What are Floaters and Flashes of Light in Your Vision?
Floaters and flashes of light in your vision are in most cases a normal age-related process which are a simple annoyance. However, in some cases they can be signs of serious retinal problems which need to be addressed immediately. In ALL cases of new floaters and flashes, and eye examination with dilation of pupils and inspection of the entire retina is required preferably the day the symptoms begin.
Signs and Symptoms of Floaters and Flashes of Light in Your Vision
I have heard multiple descriptions for floater such as cobwebs, amoebas, lines, cracks, etc. Flashes are usually described as lightning streaks or multicolored lights often associated with a quick eye movement or trauma to the eye. They can often be confused with ocular migraine symptoms which vary widely in their presentation.
What Causes Floaters and Flashes of Light in Your Vision?
To fully understand flashes and floaters, patients need to understand the anatomy of two tissues – the vitreous and the retina. The vitreous is a Jell-O like substance composing the majority of the inside body of the eye. The retina lines the inside of the eye like wallpaper and acts as the “film in the camera” for your vision. The vitreous is attached to the retina at different points. When we are younger, the vitreous is solid and firm like cold Jell-O. As we age, the vitreous shrinks like dried up Jell-O and can put tension or traction on the retina. When this pulling on the retina happens, patients may often see a flash of light in their vision as the retina will respond to this stimulus similar to getting poked in the eye, except the poking is from the inside.
In most cases, the vitreous will shrink and pull away from the retinal attachment points resulting in an end to the flashes. This is called a posterior vitreous detachment and is a normal aging process. Any fold or wrinkle on the surface of the vitreous face will then cast a shadow on the retina which patients perceive as a floater in their vision. In more serious cases, the vitreous will pull the retina off just like wallpaper coming off of the wall resulting in a retinal tear or detachment. These are considered to be ocular emergencies and need to be addressed immediately. Symptoms of a retinal detachment are excessive flashes in the vision followed by a shower of floaters blurring the vision and in many cases a blurry curtain coming obstructing the vision completely.
How are Floaters and Flashes of Light in Your Vision Diagnosed?
Proper diagnosis is accomplished with a dilated pupil retinal examination. If a retinal problem exists, patients are referred to a retinal specialist.
How are Floaters and Flashes of Light in Your Vision Treated?
The flashes of light will eventually resolve but there is no cure for floaters. They cannot be lasered or physically removed without a procedure called a victrectomy which involves complete drainage of the vitreous. This procedure is very invasive and has a high complication rate. For most patients (myself included) floaters are an annoyance which your brain will in time unconsciously tone out like any other constant stimulus. I recommend not concentrating on the floaters and natural suppression of the floaters will occur much faster. However there will be circumstances when the floaters can’t be ignored. Example, while walking on a frozen Minnesota snowy Lake recently, I was amazed at how many floaters I had in my vision while looking at the snow. Once I got back into the house, all the floaters appeared to have disappeared as they were hidden in the background “visual noise.”
What Steps Should I Take If I'm Having Floaters and Flashes of Light In My Vision?
I recommend making an appointment as quickly as possible to determine if the flashes and floaters involve a serious retinal problem. I have 22 of years of experience treating patients with this problem and other related conditions. The sooner I can check your eyes, the better. All doctors agree that waiting and hoping it will get better is not a prescription for success.