Eye spots.

[TMHeimer]

Just had my annual eye exam. Seems there are 2 very small blood spots in my eye. Dr. said it is from capillaries busting. She said it could be from diabetes (my Dr. said I may at some point be prone to that, but don't have it), or sometimes these tiny bloodspots just happen. I mentioned scuba and she said it's possible that pressure changes could cause this, but not very common. I am 58. Anyone ever had this and been diagnosed as it being from diving?

 

[gert7to3]

How is your blood pressure? Hypertension is a common root cause of retinal hemorrhages. Other factors include diabetes, myopia (nearsightedness) or even macular degeneration.

You did not mention where in these retinal hemorrhages occurred.

Have you had a mask squeeze or other head/eye trauma?

People who undergo exertion at high altitude can also spontaneously develop retinal hemorrhages.

It would be prudent to determine if there are any underlying health issues at work here. More frequent eye exams might be in order as well.

 

[TMHeimer]

Blood pressure has always been normal. Was nearsighted, had lazer surgery 7 years ago. No mask squeeze/head trama or exertion at high altitude. Can't recall where exactly the Dr. said the spots were in the eye. She passed on the info. to my regular G.P. Dr. -- also has scheduled me for a followup in 3 months. She will dialate my eye again to see if the spots remain. She said to come in sooner if there is seems to be anything wrong with the vision in that eye. The reason she did the dialation (eye drops) exam was because I hadn't had this done for 3 years, so I don't know how long these spots have been in the eye. I only dive deep once in a while, as most of my diving is 30' shore dives and DMing pool, OW checkout dives, etc. So not a lot of higher pressure very often.

 

[DocVikingo]

I mentioned scuba and she said it's possible that pressure changes could cause this, but not very common.

Hey TMHeimer,

At depth the pressure inside the eye does not increase, since, like the rest of the body structures that normally contain no gas, the eye is not compressible. As such, the alterations in ambient pressure inherent in SCUBA itself should pose no risk of capillary rupture/leakage. And research shows that during increased atmospheres of pressure intraocular pressure actually drops some.

Of course there is the issue of posible mask squeeze. As a diver descends air within the mask compresses and, indeed, if the pressure differential between the inside of the mask and the eye becomes extreme enough, it does risk traumatizing the orb (e.g., hyphemia, incisional rupture) and surrounding tissues (e.g., periorbital edema, ecchymosis). For this reason, most divers with any experience quickly equalize these pressure changes as they move down and up in the water column, and research suggests that this equalization typically achieves pretty close to comparable pressures, probably because it's darn uncomfortable when they don't. Plus, you have indicated that you have not been subject to this.

I'd also raise the issue of immersion-caused shifts of blood into the thorax & constriction of peripheral blood vessels, especially in cold water, that can cause sudden increases in BP and could contribute to capillary rupture/leakage. However, given a diver with normal BP and otherwise in a state of good health & fitness, this phenomena seems a relatively minor worry. As the doctor who examined your eyes indicated, sometimes "tiny bloodspots just happen," and she appears to be following up appropriately and not alarmed by the findings to date.

You might find the following DAN piece regarding diving and the eye to be informative, particularly the section on "What eye conditions would preclude someone from diving?" --> DAN Divers Alert Network : High-Pressure Ophthalmology

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[scuba andy]

80% of people with diabetes for 10 years or more get this (retinopathy). Regular health checks. They will laser and retina bleeds.

 

[Kevrumbo]

My Ophthalmologist/Cornea Specialist has not yet ruled-out the possibility of cumulative pressure effects contributing to my ruptured left cornea/Descemet's membrane (Dx Corneal Hydrops OS) last April. Still have visual haziness out of left eye due to residual/remaining fluid occluding the normally translucent cornea tissue. The good news is the scarring from the rupture is not in my left eye's central axis & field of vision, so no cornea transplant tissue donor & surgery may be necessary.

Hydrops « Keratoconus Info

 

[chrpai]

Thanks for this thread. I had an exam yesterday and I'm pretty much in the same boat. I'd like to ask DocV a question though.

My Dr dialated me and examined me using the traditional approach and the fundus camera approach. What's a little different from the OP is that she only said two areas looked like a hemorrhage. She hesitated to say for certain and asked for a follow up in 1 month instead of 3 months. She thought that if it went away then it was a hemorrhage but if it remained it was my normal baseline.

Does that sound plausible? Sounds like at this point I don't have anything extra to worry about diving.

 

[MalibuJerry]

I experienced what Scuba Andy described. It had nothing to do with diving and everything to do with aging. As the eye ages the fluid becomes more jelly like and that pulls on the retina. For me it resulted in some blood in the eye which was later absorbed. But it also came with a torn retina, so it is a good idea to study up on the symptoms just in case.