Flashers and Floaters

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What Is It?

One of the most common symptoms an eye doctor encounters is that of flashes and/or floaters. Someone will notice a “bug” that’s not there. Others notice “lines, webs or dots”. These may range from very small to disturbing “clouds” effecting the vision.

It is common for patients to notice occasional small spots in the vision, particularly near-sighted individuals. These are usually harmless protein particles that occasionally are noticed in certain backgrounds and move about. When a patient notices a burst of new floaters, it can mean a Vitreous Detachment. This event is most common between the ages of 55 and 70. A patient will come in having noticed some fleeting flashes, usually arc-shaped in the far edges of their vision. These will have occurred off and on, lasting only seconds. These peripheral flashes are more often noticed at night, when lying down in the dark. The flashes are followed at some point by some new floaters.

These floaters are often shaped as lines, webs, circles or clouds effecting the vision. The patient can see fairly well, but the new floaters are disturbing.

It is important to have the eyes checked when this occurs to make sure the retina is OK.


Posterior Vitreous Detachment

A posterior vitreous detachment is an event that occurs when the firm “jelly” in the back of the eye moves toward the center of the eye. Areas of this “jelly” or vitreous, become liquid with age. At some point (50-70 years) these liquid areas come together in the very back of the eye. This pushes the firmer vitreous forward.

This in itself is a normal, harmless event. In fact it may be protective for some patients. However, as the firm jelly moves forward, it must release its attachments to the retina. It is most firmly attached to the retina in the far periphery (far edges of the retina). As the jelly pulls loose, the traction stimulates the retina leading to the noted arc-like flashes. As you might expect, these will be in the far peripheral vision.

There are other causes of flashes and floaters. Some of these are: migraine, inflammation behind the eye and infection behind the eye. These problems also have other signs and symptoms associated.


Can a posterior vitreous detachment be dangerous for my eyes?

One should have a dilated eye exam if new flashes and floaters develop. As the firm vitreous detaches from the retina, there is traction. This traction is what causes the flashes. Occasionally the traction is strong enough to tear the retina. When the retina is torn, the number and size of the floaters is usually much more noticeable. One may see hundreds of small dots (blood cells), or large strings in the vision. When the retina tears, it can lead to a detached retina. This problem will cause a “shadow” to develop like a “bubble” or “curtain” in the side-vision. If untreated it can progress to detach the entire retina. Then only light or motion can be detected with the effected eye.

Fortunately retinal tears can be treated. A laser is used to surround the tear. This causes a scar around the problem area, so that fluid can’t get under the retina and detach it. It is much easier to treat a retinal tear, than a full-blown detachment.

Actually, most retinal detachments can be fixed. It does require surgery. Retinal Detachment surgery should be done before the central vision is effected, if at all possible. Thus, if someone has the symptoms noted above, they should be seen urgently.

Retinal tears are easier to treat than a detached retina.