Floaters & Flashes

1. Home
2. Retinal Care
3. Floaters & Flashes

Eye Flashes and Floaters

Eye flashes and floaters are a normal part of aging, and typically, they don’t require treatment. It’s estimated that 7 out of every 10 people will have floaters at some point, and they are a leading reason for ophthalmological visits. Most often, floaters and flashes result from posterior vitreous detachment (PVD). A common condition, PVD targets the vitreous (also known as vitreous gel or humor), the gel-like jelly that makes up most of the eye’s volume and supports its structure.

Over time, the vitreous shrinks and pulls on the retina, creating floaters, tiny, solidified particles that slowly drift, casting their shadows on the retina. There’s no limit to floaters’ appearances, and while permanent, eventually, you may even not notice them. As for flashes, you may see them in your field of vision, appearing like streaks of light or bursts.

Floaters and flashes may also develop due to injury or as a result of another eye condition or disease. They may indicate more serious issues, and in the case of floaters, be mistaken for other conditions. As such, regular ophthalmologic examinations can help to determine the specific issue.

Demographics

Studies show that 75 percent of people over the age of 65 experience floaters. Both floaters and flashes usually develop in one eye at a time, so if a patient has one of these conditions in a single eye, it generally indicates PVD. Research suggests that PVD prevalence increases from 24 percent in adults 50-59 to 87 percent in those 80-89 years. But unless associated with an eye disease, it is unusual for children under 16 years of age to notice eye floaters.

However, having myopia, or nearsightedness, increases the risk of developing floaters, especially among younger people. The more myopic your eyes, the faster the vitreal aging process. In addition, myopia increases retinal tear and detachment risks, which are also associated with floater development.

Floaters and flashes may develop from injuries involving physical force on the retina, such as being hit in the eye. Less commonly, floaters may occur with such conditions as diabetes or uveitis, which involves inflammation in your eye. They may also develop if you have blood in your eye, as with diabetes-related retinopathy, or if you had past eye issues, like swelling within your eye, or cataract surgery.

As for flashes, they often occur first thing in the morning and fade throughout the day, or they can appear in a dark room. Flashes may be seen with various underlying conditions, such as retinitis pigmentosa, while younger people may experience them with ocular migraines. You may have a greater likelihood of flashes if you have family members who have had retinal detachments. Having undergone eye surgery, such as for cataracts or glaucoma, or taking glaucoma medication, may raise your risks, as well.

Clinical Appearance & Symptoms

Floaters can appear as spots, squiggly lines, or really anything, like clouds, but they’re permanent and will return, even with blinking. Regarding flashes, they often occur first thing in the morning and fade throughout the day, or you may see them in a dark room. In your field of vision, they may appear as streaks of light or bursts, jagged lightning, or the brief lights you see when you hit the back of your head. For flashes due to ocular migraines, these can look like zig-zag shapes, orbs of light or blind spots.

Generally, floaters and flashes are harmless and do not require treatment. However, should you notice either, it’s important to have your vision regularly monitored. If you notice any of the following symptoms, you need to contact your eye doctor immediately:

• Your flashes or floaters suddenly multiply.
• You start seeing gray or dark floaters or repeated flashes of light.
• You experience vision changes.
• You have a dark area or “curtain” in your field of vision.
• You see flashes after being hit in the eye or face.

These symptoms can indicate a retinal tear, a break or hole, or a retinal detachment, which is a break allowing fluid to leak behind the retina.

Diagnosis

Aside from indicating an underlying condition, floaters are confused with other conditions, such as diabetes or high blood pressure or diabetes. It is essential for adults to get an annual ophthalmological exam to determine the causes of the floaters and flashes, whether PVD, retinal tears or detachment, or anything else.

This painless exam will include dilation, in which your eye doctor applies special eye drops to dilate (widen) your eye’s dark center, allowing them to better the vitreous and the back of your eyes. To check for retinal tears, your ophthalmologist may also press on your eyelids. And should the exam not show the cause, additional testing, such as an ultrasound of the eye, may be necessary.

Treatment

Typically, floaters and flashes caused by vitreal aging will not require any treatment. But if they indicate another issue, it may be beneficial to treat that condition, especially if you are having problems seeing clearly (although this is rare). Truthfully, floater treatment is rarely recommended, as the treatment options may not be effective and have potential health risks. Common options include:

Vitrectomy

This minimally invasive surgical procedure involves the removal of the vitreous from the back of the eye. The retinal specialist makes microscopic incisions through the sclera, the eye’s white part. The vitreous is replaced with a solution, such as air, gas, silicone oil, or a balanced saline solution, to help your eye maintain its shape. However, this procedure may not remove all the floaters, and new ones may develop again. Additionally, its risks include infection, bleeding and retinal tears.

Vitreolysis

With this procedure, a special laser breaks up the floaters and makes them less noticeable. While some patients have improved vision, others find little or no improvement. And if the laser is aimed incorrectly, you may develop retinal damage.

As for flashes, treatment is not advised for those seen occasionally. But should they appear frequently, your ophthalmologist may decide to treat the underlying cause, such as a retinal tear or detachment. Among the potential treatment options are cryotherapy (freezing treatment) or laser repair. And for scarring due to diabetic retinopathy, you may require laser treatment to remove new blood vessels, eye surgery to remove scarring, or eye injections to prevent new blood vessel development.

Various surgical procedures may be used for retinal detachments, such as vitrectomies. Other procedures include:

Pneumatic Retinopexy

Retinal specialists may consider a pneumatic retinopexy, a simple, in-office procedure. Performed in conjunction with laser therapy or cryotherapy, a gas bubble is injected into the vitreous, pushing the torn retina closed. While you heal, new fluid is produced to fill the eye.

Scleral Buckle

With this procedure, a retinal specialist places a small piece of silicone sponge or semi-hard plastic on the outside of the eye, specifically, the sclera, securing the retina in place until a seal forms. During this procedure, your surgeon will remove any vitreal liquid that has seeped under the retina.