Flashes and Floaters

Flashes and floaters are symptoms of the eye that commonly occur as a result of age-related changes to the vitreous gel. 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 thinner and 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.

Flashes in vision occur as a result of pressure on the retina in the back of the eye, the bundle of nerves in the back of the eye where images are detected and transmitted to the brain, causing patients to see flashing lights or lightning streaks. Floaters occur when fibers move across the vitreous and into your field of vision, causing patients to see specks, strands, webs or other shapes as the fibers cast shadows on the retina.

These symptoms are most visible when looking at a plain, light background. Flashes and floaters often appear at the same time, although some patients may only experience one symptom.

Causes and Risk Factors

Floaters appear most often in eyes that are injured, inflamed or nearsighted. Flashes may occur after a blow to the head, or from a spasm of blood vessels in the brain, which is associated with migraine headaches. In these cases, flashes and floaters are harmless symptoms that are not of medical concern.

These symptoms may also occur as a result of:

• Cataract surgery
• YAG laser surgery
• Diabetes
• Retinitis
• Eye infections

However, in some patients, flashes and floaters appear as the vitreous pulls loose from the retina, creating shadows within the eye. This may indicate a retinal detachment, or more commonly, a posterior vitreous detachment (PVD), which involves the vitreous separating from the retina.

Diagnosing Flashes and Floaters

Although flashes and floaters are common, especially as we age, it is important to see your doctor if you experience them, as they may indicate a retinal tear or hole. Your doctor can distinguish between harmless flashes and floaters, and those that may require treatment for an underlying condition.

Flashes, floaters and other visual disturbances that appear suddenly may indicate that the vitreous is pulling away from the retina and could lead to a retinal detachment. Anyone experiencing a sudden abundance of these symptoms should seek immediate medical attention in order to reduce the risk of complications such as severe vision loss.

Most flashes and floaters will become less noticeable with time as patients adjust their vision. Although these floaters are harmless, it is important to continue to receive regular eye exams to ensure that any permanent changes to your vision do not occur.

Treatment for Flashes and Floaters

Once it has been determined that the floaters and flashes are not the result of a retinal hole or a retinal detachment, Drs. Kalt and Katz will monitor the patient and request that they return within several months for a recheck of the retinas. Even after the patient has been reassured that they have not experienced a retinal detachment, a follow-up examination is important to make certain that a new retinal hole or detachment has not occurred after the initial exam. Unfortunately, many of us have to get used to living with our floaters, and luckily, for most of us, they tend to sink down in the vitreous out of our line of sight.