EYE DISORDERS
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Floaters and Flashes
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Small specks or clouds moving in your field of vision as you look at a blank wall or a clear blue sky are known as floaters. Most people have some floaters normally but do not notice them until they become numerous or more prominent. Floaters are actually tiny clumps of cells or material inside the vitreous, the clear, gel-like fluid that fills the inside of your eye.
In most cases, floaters are part of the natural aging process. Floaters look like cobwebs, squiggly lines, or floating bugs. They appear to be in front of the eye but are actually floating inside. As we get older, the vitreous tends to shrink slightly and detach from the retina, forming clumps within the eye. This process is called a posterior vitreous detachment (PVD). What you see are the shadows these clumps cast on the retina, the light-sensitive nerve layer lining the back of the eye.
The vitreous is quite sticky, similar to uncooked egg white. When it shrinks, it can pull on the retina, which lines the inner wall of the eye. This pulling can cause flashes of light or lightning streaks in your vision. These are called flashes. These flashes can appear off and on for several weeks to months while the vitreous undergoes the process of shrinking and pulling away for the retina.
Causes of a Posterior Vitreous Detachment
A posterior vitreous detachment occurs much more frequently as we get older, but there are a few risk factors that can stimulate this process to occur leading to the development of flashes and floaters.
  • Myopia or near-sightedness
  • Cataract surgery
  • YAG laser surgery, which is a procedure commonly performed at some point after cataract surgery if the vision blurs again
  • Previous inflammation inside the eye
  • Previous injury to the eye
Is a Posterior Vitreous Detachment Dangerous?
The posterior vitreous detachment itself is not dangerous, however, it can lead to a sight-threatening problem. As the vitreous separates from the retina and causes traction or pulling on the retinal tissue, a tear may form in the retina. This is called a retinal tear. If that occurs, fluid from inside the eye can migrate through the tear and under the retina. Like water under wallpaper, the retina can then detach and peel away from its underlying attachment. This is called a retinal detachment and is an ocular emergency requiring immediate surgery to save the vision.
There are several signs to watch for that, if noticed, you should call your eye doctor immediately.
  • A sudden increase in size and number of floaters
  • A sudden appearance of flashes
  • Having a shadow or curtain appear in the periphery (side) of your field of vision
  • Seeing a gray curtain moving across your field of vision
  • Having a sudden decrease in your vision
Diagnosis
If you notice any of these symptoms including new floaters, you should always contact your ophthalmologist for a dilated eye examination. Thorough evaluation of your retina is necessary to make sure there are not tears in the retina that can be treated to prevent a retinal detachment.
Treatment
There is typically not need to treat floaters as they are usually a mild nuisance. If the floaters significantly disrupt vision, the vitreous and floaters can be surgically removed.
If you are found to have a tear in the retina, it can be treated with an in office laser procedure to make sure the tear does not progress to a detachment.
If you develop a retinal detachment, you will likely need a surgical procedure to repair the detachment as soon as possible to prevent any further vision loss.
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