worried about retinal detachment again

[Eliza1853]

A few months ago I started noticing more floaters than usual. I also saw a couple of flashes in my peripheral vision. I made an appointment with my optometrist, who did a dilated eye exam and said everything looked fine.

Shortly after the exam, I started noticing other flashes- they typically happen in the shower, which makes me think it could be a blood pressure issue, but they also only happen when I move my eyes upwards suddenly, which makes me think it's an eye problem. It seems to be in both eyes simultaneously. The flash is quite large, blue or black, and appears as a horizontal blob in the center or lower-center of my vision, taking up a significant portion of my visual field but only lasting a second at a time. These flashes tend to happen several times per shower and have happened once or twice in other settings.

So I've made an appointment with an ophthalmologist. The problem is that now I'm even more worried about the cost than I am about retinal tears. The office can't give me a definite answer about how much the appointment will cost but estimated 400 to 500 dollars. If that's really all it is, and my insurance covers it, then I won't have to pay anything because my employer pays for the first $500 of my deductible. But I'm concerned that insurance won't cover it because I had the same sort of eye exam with my optometrist in December (I was on a different insurance then, if it matters). I'm worried that for some reason it'll end up costing thousands of dollars (i.e. all of my money). I really wish doctors could give a firm price for an appointment ahead of time. I'm also wondering if it could cost more b/c they're squeezing me in (they're scheduling in June for routine appointments but gave me an appointment on Friday because of my symptoms) and because I'm seeing a corneal specialist (I didn't ask for any particular doctor but I guess he's who's available).

I'm wondering if I should cancel the appointment and just go back to my optometrist ($80) to ask specifically about the flashes I've been seeing when showering. The problem is that the flashes are only half of my concern- I'm also just concerned that the optometrist could've missed something, so if I see him again that concern will persist even if he can explain the shower flashes.

As to the likelihood of my developing retinal tears/ eventual retinal detachment(s), I'm 25 and haven't had any head trauma but am severely nearsighted, so it's a real possibility.

Any thoughts you guys may have about all of this would be appreciated.

Edit: When rereading the post, I realized it may not be clear why I'm posting this in a HA forum. I have a long history of HA, which makes it difficult for me to know how seriously to take my own concerns. It can also, as you all know, cause hyper-awareness of symptoms. Have I always had these shower flashes but didn't notice them until after I'd read a lot online about retinal detachment? Maybe. Maybe not. Hard to know. Would they bother someone without HA? No idea.

[melfish]

Firstly, what you're experiencing in the shower aren't flashes. They are pressure phosphenes from eye movement. When you look up hard like that, the retina is tugged, generating the phosphene. They are normal, you are just more observant than most. You can see them better in the shower, because the walls are likely a light, uniform colour and there are few other distractions. You will probably notice something similar if you move your eyes hard left or right too.

I understand your fear completely because I have a different eye issue going on at the moment, and I too saw an optometrist for it initially and went through the whole doubt cycle. My ophthalmologist appointment is next week and I am scared af.

Regarding your question about cost, I don't know where you're located but I'm in CA and optometrists are ophthalmologists are covered by two different insurers. One is for vision/glasses, the latter falls under my regular health insurance. And yes, if they see you on an emergency basis, it will cost more usually. They can't tell you in advance what it will cost, as they don't know what tests they will have to perform until they examine you.

Hope that helps. Seriously, the eye blobs you are seeing - one in each eye - are a totally normal part of eye physiology. You are just hypervigilant. Our brains normally tune that stuff out. My advice is to stop checking for them. You'll just train your brain to see them all the time.

[Eliza1853]

Thanks for your response! You're right, it makes more sense that they'd be phosphenes. I'm still not sure why I (almost) only see them in the shower- there are other situations where I'm in rooms with light/white walls and few other distractions (and hyperawareness). But this symptom doesn't seem to be consistent with retinal tears, and I did get an eye exam as recently as December.

I've cancelled the ophthalmologist appointment- I really don't want to get in the habit of spending lots of money on appointments that probably aren't necessary. I may go see my optometrist just to be on the safe side, and if he recommends that I see a specialist then I will.

[Insert rant about the expenses of healthcare in the US here]

As a result of all of this worry about retinal tears and detachments, I now have the eye center's 24/7 emergency number saved as a contact in my phone, so I know who to contact if I do experience a retinal detachment at some point.

If anyone has more information (including experiences!) about pressure phosphenes that present in this way, or in similar ways, that would be nice to hear about.

[melfish]

It's not at all consistent with a retinal tear. I have the exact same pressure phosphenes too. The visual disturbance from a detachment would be there 24/7, not just with eye movement. And it would get worse. (I've noticed all my weirdest visual disturbances in the shower, lol)

---------- Post added at 11:44 ---------- Previous post was at 11:43 ----------

There's one in each eye, yes?

[doglover1967]

Third person here with pressure phosphenes! It really freaked me out for some time, until I realized it’s normal and other people have them and mostly just don’t notice them. I’ve noticed them for about 6 years now, because like melfish said, I’m hyper observant.

[Eliza1853]

melfish- It seems to be in both eyes. It comes and goes so quickly that I've only been able to check (close/cover one eye) a couple of times, but when I've checked it has seemed to be both eyes. And it's in the center of my vision (a horizontal line/blob in the center).

It's comforting that others have pressure phosphenes as well, though of course we each can't know exactly what the other is seeing.

As if I weren't worried enough, I somehow hit myself in the eye early this morning when I was half asleep. It still hurts a little bit hours later. No flashes or new floaters as far as I can tell, though I think a after-image-like-floater (?) that I've had for a while seems a bit bigger.

On the plus side, I've been watching videos on Molly Burke's YouTube channel and it makes me feel a little bit better about the possibility of going blind. I also console myself with the fact that one of my coworkers is blind and all of our work was made accessible to visually impaired people when he was hired a few months ago. So I'd still have a job.

[melfish]

Does the afterimage-like floater NOT float. I mean, does it stay in a fixed position relative to your eye movements?

With the blob in the shower, can you replicate it on demand?

omg, that's so weird. I've been watching her channel too

[Eliza1853]

The afterimage-like floater only appears occasionally... I think it floats? Now that I'm trying to remember, I can't say for sure whether or not it stays in a fixed position relative to my eye movement. It's always in the same general vicinity though- upper left-of-center of my visual field. Is that significant? It only hangs around for... thirty seconds at a time? A minute?

The blob in the shower happens pretty reliably when I move my eyes rapidly (though not *every* time). And as I said, it almost never happens outside of the shower even when I do the same eye movements against white backgrounds.

[melfish]

Nah, not significant. Just curious if it's similar to something else I have. If the visual thing is reproducible, it usually means it's a phosphene or part of the normal eye physiology. Eyes are imperfect, and I think when we are hypervigilant we start to notice all sorts of things. I really started paying attention to my vision after my last migraine aura, for some reason. It coincided with my first eye exam in a decade, and it was all downhill from there ...

[Eliza1853]

I'm once again thinking of making an appointment. The flashes in the shower have gone away- my HA about my eyes calmed down for a few days and maybe I stopped semi-intentionally triggering the shower flashes, because they happen less frequently if at all. BUT. When I was walking from the metro stop to my house yesterday, I saw a couple of flashes (not spots in my peripheral vision, but rather a line in the same place as the shower flash, but yellow light rather than blue) that *weren't* prompted by eye movement. That's scary. It only happened two or three times. Now even my partner, who usually tells me not to worry, thinks I should see an ophthalmologist. But I'm afraid because 1) $500 and 2) what if the ophthalmologist finds a tear, treats it with a laser, and then there's some kind of complication?? Should I just stay away for now and seek emergency treatment if I ever see sure signs of a retinal detachment (unmistakable things like part of my eye actually losing vision)??