Flashes and Floaters

Flashes and floaters in the vision are very common. Sudden onset of these symptoms may indicate development of a posterior vitreous detachment (PVD) or more serious issues as discussed here.

What is a Posterior Vitreous Detachment?

The inside cavity of the eye is filled with a material called vitreous, which is usually transparent and has the approximate consistency of an egg white. Early in life, the vitreous is adherent to the surface of the retina (the tissue lining the inside of the eye which is responsible for converting light into an image). At some point in most individuals, the adhesion between the retina and vitreous weakens due to natural processes, and the vitreous separates from the retinal surface. When the vitreous separates from the retinal surface, it is common for small condensations of opaque tissue to separate along with the vitreous and float around freely inside of the eye. This does not usually cause any serious problems, but is noted by the patient as floaters or floating debris in the vision and can be very bothersome when it is first noticed.

What are the symptoms of a Posterior Vitreous Detachment?

The most common symptoms are floaters and flashes. Floaters are small clumps of vitreous gel that float around inside the eye. Floaters can look like dots, circles, lines, or cobwebs, and they move when the eye moves. People notice floaters more often when they are in bright light, such as on a sunny day, or in a bright room with white walls. Flashes of light, or lightning streaks, can also be seen when the vitreous separates from the retina due to mechanical forces on the retinal tissue. Usually, the process of a posterior vitreous detachment happens over the course of days to weeks, and flashes of light can be seen during this period of time. Occasionally, the flashes of light may persist for many months.

Sometimes, when the vitreous pulls away from the retina, it causes a small amount of bleeding into the eye, and this can cause numerous, string-like or dot-like floaters. If any bleeding is noted in the eye, the risk of more serious complications is much higher and will require very close follow-up.

Is a Posterior Vitreous Detachment serious?

Usually, a vitreous detachment does not cause any serious problems other than a few bothersome floaters in the vision. Within several months, these floaters almost always become less prominent and no longer bother the patient.However, in some cases, the vitreous is stuck firmly to the retina in small areas and is unable to separate from it. Instead, the vitreous pulls on the retina and can cause it to tear open, causing a hole or tear in the retina. A retinal hole or retinal tear can lead to a retinal detachment, which is a serious problem.

What should you do if you have floaters or flashes?

Without an examination by an eye doctor, there is no way for a patient to determine if floaters or flashes are serious. If you have new onset floaters or flashes, or a significant increase or change of these symptoms, you should be examined by an ophthalmologist as soon as possible. It is necessary to have a complete, dilated eye exam to check for retinal holes, retinal tears, or a retinal detachment.