March 12, 2009
Ask the experts
KEEPING AN EYE ON FLOATERS
Q: I was recently diagnosed with floaters by an eye specialist. These are dots and squiggles I see that refuse to go away. At first, I thought that I had a torn retina. However, I was assured that this was not the case and I was advised not to have surgery. I was also told that there is no cure and that I have to live with this condition.
I am 62 and have also been suffering from glaucoma for five years. It is at present under control with a slight cataract formation. I'm an avid reader and I find it very irritating and frustrating to have to work so hard to focus on the text. It takes me a long time to read an article. What can I do to improve my situation?
A: We may sometimes see small dots moving in our field of vision. They are called floaters. These are actually tiny clumps of gel or cells inside the vitreous, the clear jelly-like fluid that fills the inside of our eyes.
When people reach middle age, the vitreous begins to liquefy and contract.
The vitreous gel pulls away from the retina, forming strands inside the eye. This is a common cause of floaters.
It can also happen in young people, especially those who are short-sighted.
Most floaters in the eye are harmless. However, vitreous detachment can result in tears in the retina in some situations. This can lead to retinal detachment, a sight-threatening condition.
The sudden appearance of a significant number of floaters, accompanied by flashes of light or other vision disturbances, can indicate a retinal tear or detachment or some other serious problem in the eye.
If you suddenly see new floaters, please visit your eye doctor immediately.
Glaucoma is a group of eye diseases that gradually affect the field of vision without warning. Cataract is clouding of the natural lens in the eye, resulting in the blurring of vision.
Initially, in patients with early cataract, vision may be improved with glasses. However, when the cataract becomes more mature, the best treatment option is cataract surgery. There is good visual recovery in most patients.
In your situation, both glaucoma and cataract can result in difficulty in focusing and reading. You may wish to see your eye doctor to determine the stage of your glaucoma condition and whether it is under control.
You also need to determine the severity of the cataract and whether changing to a new pair of glasses will help to improve your vision. Often, a good reading environment with proper lighting will greatly improve your reading ability and comfort.
Should the cataract condition worsen, your eye doctor will be able to tell you whether cataract surgery with an intraocular lens implant may be a good option to improve your vision.
Dr Lee Jong Jian is a specialist in ophthalmology at Raffles Hospital.
WHAT ARE THESE RED, ITCHY PATCHES?
Q: My mother is 64 years old. Recently, many large ring-shaped spots have appeared on both her ankles and feet. It started with a small round red patch about two years ago.
Lately, these spots have been getting bigger - about 3 to 4cm in diameter each - and they itch too. They look like round bruises which grow in size on the protruding bones of the ankles.
I would like to know what caused the spots to appear in the first place. Is there any medication to apply to stop the growth of the existing spots and to inhibit new growth?
A: Your mother needs to consult a dermatologist for a diagnosis (which may entail removing a tiny piece of skin under local anaesthesia) to ascertain its underlying pathology and its cause or causes.
From your description, it does appear that antihistamines may be helpful to control the spots, but a rational treatment plan can only be made after a diagnosis is firmly established.
Dr Derrick Aw is a dermatologist at the National University Hospital.
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