Flashes and floaters are very common. Almost everyone experiences them at one time or another. They become more frequent as we age. In rare cases, a doctor’s exam may reveal a more serious problem called a retinal tear or retinal hole. Hence, it’s important to get regular eye exams and inform your doctor if you’re experiencing flashes or floaters.
Causes of flashes and floaters
Most flashes and floaters are caused by age-related changes in the gel-like material, called vitreous, that fills the back of the eye. When you are born, the vitreous is firmly attached to the retina. In the very young, the vitreous is rather thick, like firm gelatin. Within the vitreous, there may be clumps of gel or tiny strands of tissue debris leftover from the eye’s early development. These clumps or strands are firmly embedded in the thick, young vitreous and cannot move around much.
As you get older, the vitreous gradually becomes thinner or more watery. By the time you are in your twenties or thirties, the vitreous may be watery enough to allow some of the clumps and strands to move around inside the eye. This material floating inside the eye can cast shadows on the retina, which you see as small floating spots.
Sometime after about age 55, you may experience the onset of larger, more bothersome floaters or flashes of light. By this age, the vitreous gel has usually become much more watery. It jiggles around quite a bit when you move your eye, making flashes and floaters much more common.
Eventually, the aging vitreous can pull away from the retina and shrink into a dense mass of gel in the middle of the eyeball. Shadows cast onto the retina by the detached vitreous can cause you to see large floaters.
Using special instruments to look into your eyes, your doctor can distinguish between harmless floaters and flashes and more serious retinal problems such as holes, tears or detachment. The usual symptoms of these more serious problems include seeing hundreds of small floating spots, persistent flashing lights, or a veil-like blockage of a portion of the vision. If you experience any of these, you should contact your doctor immediately.
Unfortunately, no medication can eliminate floaters. However, over time the floater will become less noticeable as the brain adjusts to its presence and can “tune out” the floater. The floater will always be somewhat observable and present, particularly if one eye is covered and the patient looks at a light-colored background. If the floaters are quite large, impact vision significantly, and symptoms have not improved over time; we can use a YAG laser to break up large floaters. In certain circumstances, we can perform surgery (Pars Plana Vitrectomy) to remove them.
Anyone with flashes or the sudden onset of a new floater should be examined promptly by an ophthalmologist. The ophthalmologist will perform a dilated exam and look at the vitreous and retina with specialized equipment. Sudden flashes or floaters could be symptoms of a vitreous detachment, which is a benign condition that carries the risk of developing into a retinal tear and/or retinal detachment.
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Floaters look like small specks, dots, circles, lines or cobwebs in your field of vision. While they seem to be in front of your eye, they are floating inside. Floaters are tiny clumps of gel or cells inside the vitreous that fills your eye. What you see are the shadows these clumps cast on your retina. Click here to read on.
When we are young, the gel inside your eye (the vitreous) is firmly attached to the back of your eye. As we get older, the vitreous gel naturally becomes more liquid and collapses away from the retina. This is called posterior vitreous detachment (PVD). Click here to read on.
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Dr. Bennett Chotiner is the founder and medical director of Memorial Eye Institute. A noted innovator, in 1977 he established his clinical practice, the Pennsylvania Eye Associates. In 1984, he established the Pennsylvania Eye Surgery Center, Pennsylvania’s first …
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Erik Chotiner, M.D. diagnoses and treats a wide range of medical eye conditions. He is a Phi Beta Kappa graduate of Franklin and Marshall College. Dr. Chotiner attended Jefferson Medical College in Philadelphia where he received multiple awards including the Physiology Prize for …
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