- recommend evaluation by eye professional to rule out visual significant pathology
- Lee Katzman MD
Hope this has been helpful.
What are floaters?
You may sometimes see small specks or clouds moving in your field of vision. They are called floaters. You can often see them when looking at a plain background, like a blank wall or blue sky. Floaters are actually tiny clumps of gel or cells inside the vitreous, the clear jelly-like fluid that fills the inside of your eye.
Although the floaters appear to be in front of the eye, they are actually floating in the vitreous fluid inside the eye. While these objects look like they are in front of your eye, they are actually floating inside. What you see are the shadows they cast on the retina, the nerve layer at the back of the eye that senses light and allows you to see. Floaters can have different shapes: little dots, circles, lines, clouds or cobwebs.
What causes floaters?
When people reach middle age, the vitreous gel may start to thicken or shrink, forming clumps or strands inside the eye. The vitreous gel pulls away from the back wall of the eye, causing a posterior vitreous detachment. It is a common cause of floaters. Posterior vitreous detachment is more common for people who:
- are nearsighted;
- have undergone cataract operations;
- have had YAG laser surgery of the eye;
- have had inflammation inside the eye.
The appearance of floaters may be alarming, especially if they develop suddenly. You should see an ophthalmologist (Eye M.D.) right away if you suddenly develop new floaters, especially if you are over 45 years of age.
Are floaters ever serious?
The retina can tear if the shrinking vitreous gel pulls away from the wall of the eye. This sometimes causes a small amount of bleeding in the eye that may appear as new floaters. A torn retina is always a serious problem, since it can lead to a retinal detachment. You should see your ophthalmologist as soon as possible if:
- even one new floater appears suddenly;
- You see sudden flashes of light.
If you notice other symptoms, like the loss of side vision, you should see your ophthalmologist.
What can be done about floaters?
Because you need to know if your retina is torn, call your ophthalmologist if a new floater appears suddenly. Floaters can get in the way of clear vision, which may be quite annoying, especially if you are trying to read. You can try moving your eyes, looking up and then down to move the floaters out of the way. While some floaters may remain in your vision, many of them will fade over time and become less bothersome. Even if you have had some floaters for years, you should have an eye examination immediately if you notice new ones.
What causes flashing lights?
When the vitreous gel rubs or pulls on the retina, you may see what look like flashing lights or lightning streaks. You may have experienced this same sensation if you have ever been hit in the eye and seen "stars." When the vitreous rubs or pulls on the retina, it creates a sensation of flashing lights.
The flashes of light can appear off and on for several weeks or months. As we grow older, it is more common to experience flashes. If you notice the sudden appearance of light flashes, you should visit your ophthalmologist immediately to see if the retina has been torn.
Some people experience flashes of light that appear as jagged lines or "heat waves" in both eyes, often lasting 10-20 minutes. These types of flashes are usually caused by a spasm of blood vessels in the brain, which is called migraine. If a headache follows the flashes, it is called a migraine headache. However, jagged lines or "heat waves" can occur without a headache. In this case, the light flashes are called ophthalmic migraine, or migraine without headache.
How are your eyes examined?
When an ophthalmologist examines your eyes, your pupils will be dilated with eye drops. During this painless examination, your ophthalmologist will carefully observe your retina and vitreous. Because your eyes have been dilated, you may need to make arrangements for someone to drive you home afterwards. Floaters and flashes of light become more common as we grow older. While not all floaters and flashes are serious, you should always have a medical eye examination by an ophthalmologist to make sure there has been no damage to your retina.
Amjad Khokhar, M.D., F.A.A.O.
Houston Lasik & Eye
In general everyone should have a complete eye exam every year, in 10 years a lots of diseases might happen (like glaucoma). Please see an eye doctor!
What's important to note is that if there are lots of flashes of light in the vision, or if there is a darker curtain starting to affect the vision, then an eye examination is required usually within a day or two. This is to make sure there is no retinal tear or detachment.
If there are large floaters which are affecting the vision, there is now a safe and novel laser treatment which can break down and vaporise these floaters. I have had good results using this laser on many patients, but an assessment is needed to make sure you are suitable for such laser therapy.
However, when the gel separates, there is sudden traction on the inner visual eye tissue known as the "retina". Small retinal tears can occur, which, if left untreated, can progress to retinal detachment and visual loss.
So, any "new" onset of floaters, light flashes, "specks" or "blobs" in your vision do warrant a complete dilated eye and retina exam. The vast majority of "floaters" will be benign, but a small percentage of people will have issues that need to be medically addressed.
Edwin H. Ryan, MD