Flashes And Floaters

The ability to visualize "floaters," dark specks or lines when looking against a light-colored background, is extremely common.

The back cavity of the eye is filled with a jelly-like material called the vitreous. With age, the vitreous becomes more liquefied and can contract, separating from the back wall of the eye. When the vitreous separates from the back wall, a shadow is created on the retina and patients may experience the rapid onset of a single large or multiple "floaters." Patients often describe the floater as appearing as a fly or spider in their vision. The term used to refer to the condition of a separated vitreous is "posterior vitreous detachment" (PVD).

A posterior vitreous detachment is common, with over 80% of patients experiencing this condition eventually. With rare exceptions, a posterior vitreous detachment is not a dangerous condition and does not lead to further damage to the eye. Occasionally, however, when the vitreous separates from the back wall of the eye, it can pull and cause a tear in the retina. A tear in the retina may allow fluid to seep under the retina and cause a retinal detachment, a serious eye condition.

Occasionally, the separation of the vitreous will result in floaters as well as "flashes" of light which appear as small sparks or fireworks in the peripheral portion of the visual field. Flashes may occur as a result of adhesion of the vitreous to the retina which stimulates the retina, causing the perception of sparks oflight when no lights actually exist.
Diagnosis of posterior vitreous detachment is accomplished by an eye examination with dilation of the pupil. The doctor is able to visualize the vitreous separation directly. Dilation is required so that the peripheral retina can be carefully examined to rule out the presence of tears, holes or other areas of weakness in the retina which may predispose to a retinal detachment. Occasionally, a retinal tear may develop subsequent to the onset of symptoms of flashes and floaters. Therefore, an examination with dilation of the pupil of the peripheral portion of the retina is required again 2-6 weeks following the onset of symptoms.

A vitreous detachment is part of the natural aging process of the eye. There is no way to eliminate the floater through surgery, laser treatment and/or medication. With time, the floater will become less apparent as the mind adjusts to its presence nd "tunes out" recognition of the floater. The floater will always be observable and present, however, particularly if one eye is covered and the patient looks at a light-colored background.

A complete eye examination with dilation of the pupils is warranted when flashes and or floaters occur. A vitreous detachment is a benign condition; however, because of the risk of developing a retinal tear and/or retinal detachment, should be evaluated promptly upon noticing the symptoms of flashes or floaters.

Regular visits to your family optometrist will ensure a lifetime of healthy eyes and good vision.