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Flashes and Floaters in Your Vision: Do I need to be concerned?

Flashes and Floaters in Your Vision:

Do I need to be concerned?

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Upwards of 60% of people over the age of 50 experience some degree of “floaters” in their vision. People frequently describe this as 'nats', 'bugs', or 'debris' in their vision, and at times these symptoms can be very worrisome. In some cases, people may experience flashes of light -- like a camera flash or lightning bolt -- typically seen in the periphery of the vison. These symptoms can be very bothersome and nerve racking when they occur.

The back chamber of the eye (behind the lens) is called the vitreous cavity. The vitreous gel is clear and has a thick, sticky consistency. The gel is tightly adherent to the peripheral retina, optic nerve, and less so along retina blood vessels and the macula. As we age, the gel becomes more liquefied and wants to separate from the retina. (If you think of your eye as a camera, then the retina would be the film.) The retina is composed of over 120 million photoreceptors and is responsible for sending the signal of an image to the brain via the optic nerve. When the vitreous gel separates from the retina it can pull some pigment and debris off the surface of the camera film resulting in floaters. This process of the vitreous gel separating from the surface of the retina is known as a Posterior Vitreous Detachment (PVD).

When a Posterior Vitreous Detachment first occurs, it is usually very symptomatic. However, with time the vitreous debris migrates to the bottom of the eye, dissipates, and becomes much less bothersome. If the floaters persist they can be surgically removed with an outpatient sutureless procedure called a vitrectomy, fortunately in most cases after a few months the floaters improve significantly on their own.

In severe cases, the vitreous gel can pull abruptly away from the retina resulting in a tear of the retina. When the gel places significant traction on the retina flashes are frequently seen. A retinal tear is an ocular emergency because it can lead to retinal detachment which is blinding without surgical intervention. If a retinal tear is found quickly a laser light can be used to seal the tear preventing a retinal detachment. An analogy I have found helpful to patients; imagine the room you are sitting in is the inside of your eyeball and is filled with fluid. The wall paper on the back wall represents your retina, if you tear the wall paper it is only a matter of time before the fluid in the room migrates through the hole and behind the wallpaper resulting in the wall paper separating from the wall. This is how a retinal detachment occurs.

Risk factors for retinal tears include, people who are highly nearsighted, cataract surgery, trauma to the eye, genetic disorders (such as Stickler’s syndrome), weak areas in the retina, history of a retinal tear in past. The good news retinal detachment is overall an uncommon occurrence with an incidence of less than 1% even with most risk factors.

Timing is key when it comes to retinal tears. Any retinal tear can cause retinal detachment. Prompt treatment with laser or cryopexy treatment done in the clinic setting can prevent a blinding retinal detachment. There is no pain with a retinal tear or detachment only the below mentioned visual symptoms.

Immediate dilated eye exam by an eye doctor is recommended if you experience any of the following:

  • Flashes of light (quick bursts lasting only a second)

  • Sudden dramatic increase of floaters (more than just occasional few); this can be an indication of bleeding inside the eye from a tear

  • Floaters with a clouding of vision

  • Dark curtain or shadow in periphery of vision that doesn’t go away.

At Florida Retina Specialists, we specialize in retinal tears and detachments along with macular degeneration and diabetic retinopathy. We are also equipped with the newest retina laser system. To get more information on retinal tears and detachments please visit our page on this website: Conditions We Treat and click 'Floaters' or 'Flashes'.

Know the signs and symptoms of a retinal tear and seek immediate care; it could save your vison.

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