Shadow in vision I see only at night

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Even if I hold my left eye closed, against the faint light of my window, I will notice in the right peripheral vision of my right eye a shadow blacker than the night. It is longer vertically than horizontally and is kind of a distended blob. Earlier this month, I had flashes that were like lightning strikes in my right peripheral vision, especially when coughing or moving my head, though they have since gone away. As well, I have had dark floaters for more than a year now, and received an ophthalmoscopy exam back in August which came out normal, just a posterior vitreous detachment (which is benign in and of itself). The dark floaters come and go: sometimes there are 10 or more and at other times there are none that I can see. Earlier this month, I would occasionally see what looked like a big stationary floater if I looked in a certain direction which would fade away as I move my eyes, but I haven't seen it lately.

This stuff is confusing and weird! I am seeing an ophthalmologist on Thursday, but the co-pay would be $45 (as I would have to use my medical insurance instead of my vision insurance), and with the $200+ I need to fix my wheel on my car, I'm not sure if I want to spend all that money.

Please get to the bottom of it. You may need to see multiple doctors before you know for sure what's causing all that. You can't save money on your health. You can forget about your car for now but not your eye. I hope you'll find out it's nothing to worry about.

I went to the ophthalmologist today and needless to say they were very very thorough. If I recall, they checked my vision (with my glasses on), which was fine; they numbed my eyes and poked this thing in my eye to check pressure (for glaucoma), which was normal; they then dilated my eyes, and after a little while had me go in front of this thing that took photographs of my eyes--I know it was not fundus photography. I then met the ophthalmologist and he was like something out of the 70s, but boy was he very thorough, careful, and smart! He discussed with me my symptoms, then took out the slit lamp followed by ophthalmoscopy. As he made observations, he spoke them to his technician, who I suppose entered them on the computer. At the end of it, he talked to me about his observations.

He said that he saw the vitreous floaters and the posterior vitreous detachment in both eyes, but did not see a retinal tear or detachment in either eye, which is a very good thing. He also observed that my eyes were larger than normal and that my left eye was larger than my right eye, so he could tell I had myopia and that I was likely more myopic in my left eye than my right eye. (Indeed, I am myopic, with -6.5 dioptres in my left eye and -5 dioptres in my right eye.) At some points during the exam, I coughed, and he said he could see the impact each cough had on the eye he was examining at the time. He said that coughing increases the pressure in the eye and can have an effect on the blood vessels in the eye. He mentioned how some people with asthma who were coughing up a storm, their eyes were like tomatoes! He saw a blood vessel in one of my eyes burst when I coughed once, creating a white spot inside the eye, which he said he would expect to clear up by my follow-up appointment in 6 weeks.

He went into a whole bunch of other stuff that I will probably begin to remember as I begin to ruminate more on the conversation. At the end, he had my blood pressure taken (normal) and had me go for fundus photography. After that, that was it!