Flashes and floaters are symptoms of the eye that commonly occur as a result of aging changes to the vitreous gel. Sometimes a section of the vitreous pulls away from the retina all at once, rather than gradually, causing many new floaters to appear suddenly, which in most cases is not sight-threatening and requires no treatment.
However, a sudden increase in floaters, possibly accompanied by light flashes or peripheral (side) vision loss, could indicate a retinal detachment.
We recommend a dilated eye examination for flashes and floaters to evaluate your retinal health and also utilize Optomap wide angle retinal photography to help diagnose and electronically document the retina for changes.
What are floaters?
Floaters are little "cobwebs" or small, dark, shadowy shapes that can look like spots that float about in your field of vision. They move as your eyes move and seem to dart away when you try to look at them directly. Floaters can become apparent when looking at something bright, such as white paper or a blue sky.
When we are born, the vitreous is firmly attached to the retina and is a thick, firm substance without much movement. But as we age, the vitreous becomes more watery, and tissue debris that was once secure in the firm gel can now move around inside the eye, casting shadows on the retina.
Floaters and Retinal Detachment
Sometimes a section of the vitreous pulls the fine fibers away from the retina all at once, rather than gradually, causing many new floaters to appear suddenly. This is called a vitreous detachment, which in most cases is not sight-threatening and requires no treatment.
However, a sudden increase in floaters, possibly accompanied by light flashes or peripheral (side) vision loss, could indicate a retinal detachment. A retinal detachment occurs when any part of the retina, the eye's light-sensitive tissue, is lifted or pulled from its normal position at the back wall of the eye.
A retinal detachment is a serious condition and should always be considered an emergency. If left untreated, it can lead to permanent visual impairment within two or three days or even blindness in the eye.
Those who experience a sudden increase in floaters, flashes of light in peripheral vision, or a loss of peripheral vision should have an eye care professional examine their eyes as soon as possible.
Causes and Risk Factors
What causes floaters?
Floaters occur when the vitreous, a gel-like substance that fills about 80 percent of the eye and helps it maintain a round shape, slowly shrinks.
As the vitreous shrinks, it becomes somewhat stringy, and the strands can cast tiny shadows on the retina. These are floaters.
In most cases, floaters are part of the natural aging process and simply an annoyance. They can be distracting at first, but eventually tend to "settle" at the bottom of the eye, becoming less bothersome. They usually settle below the line of sight and do not go away completely.
However, there are other, more serious causes of floaters, including infection, inflammation (uveitis), hemorrhaging, retinal tears, and injury to the eye.
Who is at risk for floaters?
Floaters are more likely to develop as we age and are more common in people who are very nearsighted, have diabetes, or who have had a cataract operation.
Treatment for Flashes and Floaters
For people who have floaters that are simply annoying, no treatment is recommended.
Most flashes and floaters will become less noticeable with time as patients adjust their vision. Treatment of an underlying condition, such as a retinal tear, can help clear symptoms. On rare occasions, floaters can be so dense and numerous that they significantly affect vision. Regular eye exams can help reduce the risk of complications.
Vitreous Detachment Defined (part of floaters)
What is vitreous detachment?
Most of the eye's interior is filled with vitreous, a gel-like substance that helps the eye maintain a round shape. There are millions of fine fibers intertwined within the vitreous that are attached to the surface of the retina, the eye's light-sensitive tissue. As we age, the vitreous slowly shrinks, and these fine fibers pull on the retinal surface. Usually the fibers break, allowing the vitreous to separate and shrink from the retina. This is a vitreous detachment
In most cases, a vitreous detachment, also known as a posterior vitreous detachment, is not sight-threatening and requires no treatment.
Who is at risk for vitreous detachment?
A vitreous detachment is a common condition that usually affects people over age 50, and is very common after age 80. People who are nearsighted are also at increased risk. Those who have a vitreous detachment in one eye are likely to have one in the other, although it may not happen until years later.
Symptoms and Detection
What are the symptoms of vitreous detachment?
As the vitreous shrinks, it becomes somewhat stringy, and the strands can cast tiny shadows on the retina that you may notice as floaters
, which appear as little "cobwebs" or specks that seem to float about in your field of vision. If you try to look at these shadows they appear to quickly dart out of the way.
One symptom of a vitreous detachment is a small but sudden increase in the number of new floaters. This increase in floaters may be accompanied by flashes of light (lightning streaks) in your peripheral, or side, vision. In most cases, either you will not notice a vitreous detachment, or you will find it merely annoying because of the increase in floaters.
How is vitreous detachment detected?
The only way to diagnose the cause of the problem is by a comprehensive dilated eye examination. If the vitreous detachment has led to a macular hole or detached retina, early treatment can help prevent loss of vision.
How does vitreous detachment affect vision?
Although a vitreous detachment does not threaten sight, once in a while some of the vitreous fibers pull so hard on the retina that they create a macular hole to or lead to a retinal detachment. Both of these conditions are sight-threatening and should be treated immediately.
If left untreated, a macular hole or detached retina can lead to permanent vision loss in the affected eye. Those who experience a sudden increase in floaters or an increase in flashes of light in peripheral vision should have an eye care professional examine their eyes as soon as possible.