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Flashes and Floaters: What They Mean
Floaters are specks and threads drifting across your vision; flashes are brief sparkles or streaks of light. Both come from age-related changes in the vitreous gel inside the eye and are usually harmless — but a sudden shower of new floaters or flashes can signal a retinal tear. Dr. Michael E. Rom examines the retina at Insight Eye Center in Mentor and tells you plainly which it is.
What are flashes and floaters?
Floaters are specks, threads or cobwebs that drift across your vision, most visible against a bright wall or sky. They are shadows cast on the retina by small strands of the vitreous — the clear gel that fills the eye — which shrinks and clumps with age. Flashes are brief streaks or sparkles of light caused by the vitreous tugging on the retina. Both are common and usually harmless.
Flashes and floaters do not necessarily occur together; some people experience one and never the other. In most cases neither indicates a serious eye problem — they are a result of the eye aging. The most common single event behind them is a posterior vitreous detachment, when the vitreous gel separates from the retina, which happens to most people eventually, often in their fifties to seventies.
Occasionally, though, that tugging tears the retina. A retinal tear can lead to a retinal detachment, which is why a sudden change in flashes or floaters always warrants an examination.
When do flashes and floaters need urgent attention?
Call the office the same day for a sudden shower of new floaters, a sudden increase in flashes, a dark curtain or shadow moving across part of your vision, or a sudden drop in vision. These can be signs of a retinal tear or detachment, which is treatable — and the sooner it is treated, the better the chance of preserving your vision.
A few long-standing floaters that drift and settle, with no new flashes, are generally not urgent, but mention them at your next exam. A rapid increase in the number or severity of either symptom warrants a thorough dilated eye examination, and if a tear is found treatment often takes place at the same visit.
How are flashes and floaters diagnosed?
Flashes and floaters are subjective — only you can see them — so the examination looks at what is causing them. A dilated eye exam takes less than an hour and gives Dr. Rom a detailed view of the vitreous gel, the retina and the optic nerve, including the far edges of the retina where tears occur. Eye pressure is measured, and additional imaging is used when needed.
Every test is explained so you know why it is being done and what it shows. If no tear is found, the exam is often repeated a few weeks later, because a tear can appear during the weeks after a vitreous detachment begins.
- the vitreous gel and whether it has separated from the retina
- the entire retina, including the periphery, for tears or holes
- the macula and optic nerve
- eye pressure
How are flashes and floaters treated?
Usually they need no treatment. Floaters tend to settle out of the line of sight and become less noticeable as the brain learns to ignore them, and flashes from a vitreous detachment fade over weeks. Dr. Rom monitors them from one exam to the next. If a retinal tear is found, it is sealed promptly with a laser or freezing treatment to prevent a detachment.
If the retina has already detached, surgery — such as pneumatic retinopexy, a scleral buckle or vitrectomy — is needed to reattach it and prevent vision loss; see retinal detachment. Surgery to remove bothersome floaters alone (vitrectomy) exists but carries real risks, and is rarely recommended.
Common questions about flashes and floaters
Short answers to the questions patients ask most often. For anything specific to your eyes, ask Dr. Rom at your visit or call the office at (440) 286-1188.
Are floaters dangerous?
Usually not. Most are harmless shadows from the aging vitreous gel. A sudden shower of new floaters, especially with flashes or a shadow in your vision, can signal a retinal tear and should be examined the same day.
Will my floaters go away?
Often they settle below the line of sight and the brain learns to ignore them, so they become far less noticeable over weeks to months. They can reappear or new ones can form as the eye continues to age.
What do flashes of light mean?
Flashes come from the vitreous gel pulling on the retina. They are common during a posterior vitreous detachment and usually fade, but a sudden increase should be examined promptly to rule out a tear.
Can stress cause floaters?
No. Stress alone cannot cause floaters, which result from age-related changes in the vitreous gel. Being stressed can make you more aware of floaters you already have.
Is there surgery for floaters?
A vitrectomy can remove floaters, but it carries risks of cataract, retinal tear and infection, so it is reserved for the rare cases where floaters seriously interfere with vision. Dr. Rom can discuss whether that applies to you.
Does the exam hurt?
No. Dilating drops sting briefly and blur near vision for a few hours. Bring sunglasses, and a driver if you are unsure about driving while dilated.
New flashes or floaters? Get them checked.
Request an eye exam with Dr. Rom in Mentor — and if the change was sudden, call the office today rather than waiting for a callback.
