Flashes and Floaters at
The Eye Care & Surgery Center in New Jersey

The space between the crystalline lens and the retina is filled with a clear, gel like substance called the vitreous. When we are young, the vitreous has an egg-white consistency and is firmly attached to the retina. As we age, the vitreous starts to liquefy and shrink. When these changes occur, we may sometimes see small specks, strands or clouds moving in our field of vision-these are called floaters. They are actually tiny clumps of gel or cells inside the vitreous. What is actually being seen are the shadows they cast on the retina as light shines on them. They are usually most apparent when seen against a bright background. Less commonly, floaters may be a sign of inflammation, infection, or a hemorrhage in the eye.

Eventually, the gel may separate from the retina. This is called a posterior vitreous detachment (PVD), a very common, and usually harmless condition. As the gel pulls on the retina, brief sparks of light may be seen in the peripheral portion of the field of vision-these are called flashes. They are most noticeable in the dark, usually last for a second or so, and may occur repeatedly, especially with sudden eye movements. This is different from the flashes of light that are a sign of an ocular migraine; those flashes persist for 5-20 minutes, expand outwards in the filed of vision, and may be followed by a headache. A PVD is more common in people who are nearsighted, or have undergone cataract surgery or a YAG laser surgery of the eye.

Occasionally, when the vitreous separates from the retina, it can pull and casue a tear in the retina or in a blood vessel in the retina. When a tear occurs, fluid from the gel may then seep under the retina and cause a retinal detachment-a sight-threatening condition.

Treatment of Flashes and Floaters

Because of the risk of a retinal tear or detachment, or another serious condition, any person who has the sudden onset of floaters or flashes of light should see their eye doctor as soon as possible. If accompanied by any decrease in vision (including peripheral vision), or a veil that obstructs part of or all of the vision, the patient should be seen urgently. In somebody with a long-standing history of floaters any increase in the number of floaters could indicate a problem and requires prompt re-evaluation.

If the flashes and floaters are simply a sign of a PVD, and no other problem is present, then no treatment is necessary. The flashes are likely to go away on their own within a few days or weeks. Floaters tend to last longer; they may take weeks or months to diminish, and may not completely go away. With time, floaters will become less apparent as the mind adjusts to their presence.