What are floaters and flashes?
Floaters are small specks, fibers, or bug-like objects that may appear to move in front of your eye. They appear black or gray and may be few or numerous. At times they may appear like a veil or cloud moving in the vision even after the eye is still. They are frequently seen when looking at a brightly lit background, like a blank wall or blue sky. Floaters are actually tiny clumps of fiber or cellular debris within the jelly-like fluid (vitreous) that fills the inside of the eye. Many dot-like floaters may be due to bleeding inside the eye, especially when they come on suddenly. Long-standing, numerous, dot-like floaters may represent inflammation in the eye.
Flashes are brief streaks of light that are usually seen off to the side, especially at night when you turn your head or eyes. They may appear curved or like a brief lightning flash and last for only a second. Flashes are caused by fibers in the vitreous gel tugging on the retina with eye movement. This type of flashing light is different from migraine.
What do these symptoms mean?
Although many people have occasional floaters or flashes of light, the sudden onset of many new floaters with or without flashes is an important sign of abnormal pulling on the retina by the vitreous. In some instances, the retina may tear and cause blindness from detachment of the retina.
What causes floaters and flashes?
Floaters and flashes are usually due to degeneration of the vitreous gel in the eye from ageing. Over time, the vitreous shrinks, condenses, and pulls away from the retina. The condensation causes floaters and the pulling irritates the retina and is perceived as flashes of light. Myopia (near-sightedness) is a common cause of long-standing floaters.
What should be done about these symptoms?
The most important step is to have a thorough dilated eye examination, preferably by a retinal specialist. The need for examination is urgent if the onset of symptoms is sudden. The eye doctor will check for the presence of a tear in the retina. If a tear is found, laser or cryopexy is usually recommended to decrease the chances of blindness from retinal detachment. If a retinal detachment is found, more extensive surgery is required in attempt to repair it.
Once an exam has demonstrated no retinal damage, he symptoms of flashes and floaters do not require specific treatment. The flashes usually occur less frequently over time. It may take days or weeks for the flashes to subside. Rarely, flashes will continue over many years. Likewise, floaters subside with time, but take weeks to months to become less noticeable. It is best not to concentrate on following floaters by moving your eyes as it may make them more bothersome. Depression and stress may worsen the degree in which floaters interfere with daily visual activities.
Many people have long-standing floaters that are not bothersome. In these cases, no treatment is needed after an examination to insure good eye health. Very rarely floaters will persist and interfere with vision. In these unusual cases, vitrectomy surgery may be considered. There are options to consider.
What should you be on the lookout for?
After examination or treatment, any significant new floaters (especially, many new dot-like floaters) or any loss of side vision should be reported to the doctor without delay. An occasional flash of light in itself is not usually indicative of damage to the retina. Sometimes, new tears or a retinal detachment can occur at a later date after the initial examination.
For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida.
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