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Flashes and Floaters

Sometimes people see small spots or specks moving in their field of vision or experience flashes of light. In many cases these problems are benign; however, in some cases they can symptoms of a more serious eye problem such as a retinal detachment.

What are Floaters?
The main body of the eye is filled with a clear gel called vitreous. Floaters are small clumps and condensations in this vitreous gel. They may be seen as dots, lines, cobwebs or spiders, and are most often noticed reading, or looking at a blank wall or clear sky. Although they appear to be in front of the eye, these clumps are actually floating in the vitreous and casting shadows on the retina (The retina is the thin membrane in the back of the eye that absorbs light and converts it to electrical impulses that form images sent to the brain).

What Causes Floaters?
The most common cause of new floaters is a separation of the vitreous from the retina called a posterior vitreous detachment (PVD). This commonly occurs after age 55, and is a normal part of aging. As we mature, the vitreous gel liquefies, shrinks, and pulls away from the retina. Floaters are most commonly formed by reorganization of the vitreous, but can also represent retinal fragments or blood. Rarely, as the vitreous detaches it pulls on the retina and may tear it, this can lead to a retinal detachment, a serious complication from a normally benign process. If you experience a sudden onset of new floaters or flashes, you should have a dilated eye exam to ensure that a retinal tear or detachment has not occurred. Prompt treatment may be essential to preserve your vision.

What Causes Flashes?
Flashing lights or lightening strikes in the vision may be caused by traction or tugging of the vitreous gel on the retina. They may occur in conjunction with a posterior vitreous detachment (PVD), and when they do they indicate that there is tension on the retina that could lead to a tear. If you begin experiencing these flashes you should have a dilated eye exam to ensure that you do not have a retinal tear or detachment. Flashes may also be caused by migraines. These type flashes may appear as jagged lines or geometric shapes. They may start peripherally and move to your central vision, and they usually last less than an hour. In classic migraines they are followed by a migraine headache, although a specific subclass called “ocular migraines” is not followed by a headache. If you have these symptoms you should have a full eye exam to ensure that a more serious condition does not exist.

Will Flashes and Floaters ever go away?
Floaters may fade or get smaller, or they may be stable over time. Even if floaters do not disappear completely, we become very used to and tolerant of floaters. It is rare that stable floaters require treatment. Flashes usually occur only during the period before and shortly after a posterior vitreous detachment. Prolonged or worsening flashes are cause for concern and should be evaluated.

Retinal Tears and Retinal Detachments
Retinal tears and detachments are serious eye conditions which the only early symptoms may be flashes and floaters. If untreated, retinal detachments lead to permanent blindness. Other than new floaters and flashes of light, symptoms may include a curtain or veil coming across one eye’s field of vision, or simply blurred vision in one eye. If caught early retinal tears can be treated with laser to strengthen surrounding retina tissue and prevent a retinal detachment. Retinal detachments usually require emergent surgical treatment. If you have any of the symptoms of retinal tears and detachments you should have a full eye exam immediately.

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