Floaters Flashes
Warning signs not to be ignored
Floaters are little “cobwebs” or mosquito like specks that you may see floating about in your field of vision. Best visible while watching a light coloured background, these floaters move along with the eye but not precisely and tend to drift slowly as if floating.
- Why worry about floaters?
Floaters are for most people just a part of the natural aging process and an annoyance. They can be distracting, but usually “settle” down becoming less bothersome. Most people also learn to ignore them and do not notice them till they become numerous or prominent. Myopes or shortsighted people tend to get them at an earlier age.
In some cases, the presence of floaters may have more ominous significance suggesting presence of blood, inflammation or pigments within the eye. It is for these reasons that the presence of floaters - though mostly innocuous - should still never be ignored.
More Questions and Answers
80 percent of the eye especially the back part of the eye is filled with “Vitreous”, a gel-like substance. Floaters are seen when there is an opacity, bubble, strand in this gel. It is the shadows of these that are seen as floaters.
Posterior Vitreous Detachment with floaters
This most commonly occurs with aging when this gel slowly shrinks, a process called PVD (Posterior Vitreous Detachment).
A shrinking vitreous becomes somewhat stringy and the strands are seen as floaters.
However sometimes there are other, more serious causes of floaters, including infection, inflammation (uveitis), hemorrhaging (bleeding inside the eye), retinal tears / holes and injury to the eye.
Flashes of light are also a common symptom of PVD. As the vitreous gel separates from the retina it can pull on it which stimulates this light sensitive membrane. This stimulation is perceived by the brain as a flash of light.
‘For most people, floaters are just a sign of ageing and are a minor annoyance. No treatment is recommended for these patients. On rare occasions, floaters can be dense and numerous significantly affecting the vision. In these cases ‘vitrectomy’, a surgical procedure that removes the vitreous gel may be done.
Since this surgery carries risks to sight because of possible complications, most eye surgeons are reluctant to recommend this surgery unless the floaters seriously interfere with vision.
Though PVD and the resultant floaters and flashes are mostly harmless, in some eyes the pull of the shrinking vitreous gel on the retina can cause a tear to develop.
Retinal tear
A torn retina is a serious problem, since it can lead to a retinal detachment and loss of vision. It is a serious condition and should always be considered an emergency. This is the main reason why a new floater or flashes should not be ignored and a proper retinal examination should be done by your eye surgeon as soon as possible.
Each patient with recent onset floaters or flashes should be thoroughly examined including the evaluation of the retina. Special emphasis is required for examination of the peripheral areas of the retina because that's where most of the holes or tears in the retina happen. To be able to see those areas, the pupils are first dilated with eye drops. This will cause temporary blurring of vision for a few hours.
Retinal evaluation with Indirect Ophthalmoscopy
A proper exam includes indirect ophthalmoscopy where the eye surgeon wears a light source on his or her head and examines the retina with a hand–held lens. Fortunately the great majority of PVD’s do not cause a retinal tear but in case a tear is detected, it should be treated with laser or cryotherapy to prevent development of retinal detachment.
