Floaters and flashes are symptoms of the eye that commonly occur as a result of age-related changes to the vitreous gel. When we are born, the vitreous is firmly attached to the retina and is a thick, gelatinous substance without much movement. But as we age, the vitreous becomes thinner and more watery, and tissue debris that was once secure in the firm gel can now move around inside the eye, casting shadows on the retina or floaters.
These changes are generally well-tolerated. In some patients, however, flashes and floaters are a more ominous sign and can appear as the vitreous suddenly pulls loose from the retina and tears the retina. Thus, anyone presenting with sudden onset of floaters and flashes of light may in fact have a retinal detachment, retinal tear, or simply a posterior vitreous detachment (PVD). A Retina specialist through a detailed exam can pick up on these problems and render emergency treatment of these problems before vision is lost.
What are Eye Floaters?
Floaters in the vision can represent clumps of cells in the vitreous cavity (blood, inflammation) or more commonly they represent normal age-related degeneration of the vitreous gel inside the eye causing clumps of collagen to form. These clumps of collagen cast shadows on the retina which appear as small dark spots, strings, or clouds in the vision that typically move around. Vitreous degeneration by itself is benign. However, if the vitreous pulls on the retina, this could then represent an emergency. For example, new floaters especially in middle age or upper age may be a sign of a posterior vitreous detachment and should be examined by an eye professional to ensure that no retinal tear or retinal detachment has resulted from vitreous detachment. Trauma to the eye or cataract surgery can cause floaters in the vision and this too needs prompt evaluation by an eye professional to ensure the retina has not been harmed. Treatment of floaters depends on the cause. Most floaters related to degeneration of the vitreous gel can be observed and often times the brain neuro-adapts to these and ignores them. However, some patients with floaters can experience significant debilitation of their activities of daily life including reading, driving, watching TV, performing computer work, and other specific tasks. There are 2 current therapies performed for floaters from vitreous degeneration and vitreous detachment. One therapy is Yag Laser Vitreolysis with limited clinical trial data available and the other is Vitrectomy surgery. Both have specific risks and benefits and case selection for each procedure is critical. At Retina & Vitreous Consultants of Virginia, Dr. Ilyas performs both procedures and has significant experience in their use for floaters. However, it must be born in mind that in most situations, floaters can be safely observed and rarely require treatment. If you feel like floaters are severely affecting your quality of vision and your life activities, we are happy to evaluate your eyes and begin by excluding any serious retinal problems that could coexist with floaters like retinal tear or detachment.
What Causes Flashes of Light or Flickers of Light in the vision?
Flashes of light can be an indication of the vitreous gel pulling on the retina and inducing a mechanical light flash. The main issue is that the retina may be undergoing a retinal tear or retinal detachment which are vision-threatening conditions that, if not caught early, can lead to irreversible vision loss. Always report flashes of light to your eye professional or go to your nearest emergency room since this may be a sign of a serious retinal condition. Flashes of light which are more central or colored associated with blurred vision or headache can be a sign of migraine. Consult with your primary care physician if you think you may be suffering from a Migraine condition or simply see your eye care professional for an exam.
What does a Dark Shadow or Curtain in the vision represent?
Always report this emergency to your eye care professional or go straight to the emergency room. This could be a sign of a retinal detachment, severe bleeding inside the eye, or a vascular blockage in the retina or optic nerve (stroke).
To learn more about retina and vitreous diseases and cutting-edge treatments available to you, please call 540-662-1810 today to schedule a consultation.
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