I See a Fruit Fly in My Eye!

Is that normal??Argon laser can be carried out in the office
That's a very common complaint when patientssetting. The goal with this type of laser is to 'wall
call the office. They are usually puzzled, oftenoff' the tear, so that it cannot extend. It is usual
scared, and always eager to find out why theyto perform a few hundred spots, and to
are seeing weird dots, floaters or webs insidecompletely surround the tear. Commonly, 3 rows
their eye.of laser are performed around the tear, and then
The only way to really assess this problem is withthe treatment is extended to the edge of the
a complete, dilated eye exam. Even though theretina, an area known as the Ora Serrata.
eyedrops are a hassle, they allow theIf the hole or tear does extend, fluid can get
ophthalmologist to look at the entire retina,under the retina and cause a full detachment. If a
including the optic nerve, blood vessels (veins anddetachment occurs, sugical treatment is usually
arteries), the macula and fovea, as well as thenecessary. Obviously, it is better to get to this
peripheral retina. The vitreous gel is usuallyproblem BEFORE the retina begins to detach.
optically clear, but sometimes floaters or strandsSometimes detachments can be treated with
can be seen within it.more extensive laser. Other times, cryotherapy is
When a patient calls the office with theseneeded. Sometimes a gas bubble (such as
complaints, it is important that their complaint beperflourate), or silicone oil is needed. In addition,
treated in an urgent or emergent fashion. Thissome patients will need an encircling band placed
means that an examination must be carried outaround their eye. This is known as a scleral buckle,
within twenty four to forty eight hours of the calland is very successful in re-attaching the retina.
to the office. This is the safest way to examineUnfortunately, it requires a trip to an operating
and treat promptly to prevent furtherroom, and can result in high degrees of
complications.near-sightedness. This is, of course, better than
First the visual acuity is checked in each eye withhaving a complete detachment!!
glasses. The pressure check is not essential forIn a very few cases, the detachment progresses,
this type of emergency visit. Dilation withand a surgery on the inside of the eye (known as
eyedrops is carried out, usually just to the eyevitrectomy) needs to be performed. If none of
that is affected. A very careful examination ofthese treatments work, the patient may go blind
the retina is performed, usually using special toolsfrom this problem.
such as 4-mirror contact lens apparatus, orIf you, or anyone you know, has floating dots,
indirect ophthalmoscope with depression for awebs, or flashing lights in their vision, tell them not
good view of the peripheral retina. This is the areato wait!! Get it checked out, even if the
where most tears or detachments are found.symptoms seem to be getting better.
If a tear is found, immediate treatment with an