Floaters and Retinal Detachment

Eye floaters and spots are deposits of various sizes and shapes that seem to swim or "float" across vision. Everyone describes these visual symptoms differently; for some, the floaters resemble annoying gnats flying around their face, for others, it is more like tiny squiggles or cobwebs in their field of vision.

For the most part, floaters and flashes are harmless. However, they can also be a symptom of a serious eye condition like retinal detachment. If you suddenly start seeing flashes, floaters, or spots, make an appointment to see a vision specialist.

What are floaters, flashes, and spots

Floaters are clumps of undissolved gel particles that collect in the vitreous fluid of the eye. These groups of cells can take on shapes of different sizes. When we see floaters, we are not actually seeing the groups of cells; we are seeing the shadows that they cast on the retina.

Both spots and floaters come and go with eye movement. They become particularly pronounced when seen against a bright or clear background.

Symptoms of floaters, flashes, and spots

The most common sign of eye floaters include: 

  • Small objects floating in the field of vision 
  • Floating objects and/or spots accompanied by a flash of light 
  • Floating objects in vision accompanied by a headache 
  • Loss of peripheral vision

Eye floaters, flashes, and spots become more common with age. The appearance of flashes and floaters can be alarming, especially if they come into view suddenly. Make sure to see a doctor if the floaters continue, especially if you are over the age of 50.

Causes of floaters, flashes, and spots

The most common cause of eye floaters and spots is a posterior vitreous detachment, which occurs when the vitreous gel pulls away from the back of the eye. Flashes are caused by vitreous gel rubbing or pulling on the retina. They may also occur after a blow to the head (think "seeing stars").

In some cases, flashes are a side effect of a migraine, which is a spasm of blood vessels in the brain. Floaters and flashes may also be related to or caused by the following: 

  • Cataract surgery
  • Nearsightedness 
  • Diabetes 
  • CMV retinitis 
  • Laser eye surgery 
  • Eye infections

Treatment of floaters, flashes, and spots

In most cases, eye floaters and flashes are harmless and tend to fade over time, however, the sudden and persistent appearance of floaters and flashes can be indicative of a serious eye health concern like a retinal tear or detachment.

There is no specific treatment for eye floaters and flashes, but they can be reduced or eliminated by treating the underlying condition that is causing them to appear. There are several ways to fix a detached retina, including laser surgery. Medication can help to alleviate some of the symptoms associated with migraines.


Retinal Detachment

The retina is the layer of light-sensitive tissue that covers the back of the eye. When light enters the eye, it passes through the lens and focuses on the retina. The retina then transmits the images to the brain via the optic nerve. If the retina starts to separate from its supportive tissue, it can tear and eventually detach. Unless the retina is quickly reattached, severe vision loss will occur.

What is a retinal tear?

Retinal tears and detachment occur when the retina is separated from its supportive tissue. The back portion of the eye is filled with a clear gel called vitreous fluid, which is attached to the retina. As the vitreous fluid moves around and changes shape, it may start to pull on the retina, causing symptoms like flashing lights. If the pulling continues, it can eventually tear the retina. Once the retina is torn, fluid may start to seep between the retina and the back of the eye, causing the retina to lift off and detach. Because the retina cannot function when it is detached from the back of the eye, vision will become blurry and shadowy.

Symptoms of a retinal tear or detachment

The first warning signs of a torn or detached retina are: 

  • Blurry vision 
  • Shadowy vision 

Sudden onset of: 

  • Spots 
  • Flashes of light 
  • Floaters in vision

There is no pain associated with retinal tears and detachment, but the sudden decrease in vision can be a frightening experience nonetheless. Some of these symptoms on their own are not indicative of a serious eye problem; however, when they appear suddenly in a group it is best to see an eye doctor immediately.

Causes of a retinal tear or detachment

Damage to the retina seems to be linked with the aging process. The risk of retinal tears and detachment increases as we get older because vitreous fluid tends to shrink and change shape as we age. For most people, changes to vitreous fluid will not produce retinal damage. Some of the risk factors associated with retinal tears and detachment include: 

  • Family history of retinal detachment 
  • Previous eye injury 
  • Diabetes 
  • Eye surgeries (including LASIK and cataract surgery) 
  • High levels of nearsightedness

Treatment of a retinal tear or detachment

Retinal damage must be treated quickly to prevent permanent loss of vision. Small retinal tears can be treated with laser surgery or cryopexy, both of which are designed to seal off the borders of the tear. Larger retinal detachments usually need to be repaired surgically.

If you experience a sudden change in your vision, visit your eye doctor as soon as possible.

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Mid Atlantic Cornea Consultants
Sudeep Pramanik MD MBA FACS

Towson, Maryland Ophthalmologist, Dr. Sudeep Pramanik is dedicated to excellence in ophthalmology such as referrals for complex surgery, management of cornea and anterior eye disease, and laser refractive surgery.

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