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Q: I have been noticing some cloudiness in my vision once in a while. The haziness comes and go, with no pain, and seems to move around. What is going on?

A: There are several potential causes of your symptoms, so I’ll give you my best guesses.

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Number one would have to be “vitreous floaters”. The vitreous is the clear firm gel that fills our eyes. When young, this gel is firm like jello, but as the years roll by, it becomes more liquid. Commonly, the natural fibers in the gel clump together as we age and they can move or “float” within the mushy gel. They can assume countless shapes, but often seem to be strands or cobwebs. For some people the appearance is more like crumpled plastic wrap or even pieces of wax paper. If this is the cause, your eye health is likely safe, as these benign nuisances seldom progress to cause retinal damage.

Number two, however, can be early symptoms of a retinal detachment. The delicate nerve membrane that lines the back of our eyes can come loose, or can tear or rip. These scary changes are totally without any feeling or pain. The retina must remain in contact with the blood supply of our eye to function. When or if it detaches, it loses that contact, and worse yet….it can continue separating over a larger area. This partial, usually peripheral damage, can go on to cause loss of central vision as well. Treatment must begin quickly to prevent permanent vision loss.

Number three, interruptions in the vascular supply to our retina can also cause temporary, or “transient”, vision changes. Blurry areas or even dark areas can signal vascular blockages to, or within the eye. Also without any pain, these clues can worn of pre-stroke potential.

And number four, migraines can cause vision effects. With, or without, an actual headache….vision changes are common with some of the various migraine syndromes. Most in my experience cause symptoms with lights or colors shimmering or sparkling in our vision. These usually clear up totally within about 20 minutes, and while frightening….are also benign.

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As you would suspect, with these widely varying causes, you are best to see your eye doctor. Ideally, you would want to be seen during one of these episodes…but the odds of getting that timing just right are unlikely. So, schedule a complete eye examination. Your eye doc may need to use dilation eyedrops to examine all the tissue in the back of your eyes. Because those drops cause blurry vision afterwards, best to take a driver with you for the return trip home.