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Flashes and Floaters
What are Flashes?
You may see an arc of light down the side of your vision. These may appear like momentary light bursts or lightning strikes in your vision and may often occur in combination with floaters.
Flashes are usually caused by the tugging of the vitreous on the retina, which is the home of our light sensing tissue. Flashing episodes may last seconds or several minutes and can sometimes recur for a period of weeks or months.
Flashes example Gif courtesy of Wikimedia Commons/Ribaris
What are Floaters?
As you grow older, you may become aware of the presence of "floaters". These are small, dark spots or specks that seem to drift across your vision. They may appear as dots, circles, lines, or cobweb-like shapes.
Floaters are found in the vitreous body, a jelly-like substance that fills the inside of the eye. As the vitreous changes with age, tiny bits of debris or clumps of gel appear in the vitreous. These particles can cast shadows on the retina causing the appearance of floaters.
Some floaters can interfere severely with vision whilst others may be hardly noticeable, and mostly visible on clear or white backgrounds.
Complications
Sometimes, complications arise when the vitreous is more firmly attached and pulls away a piece of the retina. This is known as a retinal tear and you may notice a shower of new small floaters in your vision.
Fluid can sometimes further push the retina off the inside wall of the eye following a tear, a complication known as retinal detachment. This can cause sudden loss of vision, or the appearance of a curtain in your vision.
Retinal detachment is an eye emergency and requires urgent surgical reattachment.
It is important to get an eye exam if you notice flashes and new floaters in your vision. Posterior vitreous detachment is a normal part of ageing and is usually uncomplicated, however a dilated eye exam will ensure there are no tears, detachments or other damage to the retina caused by tugging or traction.
References
1) Bond-Taylor, M., Jakobsson, G., & Zetterberg, M. (2017). Posterior vitreous detachment -Prevalence of and risk factors for retinal tears. Clinical Ophthalmology, 11, 1689–1695. https://doi.org/10.2147/OPTH.S143898
Floaters Image Courtesy of Wikimedia Commons
Posterior Vitreous Detachment
Flashes and floaters can be signs of posterior vitreous detachment, a common and benign condition associated with ageing and, by the age of 89, has occurred in 80% of patients.1
This occurs because over time, parts of the vitreous become more liquid than gel-like and this liquid can form into pockets.
These changes can lead to the vitreous pulling away from the surface of the retina as it shrinks. As the vitreous pulls away from the retina, you may notice flashes and an increased number of floaters in your vision.
