Q. Is eye floaters an optical problem or neurological or a combination of both?

Answered by
Dr. Lalit Bansal
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 20, 2015 and last reviewed on: Oct 09, 2018

Hi doctor,

I am a 35 year old male. I have floaters in both eyes which developed after severe eye infection at the age of 28 with the use of welding light. Previously, I received treatment for stress. I had tablet Cipralex (Escitalopram) 10 mg for around 3 years. Currently, I am not on any such medication. While taking Cipralex, I used to get good sleep and my light sensitivity suppressed. I had undergone brain CT two years and four years ago, both were normal. My MRI and angio of scalp and brain done this year are also normal. I got meningitis vaccination in 2010 due to gulf visa requirement.

I used to get routine eye check up and fundus examination every six months. My eye pressure is maintained at 18/20. In perimetry, there is no glaucoma. I have normal sharp vision of 6/6. I also got OCT recently to check retina. My problems are light sensitivity and disturbed sleep. The light spot does not go away quickly. I am disturbed with dreams at night and no proper sleep. I have sound intolerance too. I would like to know whether my light sensitivity is a neurological problem or optical issue or a combination of both. My neurologist prescribed Flunarizine and Escitalopram for light sensitivity. I am concerned with these drugs as they are SSRI. I am bothered about my light and sound sensitivity along with disturbed sleep pattern. Kindly guide me.

#

Hi,

Welcome to icliniq.com.

  • Eye floaters could be due to eye or secondary to brain. As your eye testing has been normal and nothing seen on slit-lamp examination then likelihood of being it from brain is high.
  • Common eye spots or black spots caused by migraines are sometimes mistaken as floaters. This could explain the reason for you being on Flunarizine (migraine prophylaxis).
  • Photosensitivity and phonosensitivity (sound) can be seen with migraines. Flunarizine should help you with these. If you feel any benefit then there is a room to improve it by adjusting the medication or changing to other agent.
  • Since there is a history of severe eye infection (uveitis? or retinitis?), the left over debris can cause floaters. This could be seen on eye examination and helped by an ophthalmologist.
  • SSRI (selective serotonin reuptake inhibitor) can help you with your sleep, but sometime it increases your dreams. If you are very concerned with your sleep disturbance, it is worth getting a sleep study (polysomnography) and look for formal evaluation.
  • Your normal MRI of brain is a reassuring thing.

The Probable causes:

Eye floaters.

Differential diagnosis:

1. Eye infection.
2. Migraines.
3. Sleep disturbance.

Treatment plan:

Continue with current medications.

Preventive measures:

Sleep hygiene.

Regarding follow up:

For further information consult a neurologist online.---> https://www.icliniq.com/ask-a-doctor-online/neurologist


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