What Are Floaters And Flashes?

Small shapes or patterns obstructing the field of vision are called floaters. These may be little circles, specks, dots, lines, or cobwebs circulating across the visual field.

The eyeball is filled with a gel-like material called vitreous gel. Over time, the vitreous liquefies and contracts. Pockets of fluid in the vitreous can give you the sensation of floaters. As floaters form, there can be traction on the retina, which is perceived as flashes of light.

In many cases, floaters do not need any treatment as they are part of the normal aging process. People feel disturbed initially but typically notice the floaters less and less with time. Floaters do not go away; they are a permanent part of your eyes once formed, unless removed surgically.

With the formation of a new floater, there is a small risk of a retinal tear due to traction on the retina. Typically a retinal tear will cause persistent flashes and floaters. For this reason, immediate attention must be sought at the onset of symptoms.

What Do Floaters And Flashes Look Like?

The shapes of floaters are different in different individuals e.g. clouds, spiders, medusas, etc. Floaters might look like any the following:

• Strands of threads
• Spider webs
• Irregular lines
• Small shadows
• Spots of varying sizes

As mentioned, you may also see flashes of light. These appear as any of the following:

• A bright streak or spot of light
• A camera flash
• A strike of lightning

Causes Of Floaters And Flashes

Floaters and flashes may result from multiple reasons but aging is a main reason for floaters. Other causes of floaters and flashes include:

• Idiopathic
• Diabetic retinopathy
• Hypertensive retinopathy
• Retinal detachment
• Inflammation
• Migraine

Risk Factors

In most people floaters tend to occur between 50 and 70 years of age. But the presence of any of the following risk factors may result in early presentation. Some retinal conditions e.g. retinal tears run in families and may increase the odds of retinal detachment. Risk factors include:

• Age above 50 years
• Family history of retinal detachment
• Diabetes mellitus (blood may escape from arteries and accumulates in the vitreous)
• Nearsightedness (difficulty in seeing far objects)
• Hypertension
• Cataract surgery

Examination and Lab Investigations

Floaters are generally unproblematic, however they always require the following:

• Complete history
• Examination of the eye
• Fundoscopy

Treatment Of Floaters And Flashes

Floaters are typically not an emergency but do require prompt examination to ensure no retinal tears or detachement are present. Flashes more frequently indicate retinal pathology.

Eye floaters remain bothersome for a while and then typically become less noticeable. If the floaters remain very bothersome, retinal surgery (vitrectomy) can be performed.  Laser therapy may be used to disperse the floaters but it also has its side effects.

If you have new flashes or floaters, call your ophthalmologist for an appointment immediately.

References

1. What Are Floaters and Flashes? (2021, September 15). American Academy of Ophthalmology. Retrieved November 7, 2021, from https://www.aao.org/eye-health/diseases/what-are-floaters-flashes

2. Eye floaters - Symptoms and causes. (2020, August 28). Mayo Clinic. Retrieved November 7, 2021, from https://www.mayoclinic.org/diseases-conditions/eye-floaters/symptoms-causes/syc-20372346

3. Eye Floaters & Flashes: What Do They Look Like, Causes & Treatment. (n.d.). Cleveland Clinic. Retrieved November 7, 2021, from https://my.clevelandclinic.org/health/articles/14209-floaters--flashers#:%7E:text=Eye%20floaters%20and%20flashes%20are,typically%20don’t%20require%20treatment.

4. NHS website. (2020, July 28). Floaters and flashes in the eyes. Nhs.Uk. Retrieved November 7, 2021, from https://www.nhs.uk/conditions/floaters-and-flashes-in-the-eyes

Author

Eye Surgeons Associates Drs. Meiraj A. Siddiqui, Zuhair H. Peracha, Manal H. Peracha-Riyaz, Eric Zuckerman and Leila Siblani are dedicated to excellence in eye care and service. We utilize the latest treatment methods and procedures, including routine eye care, cataract surgery, glaucoma treatment, retinal disease management, diabetic eye treatment, and eyelid surgery.