Apr 17, 2008

THE EYE MAN: Bubbly vision, 'floaters' cause woman to worry

Dr. Andrew Soss / Daily News columnist

Dr. Soss: I'm a 63-year-old woman. I have been told in the past that my eye pressure is on the high side of normal. About 10 months ago, I began experiencing problems with my vision. I kept cleaning my glasses, as it seemed things were cloudy when I looked out. Now I frequently see "bubbles" of light going up the outsides of my field of vision.

I have county insurance, but those eye doctors are extremely busy and overbooked so it's hard to get any quality time with them. My doctor had me take a peripheral vision test. It was a confusing series of tiny yellow lights that would appear for a split second in this convex white sphere. I found it extremely hard to see the lights because they were there so short a time.

The doctor said there was no problem with my peripheral vision; he gave me a prescription and sent me away. He never addressed my cloudy sight or the bubble-type lights that float up the sides of my vision. I value my sight and am extremely worried about these issues Any advice as to what I should do now? - C.P.



C.P.: Having eye pressures on the high side of normal is still normal. Having eye pressures that are above normal is generally of more concern. I say generally because there are times when patients have normal eye pressures that may still be too high for them. The primary concern here is for determining whether or not a patient has glaucoma.

The symptoms you have described as "bubbles" are in no way related to glaucoma. These visual symptoms are more likely "floaters," which are actual physical substances normally found in the large cavity portion of the eye known as the vitreous. These substances change in their characteristics over time, which may lead to the visual symptoms you mentioned. Typically, floaters are of no threat to the eye, as annoying as they may sometimes be.

Glaucoma, however, can be devastating to your vision if not diagnosed. Typically, the loss of vision is slow and insidiously progressive. Basing a glaucoma diagnosis on a very subjective peripheral vision test (called perimetry) alone is certainly a mistake. Perimetry is an important test in assisting doctors to diagnose glaucoma in conjunction with several other tests and examination procedures.

You also mentioned symptoms related to "cloudy" vision. There are a great number of disorders including (most commonly at this time of your life) cataracts, which may present symptoms of cloudy vision. When you say that the doctor gave you a prescription and then sent you away, I presume that the doctor gave you an eyeglass prescription not prescription medication.

There was also mention that you have county insurance and that the doctors are too busy. Are you referring to the San Mateo County Hospital? If so, then you should perhaps consider seeing an eye doctor that is part of your health plan of San Mateo insurance in a private practice setting versus the hospital setting. I believe the quality of time issue that you are suggesting is a problem and will most likely be resolved.



Questions to Dr. Soss should be sent to his e-mail theeyedoctor@att.net or via his Web site at www.dr-andrewsoss.com. All answers and opinions are those of Dr. Soss and not necessarily shared, endorsed or affiliated with this newspaper.

Dr. Andrew C. Soss has been practicing for more than 20 years. During that time he has been a clinical instructor in the department of ocular pathology at the University of California. As a primary eye care provider in private practice in Burlingame, he is also board certified in the diagnosis, treatment, and management of primary open-angle glaucoma.