Flashes and Floaters

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How flashes and floaters develop
The retina is the light sensitive membrane at the back of the eye which transmits images to the brain via the optic nerve. In front of the retina filling the eye is the vitreous – a gel-like substance which is made of protein filaments and water. The surfaces of the vitreous and retina are normally attached in youth, but during life parts of the vitreous gel tend to “aggregate” or clump together. The clumps and strands of vitreous cast a shadow on the retina and are therefore seen as newly appearing “floaters”; they then move around within the more mobile gel within the eye. This tends to occur later in adulthood, but can also appear at a much younger age in short sighted eyes.

Flashes and floaters are usually due to separation of the vitreous gel from the retina, which is a common event occurring is those aged 40 and over, and usually does not lead to any problem. In a few cases however, the vitreous gel separation (also, confusingly, called “posterior vitreous detachment” or “PVD”) can lead to a retinal tear and this can sometimes cause retinal detachment, or bleeding into the gel which can seriously threaten vision.

What to do
As described above- there are two situations where floaters are noticed. Firstly, a gradual worsening over months or years. These long standing floaters can be removed by vitrectomy, but any intraocular surgery does carry small risks, which include development of cataract, retinal problems and also a very small risk of visual loss. Surgery is not usually indicated, but may be justified if the symptoms are sufficiently troublesome.

In the second type of onset, a new and usually sudden appearance of floaters, with or without flashes can occur which usually become obvious over a day or two due to posterior vitreous detachment (PVD). In this situation, an urgent appointment should be made to have an examination by an ophthalmologist to exclude retinal tears or retinal detachment. If a retinal tear without retinal detachment is found on examination this is usually treated by laser. A permanent and enlarging shadow in the peripheral vision may indicate that retinal detachment is occurring and urgent surgery is required to prevent permanent loss of vision.

After a new and sudden onset of floaters (with or without flashes) due to gel separation, the risk of developing a retinal detachment reduces quickly over four to eight weeks. Beyond this time the future risk of developing a new retinal problem becomes very small (similar or less than in the general population with an overall incidence of 1 in 10,000 per year). There is therefore no similar urgency to see those whose new symptoms of sudden onset started more than two months earlier.

How do I make an appointment?

Your Consultant’s secretary will be able to assist you with availability and costs for your chosen consultant. You can find their contact details by clicking on the link below or visiting the Consultants section.

For further information or to book a consultation contact:

Assad Jalil

Felipe Eduardo Dhawahir-Scala