Flashes and Floaters

Flashes and floaters are generally a harmless, common phenomenon that is part of the ageing process and it’s important to understand the causes and if treatment is necessary.

The eye is filled with a jelly-like substance called the vitreous which holds the shape of the eye. Part of the visual process is when the light passes through the vitreous to reach the retina, which is the light sensitive layer at the back of the eye. As part of the natural ageing process, the vitreous becomes thicker and shrinks which causes floaters and flashes. As a person approaches middle-age, it is common for clumps of cells to form in the vitreous which cast a shadow on the retina and these are known as floaters. Floaters in the vision can be described as the appearance of tiny cobwebs, spots or specks in your field of vision. When looking at a clear space or the sky, you might notice the presence of little shapes floating. Even if you try to blink repeatedly, these do not go away. Upon looking in another direction, the shapes move along with you. Another change the vitreous can go through as we age, is that it can start to pull at the retina which causes a phenomenon called flashes. This is when we see flashes of light intermittently which can last for weeks or months.

Floaters and flashes in the vision can be very common and are usually harmless, as they are part of the human aging process. You can experience them both together or on their own. In the majority of cases, there is no treatment required if flashes and/ floaters are an occasional occurrence. These may bother you in the beginning but gradually you get used to it. However, there are more rare cases when flashes and floaters can also be a symptom of a serious eye condition, called a retinal detachment which requires immediate treatment. As the vitreous pulls away and shrinks, it causes the retina to detach and to peel away from the back of the eye which can damage your vision severely.

When to go to the Eye Doctor

Most of the time, floaters and flashes are harmless, especially when they occur occasionally, as they are just a part of the natural ageing process. However, it is still important to be checked by your eye doctor to make sure it’s a harmless occurrence as these symptoms could be connected to a serious condition called retinal detachment.

Please make an immediate appointment at our office if you experience any of the following:

A lot of new floaters
There are many flashes
A shadow exists in the peripheral part of you visual field
There seems to be a gray veil blocking some of your vision

These symptoms are not necessarily appearing due to a retinal detachment, but it could be connected to this serious condition, and therefore you must be checked right away by an eye doctor in order to receive the proper diagnosis and treatment.

Causes

A common cause of floaters and/or flashes is a condition called posterior vitreous detachment (PVD) which thankfully is not serious or dangerous. PVD occurs when the vitreous pulls away from the back of the eye which tends to be more common as we age.

Flashes and floaters can manifest when there is a serious condition called a retinal detachment. This can cause severe damage to your vision and thus must be treated right away. A retinal detachment occurs when the retina, which is the light sensitive layer at the back of the eye, is pulled away from the back of the eye which can cause visual impairment. If you are suddenly experiencing many flashes and floaters, please schedule an appointment immediately to be checked by the eye doctor for a retinal detachment.

Risk Factors

Floaters

Age 50 plus
Nearsightedness
Having gone through cataract surgery
Eye inflammation, such as uveitis
Diabetes

Flashes

Approximately age 50 plus
Migraines

Treatment

Floaters are most often not treated as they are usually harmless and tend to stop being a nuisance over time. There are surgical procedures, such as a vitrectomy or laser surgery, to remove floaters, but these methods come with risk of complications and therefore floaters are usually not treated. Flashes are also often not treated, but just like floaters, if they appear due to an underlying condition then that is what gets treated. If flashes appear due to migraines, your doctor will provide you with the best treatment plan for migraines. If you are experiencing flashes and floaters due to retinal detachment, this condition requires urgent care to avoid severe permanent visual loss. Retinal detachment is treated with surgery and there are various effective methods of surgical procedures for this condition.

Common Questions

How does the eye doctor diagnose flashes and floaters?

The eye doctor will take a full medical history and will ask you many questions about your symptoms. Your pupils will be dilated with eye drops so that the eye doctor can observe the back of your eye including the vitreous and the retina. You will be checked for a vitreous or retinal detachment. If you are experiencing flashes and/or floaters, your eye doctor may want you to come in for more frequent eye exams so that the ageing process of your vitreous can be properly monitored to ensure it is not leading to a retinal tear or detachment which requires urgent treatment.

What questions will the eye doctor ask me at the eye exam, regarding flashes and floaters?

The eye doctor will want to have a full understanding about the symptoms you are experiencing, in order to achieve the proper diagnosis by the end of the eye exam. Be prepared to answer the following questions: When did you first notice the flashes and/or floaters? How many do you see at a time? What do the floaters look like? How often do the flashes/ floaters appear? Have you had eye surgery in the past? Have you had any eye injuries? Do you have diabetes? Do you have any autoimmune diseases? Do you feel that any parts of your vision feel blocked, as if a veil is on top? Do you see shadows in the periphery (on the sides of your visual field)?

What is the most common cause of flashes and floaters?

In nearly 66% of patients over 70 years old, posterior vitreous detachment (PVD) is the most common cause of flashes and floaters. It is an age-related degeneration of the vitreous that results in it shrinking and separating from the retina. When the vitreous separates, it tugs and causes mechanical stimulation of the retina, which results in flashes. Clinically, the patient has normal vision and does not have any visual field defects. While flashes and floaters may seem scary, they are generally harmless but should be monitored by your optometrist to preclude other complications.

Summary

Flashes and floaters are generally common, harmless symptoms of the natural aging process of the vitreous, which is the gel substance that fills the inside of the eye to hold its shape. It is important to get these symptoms checked by an eye doctor because there are rare cases where the flashes and/or floaters are presenting due to a retinal detachment which requires immediate treatment to save your vision from permanent damage. If you experience sudden flashes and floaters and there are many of them, please book an appointment with our office right away by calling (562) 925-6591 because it’s possible, but not conclusive, that there may be a retinal detachment. The eye doctor will be able to diagnose the situation and guide you with the steps moving forward.

Patients searching for advanced medical eye care visit our clinic from all over California, and we are proud to be a leading provider of medical eye care services for patients from Bellflower, Long Beach, Lakewood, and Los Angeles.

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