Flashes & Floaters

Many people experience floaters.  They are the spots or lines that we can see floating into our field of vision and look like little dots, cobwebs, lines or veils.  Floaters are usually most noticeable when we are looking at a blank wall or are trying to read. Usually floaters are caused by small pieces of protein that break apart from the vitreous jelly. When light enters the eye, it cannot pass through the protein which causes us to see spots.  If there is a shift in the vitreous jelly that is caused by rubbing or traction on the retina, people will experience quick sparks of light, usually referred to as flashes.  These flashes of light usually originate in the corner of the eye and flash across the field of vision.

Causes and Symptoms:

The retina lies in the back of the eye and is a multi-layered tissue which detects visual images and transmits these to the brain. In front of the retina lies the vitreous humor.  The vitreous is the jelly-like material that fills the large central cavity of the eye.  It is composed primarily of water, but it is also made up of proteins and other substances which are more fibrous.  The water and fibrous elements together give the vitreous a gelatin consistency.

The vitreous is normally connected to the retina.  As people age, the watery portion of the vitreous separates from the fibrous portions.  As this occurs, the fibrous elements contract and can pull the vitreous away from the retina.  This is called a Posterior Vitreous Detachment.  This contraction on the retina is responsible for the characteristic “flashes” that often accompany the Posterior Vitreous Detachment.  The “floaters” are frequently caused by the fibrous elements changing position during the Posterior Vitreous Detachment.  They can also be caused by pieces of the retina being dislodged as the vitreous contracts.  Flashes and floaters are more common in those who are older and nearsighted or have had cataract surgery or any type of laser vision correction surgery.

Treatment:

All patients who experience an onset of flashes and floaters should be examined immediately by their eye doctor.  Most of the time nothing unusual is found, and simple reassurance is all that is needed.  The flashes eventually go away, and the floaters diminish and become less bothersome with time.

However, in about 10 percent of the patients with a Posterior Vitreous Detachment, a retina tear is found.  If left untreated, these tears may lead to a full Retinal Detachment. A full Retinal Detachment is a very serious sight-threatening condition requiring a major surgical procedure to repair.  When symptoms appear, it is important to examine the eye within a day of their onset.  Changes can occur rapidly, and timing is critical if a Retinal Detachment is present. Retinal tears are treated by sealing the tear with a laser or through a freezing technique (cryotherapy).

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