Flashes and Floaters

What are Floaters?
Floaters are small specks that float within the vitreous of the eye. They typically move around and may be more visible when looking at a plain background in bright light.

Floaters are tiny clumps of tissue inside the vitreous (vi-tree-us). The vitreous is the clear jelly-like fluid that fills the inside of your eye.

Floaters sometimes look like tiny insects buzzing around outside the eye, but they are actually floating inside the eye. What is seen are the shadows they cast on the back of the eye when bright light shines on them.

Floaters can have different shapes such as little dots, circles, lines, clouds or cobwebs.

What Causes Floaters?
In young people, floaters are caused by small clumps of tissue in the vitreous and are typically harmless. In middle age people, floaters may be caused by a condition called PVD (posterior vitreous detachment).

What is a posterior vitreous detachment?
When people reach middle age, the vitreous gel inside of the eye starts to shrink. As the vitreous shrinks, it may begin to pull on the retina (the back part of the eye) which may cause flashes of light to be seen. Eventually, the vitreous completely detaches from the retina and frequently takes a small amount of tissue from the back of the eye as well. This small amount of tissue is visible as a large floater and is called a PVD (posterior vitreous detachment.)

Posterior vitreous detachment is more common in people who:

• Are nearsighted;
• Have undergone cataract operations;
• Have had YAG laser surgery of the eye;
• Have had inflammation inside the eye.

Are floaters ever serious?
In some cases, floaters can be a warning sign for a retinal detachment; therefore, you should call for an appointment right away if you suddenly develop new floaters. In some cases, the floaters may be associated with flashes of light, which can also be a warning sign for a retinal detachment.

The retina sometimes gets torn as the vitreous pulls off during a POSTERIOR VITREOUS DETACHMENT and this can lead to a retinal detachment. This process can also cause bleeding in the eye that may appear as new floaters.

A torn retina is a serious problem, since it can lead to a retinal detachment. You should see Dr. D as soon as possible if:

• New floaters appear suddenly
• You see sudden flashes of light
• You notice a loss of your side or central vision

What can be done about floaters?
In most cases, floaters are completely harmless and usually more of a nuisance than a real problem. However, because of the risk of a retinal detachment, any new floaters need to be evaluated to rule out a retinal tear or detachment.

Floaters will typically fade over time without treatment. Floaters can be removed surgically by a process called a vitrectomy. However, this procedure is rarely performed for floaters because the floaters tend to resolve on their own over time.

What causes flashing lights?
When the vitreous gel rubs or pulls on the retina, you may see what looks like flashing lights or lightning streaks. You may have experienced the same sensation if you have ever been hit in the eye and seen "stars".

The flashes of light can appear off and on for several weeks or months. As we grow older, it is more common to experience flashes. If you notice the sudden appearance of light flashes, you should call for an appointment at once to make sure the retina is healthy and/or stable.