Sometimes floaters and flashes signal a condition that can lead to vision loss where a new onset of floaters may herald retinal disease. The shrinking vitreous can tug on the retina and pull away from it. This event, called a posterior vitreous detachment, is common, and usually doesn’t threaten vision. In a few people, a posterior vitreous detachment causes the retina to tear. Fluid from inside the eye can then seep through the tear and separate the retina from the tissues that nourish it. This separation, called retinal detachment, can lead to permanent vision loss unless treated promptly.
Retinal tears and detachments are painless. Key warning signs include:
If you experience any of these warning signs, call your doctor right away. You will need to see an ophthalmologist for an eye exam as soon as possible. If a tear is detected early, prompt treatment can prevent the retina from detaching.
Retinal tears can be treated several ways. Your doctor may recommend laser photocoagulation which is usually done in the out-patient clinic. Pinpoints of laser light are used to fuse the retina to the back wall of the eye. This creates a barrier of scar tissue around the retinal tear that stops it from getting bigger. Extreme cold, a procedure called cryopexy, does much the same thing. If you have a retinal detachment, your doctor will explain how urgently you will require retinal surgery and the procedure required.
Eye floaters are small, dark, shadowy shapes—such as spots, thread-like strands, or cobwebs—that drift across your field of vision. They move as your eyes move and tend to dart away when you try to look at them directly. They are most noticeable when looking at a bright background, such as a clear blue sky or a white computer screen.
Floaters are typically caused by age-related changes in the vitreous, the gel-like substance that fills the back of the eye. As we age, the vitreous slowly shrinks and liquefies, forming microscopic clumps or strands that cast tiny shadows on the retina. While most floaters are a harmless part of aging, they can occasionally be triggered by more serious conditions such as posterior vitreous detachment, inflammation (uveitis), bleeding, retinal tears, or retinal detachment.
A sudden increase in floaters or the appearance of new symptoms can indicate a torn or detached retina, which is a medical emergency. Key warning signs include:
If you experience any of these warning signs, you should consult an ophthalmologist immediately.
Floaters become increasingly common with age. Individuals at higher risk include those who are highly short-sighted (myopic), have diabetes, have suffered prior eye trauma, or have previously undergone eye surgery.
If a comprehensive dilated eye exam rules out retinal tears or other serious complications, most benign floaters require no treatment, as they often settle down or become less noticeable over time. However, in rare cases where floaters are exceptionally dense and severely impair vision, a surgical procedure called a vitrectomy—which removes the vitreous gel and floating debris—may be considered after discussing the risks and benefits with your eye specialist.
