those people who don't look after their high blood pressure properly. So let's make sure we're looking after those two things and our just general cardiovascular system. We've got to do the best that we can. So on the list is tobacco dust. Tobacco dust is tiny little dots which are in the Jelly. So traditionally floaters are like a squiggle or like a big black BLOB. But if we're seeing lots of little tiny dots, that's what we call tobacco dust. Tobacco dust is where the retina, if you think back to that image that we looked at before that I drew for you guys, where that retina splits, and as it splits those cells, they kind of float in the anterior part, the front part of that Jelly. And so when the light comes in, it hits those. Now those are known as tobacco dust. Just for extra brownie points, these little black dots, which we call tobacco dust, presents in the front part of the eye. Now if you go to an optometrist and they check you for floaters. They might say "this is good news, There's no Schaefer sign." Schaefer sign is where we look for those little black dots on the front of the vitreous, because it's those little dots stick to the front part of the Jelly of the eye. So that's something you can even talk to your optometrist about. If you've got floaters. And if you're going to go get that checked out, just have that conversation. Just ask, do I have Schaefer's sign? Could you see any Schaefer sign? And I'm sure the optometrist would be able to direct you with that. So thank you very much, guys. And I hope that's really helped. So the next video I'm going to do for you is how to get rid of floaters naturally. How can we naturally get rid of floaters? A number of times that people have asked, or I've heard people ask their optometrist saying, I've got these floaters, what can I do about it? And they go, well, nothing, there's nothing you can do. They'll go away by itself. How many times have you heard that? Personally, I've heard that a lot. So this is something that you want to just know that there is something that you can do, and I'm going to share that in my next video. In the spirit of the community, I'll be really keen to hear your experiences with floaters, what's happened when you've actually called up and spoken to receptionist and tried to book an appointment? Did they get you in straight away? Did they ask you these six questions or any questions? How quickly were you seen? And it would be really interesting to know what was the outcome? So what did they say those floaters actually were? So I hope that all of you are OK now if any of you did have complications with your floaters. But again, put those comments and notes in the comments section so people can actually learn from experiences. So just the other day I was sitting next to my wife watching TV and she received a text from a friend. And in that text the person said that they noticed a black dot floating around. And so when I asked, I go is it actually floating? Is there a delay between when you move your eye and where that dot moves, or is it moving exactly wherever you're fixating? At that point, he mentioned that there's no delay. It's most likely to do with something at the cornea, the lens or the retina, and after having a couple of text messages forward and backwards, I told him he needs to be seen within the next day or two. So he picked up the phone, called his local optometrist, booked in, and since then I've heard back from him and he says that it was actually a small lesion at the macula, small swelling, which they're going to keep an eye on. So that in this case was not a floater, but it was. A black dot floating in the vision. These questions will help you to understand a little bit more about your own particular situation. But just remember, if there's a delay between the movement of your eye and the black dot, that is most likely something in the vitreous, which is what we call a floater. Thanks for joining me today. I hope you got something of value. Remember, stay optimistic, stay positive and I look forward to seeing you on the next one.