Flashes and Floaters

What Causes Floaters?

Most of the eye’s interior is filled with a transparent gel-like substance called the vitreous. There are millions of fine fibers intertwined within the vitreous that anchor it to the surface of the retina. These fibers tend to collapse in on themselves with age, and this creates small pockets of opaque material that cast small shadows on the retina. They are perceived as little “cobwebs” or specks that seem to float about in your field of vision. In a person’s fifties or older, the vitreous spontaneously separates from the retina, and a sudden onset of new floaters may be noted.

What Causes Flashes?

With age, fluid begins to replace the space once occupied by the shrinking vitreous. Usually, the attachments of the delicate vitreous fibers to the retina loosen and fall harmlessly away, creating what is known as a posterior vitreous detachment (PVD). Sometimes, the process is more vigorous and actual traction is generated on the retina. This produces quick flashes of light in the visual field.

What are the Consequences of PVD?

In most cases, a vitreous detachment is not sight threatening and requires no treatment. A person either will not notice a vitreous detachment, or will find it merely annoying because of the floaters.

Can There be More Serious Problems With a PVD?

In some patients, the vitreous fibers pull so hard on the retina that they cause a retinal tear or hemorrhage. A retinal tear is sight-threatening because it is the first step toward a retinal detachment. Treatment is needed right away. Therefore anyone experiencing sudden new floaters or new onset of flashes should have an eye care professional examine the eye with a dilated pupil evaluation as soon as possible.

What About Treatment for Flashes and Floaters?

In almost all patients, floaters will become less noticeable with time as the brain adjusts to their presence. The floaters will always be somewhat observable-particularly if one eye is covered and the other eye gazes at a light-colored background. There is no way to eliminate these with laser treatment or medication. Surgery to remove the floaters is called vitrectomy but this is rarely advised.

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