Lightning streaks in vision

Contents

The Facts About Eye Floaters and Flashes

  • Posterior vitreous detachment (PVD). The vitreous gel actually pulling away from the retina is a condition known PVD. Debris from the site of the detachment drifts into the vitreous gel and causes floaters that resemble cobwebs, mist, or a veil that obscures part of your field of vision. In most cases, the detachment occurs cleanly and the eye floaters become less noticeable after a few months.

Eye flashes result from thickened vitreous gel pulling and rubbing on the retina, causing visual effects that look like lightning streaks or light flickers. These flashes may appear off and on for a few weeks or months, but normally fade over time. If you see flashes accompanied by floaters, you most likely are experiencing PVD.

Flashes also can be caused by an oncoming migraine headache. In these instances, the eye flashes often will look like jagged lines or heat shimmers that last between 10 and 20 minutes.

Time Is Your Best Treatment

Eye floaters and flashes caused by the vitreous gel are most visible when you are looking at a plain, light-colored background. Close one of your eyes and look at an empty wall, a blue sky, or a white background on a computer screen. If you see a squiggle, dot, or other shape flitting around, then you have found an eye floater.

Eye floaters and flashes normally require no treatment. Flashes usually fade away, and over time most people don’t notice floaters as often because the brain learns to filter out the visual interference. An annoying floater in the center of your vision sometimes can be relieved by rolling your eyes around, which swirls the vitreous gel in the eyeball and gets the floater to move away.

A surgical procedure called vitrectomy removes the vitreous gel from the eye and replaces it with saline solution, but it is a major procedure that normally is not considered worth the risk.

When Retinal Detachment Is the Problem

The tugging from the vitreous gel can sometimes cause a more serious medical condition in which the retina tears and detaches from the eye. If this occurs, you could partially or completely lose your vision in that eye. Symptoms of retinal detachment include:

  • A sudden increase in the number of eye floaters and flashes you are experiencing, or the sudden appearance of them for the first time.
  • The loss of your peripheral vision, usually appearing like a curtain or shadow that moves toward the center of your vision over time.
  • Vision that has become blurred or distorted.

Surgery is the only treatment for retinal detachment, and time is of the essence in preserving your vision. If you are experiencing any of these symptoms, you should see your eye doctor immediately.

Photopsia: Is It Dangerous? (How to Treat It)

Table of Contents

  • Photopsia
  • Causes and Risks
  • Common Symptoms
  • Treating

A photopsia is a visual distortion caused by something inside the eye or brain. The distortions could be floaters, flashes of light, or other sudden small changes in the visual field. (Learn More)

Causes of photopsia range from direct trauma to the eye itself to damage to the optic nerve or the brain to migraines. (Learn More)

While many people have floaters or flashes of light in their vision on occasion, if these suddenly appear, do not stop, or change dramatically, you should get help from a doctor immediately. (Learn More)

Chronic illnesses can change symptoms over time. One sign of this may be changes in photopsias. A head injury or eyeball injury could also cause photopsias. (Learn More)

What Is Photopsia?

A photopsia is a flash of light or something that appears to float in the eye. They look luminous. They can occur in either eye individually or both eyes at the same time. Photopsias may be temporary, occurring very quickly, or they could be permanent features in your vision.

The term photopsia has a broad definition that covers several experiences in the eye, which have several potential causes. These flashes or streaks of light are subjective, not caused by surrounding lights or something that damages the eye directly. They are pathological, indicating a more significant problem with the organ of the eye or with the brain.

If you experience a photopsia and it causes disruption in your vision for a short time, or you develop a recurring, regular, or constant photopsia when you did not have one before, get in touch with your eye doctor for a diagnosis.

What Causes Photopsia, and What Are the Risks?

While a photopsia may be a disturbing event on its own, especially if the condition comes and goes without regularity, this is not a medical problem by itself. Photopsias are typically symptoms of another condition.

Some of the most common conditions leading to photopsias include:

  • Age-related macular degeneration. Often shortened to AMD, this is a common condition in the eyes of people who are 50 or older. The macular is the part of the eye that helps you see clearly in front of you. This is called central vision. AMD is the slow degeneration of the macula, leading to a loss of clear central vision. Some of the early warning signs of AMD include developing photopsias.
  • Ocular migraine. Most people think of migraines as recurring headaches, but there are other symptoms alongside migraines that may not be just pain, physical sensitivity, soreness, or sensitivity to light or sound. Visual changes called auras (a type of photopsia) are associated with migraines affecting the eyes. Visual snow or static can also be symptoms of ocular migraines.
  • Optic neuritis. This is inflammation that damages the optic nerve, leading to changes in how visual images are processed in the brain. The most common cause of optic nerve degeneration is multiple sclerosis. Flickering lights or flashes in the field of vision, along with pain, loss of color perception, and eventual vision loss are also part of damage to the optic nerve during optic neuritis.
  • Peripheral vitreous detachment. The vitreous humor in the eyes is the gel that spans the entire inside of the eye, keeping the shape and aiding support of structures within the organ. If the vitreous humor detaches from part of the eye, this can cause serious structural problems. When the gel detaches from the retina, at the back of the eye, it may lead to slow loss of peripheral vision. This is most likely to occur due to age — older adults are more likely to experience PVD — but it can also occur spontaneously, due to an accident, or because of an illness. When it occurs too fast, this may cause flashes of light and floaters to appear in the visual field; however, these photopsias typically go away in a few months.
  • Retinal detachment. The back of the eye contains the retina, which has a series of photosensitive receptor cells that collect information from light and transmit this data to the brain to be converted into images. If the retina detaches due to illness or injury, it can cause changes to the vision, including vision loss. Retinal detachment is a serious medical problem that needs immediate treatment. Suddenly experiencing floaters, light flashes, or other photopsias when you did not before could be a sign of this problem. It may require laser treatments, freezing, or surgery to keep your retina in place.
  • Vertebrobasilar insufficiency. Poor blood flow to the back of the brain can cause a lot of brain damage, and one of the symptoms may be changes to the visual field, including photopsias. The back of the brain is involved in processing visual images and coordinating balance and movement. When this area is damaged, you may also experience weakness, trouble walking, and difficulty making movements happen together.

Common Photopsia Symptoms

Small specks in the eye, which often move as you move your eyes or head, are called floaters. It may look like something is on your eye or very close to your field of vision, but it is actually something inside your eye, optic nerve, or brain that is causing this change to your visual field.

You can see floaters most easily during the day, with the sky in the background, or on a plain background like a white-painted wall. Floaters are usually clumps of cells that move around in the vitreous humor of the eye.

When floaters first appear, they may be accompanied by flashes of light. These flashes may also occur on their own without floaters.

Light flashes in the eye are more noticeable in the dark, during the evening in dim light, or outside at night. Serious light flashes may be visible during the day.

When new floaters appear, especially if they are accompanied by flashes, it should be reported to your optometrist or ophthalmologist immediately.

Generally, a photopsia is an anomaly in the visual field. The following are signs of this condition:

  • Flickering lights
  • Shimmering lights or flashes
  • Floating shapes in the eyes
  • Moving dots, especially that move with the eyes
  • Snow or white fuzz in the visual field
  • Zigzag lights or flashes
  • Strobing lights
  • Twinkling or glittery lights
  • Static

These can begin or recur during the day, at night, or both. They may be triggered when you move your head, move your eyes, experience low blood sugar, or for no reason that you can tell. Floaters or lights in the visual field associated with photopsias do not need to have a color, but some reported colors include:

  • White
  • High contrast
  • Yellow
  • Silver
  • A combination of all

Photopsias may be serious, especially if they begin suddenly and are accompanied by the following symptoms:

  • Dizziness or vertigo
  • Physical weakness
  • Headaches
  • Nausea or vomiting
  • Numbness
  • Syncope
  • Double vision
  • Low blood pressure or low fluid pressure in the eyes

These physical symptoms could indicate head trauma, which is a life-threatening medical condition. They could also be associated with chronic conditions that can cause photopsia.

Regardless, get emergency treatment to diagnose the underlying problem.

Treating Photopsia

Because photopsia is a symptom, treatment depends on the underlying condition. It is a symptom of a preexisting condition, and this condition is likely to be chronic. When photopsia occurs, it may mean a change in or worsening of the condition.

If there is damage to some structures in the eye, the optic nerve, or the brain, the photopsia itself may not be reversible. If it gets worse, it could indicate that the underlying condition is also getting worse, suggesting that you should return to your doctor, including your optometrist or ophthalmologist, for a change in your treatment plan.

What Is Photopsia and What Causes It? (November 9, 2018). Healthline.

Photopsia. Merriam-Webster Medical Dictionary Online.

What Causes Light Flashes in the Eye? LIVESTRONG.

Floaters and Flashes. (May 2, 2005). HealthCentral.

Photopsias: A Key to Diagnosis. (October 2015). Ophthalmology Journal, American Academy of Ophthalmology (AAO).

Flashes and Floaters

Most people in their lifetime will experience floaters. Some start in their teen and most people in the 50’s. 65% of people 65 and older have floaters. They are very bothersome and cause most people to seek an eye exam. Most of the time (about 90%), they are harmless and are a result of the natural aging process in the eye. Sometimes they are a warning sign of bleeding in the eye (most common among Diabetics) or of a retinal tear or detachment. If you are experiencing new floater activity or a change in your floaters you should have a complete eye exam.

Why do they occur?

The most common reason is due to changes in the vitreous which is the clear jelly-like hyaluronic acid which fills the back of the eye. As we age it turns from a solid like jello to a runny jelly and at the same time the attachment to the retina loosens and the back surface of the vitreous pulls off of the retina into the eye. When the vitreous separates from the retina it is called vitreous detachment or separation. Condensed vitreous, debris i.e. blood, Calcium soaps (called “Asteroid Hyalosis”), inflammatory cells, or rarer things can “float” around in the vitreous hence the name floaters. They can result in many descriptions such as, dots, spots, a circle, half moon, insect-like shapes, lines, films or cobwebs. Most of the time they are more bothersome in the first few months and then either disappear, sink down or up out of view or our brains “tune them out”. Most people become accustomed to their floaters and are not bothered by them. In extreme cases they may be always in the line of vision for driving or reading and may need to be surgically removed although this is only in very extreme cases.

What about the 10%?

In some cases when the vitreous pulls away from the retina, it can actually tear the retina. This may result in symptoms of a large, bright flash of light or a stream of floaters that is usually described as red or black ribbons swirling around or unusual or many new floaters. A torn retina is a medical emergency and needs to be treated as soon as possible before the retina detaches. If a retinal detachment occurs one will usually see part of the vision obscured by a curtain-like shape coming from the periphery toward the center. This is a medical emergency and one should seek an ophthalmologist emergently.

What about flashes of light?

Small arc-like momentary flashes of light in the peripheral vision are commonly experienced during vitreous separation. The vitreous pulls on the retina which makes one think they are seeing a light but it is caused by movement of the retina. Sometime the flashes persist for a few months until the vitreous is finished separating. Rarely flashes are associated with a tear in the retina. They should always be evaluated by an eye exam to be sure.

Another cause of flashes is acephalgic (without pain) migraine; other common names are ocular migraine, visual migraine, or optical migraine. This is the visual aura of a classic migraine which begins first with visual phenomena followed by headache. Acephalgic migraine is more common as one ages, although it can occur in youth but usually the migraines transition from severe vascular headaches in later life to visual phenomena without the headaches. Some people have no history of painful headaches but develop the visual phenomena.

These can be varied to include any or all of the following symptoms: holes or blurry places in the vision, heat waves or moving lines, jagged lightening bolt shaped lights that shimmer or move, kaleidoscope like white or colored lights that move. Sometime they are in the form of a crescent and move from the center to one side. The phenomena lasts for minutes to hours (15-20min is most common). They are there with the eyes closed. The cause is vascular spasm in the occipital lobe or visual part of the brain. They are not associated with any permanent problem and one should rest and wait for it to pass. If severe headaches are involved one should seek the care of a neurologist.

Rarely visual phenomena can be symptoms related to the optic nerve or brain and may require ophthalmic or neurological diagnosis and treatment.

Summit Medical Group Web Site

What is a scotoma?

A scotoma is a blind spot in your vision. The spot may be in the center, or it may be around the edges of your vision. Rather than a dark spot in your vision, you may have a spot of flickering light near the center of your vision that may drift around the eye, or create arcs of light. A temporary blind spot may the first sign of a migraine headache.

What is the cause?

A scotoma is caused by a problem in your brain, a problem in your eye, or a problem in your optic nerve. The optic nerve is located behind your eye and sends pictures to the brain. The kinds of problems that can cause a scotoma include:

  • A stroke
  • A tumor
  • An injury
  • Glaucoma or a problem with your retina
  • Multiple sclerosis or other diseases that can affect the optic nerve
  • Chemicals such as methyl alcohol or quinine

What are the symptoms?

Symptoms may include:

  • A spot in your vision that can be dark, very light, blurred, or flickering
  • Trouble seeing certain colors
  • The need for bright light in order to see clearly

How is it diagnosed?

Your eye care provider will ask about your symptoms and medical history and do exams and tests such as:

  • An exam using a microscope with a light attached, called a slit lamp, to look closely at the front and back of your eye
  • An exam using drops to enlarge, or dilate, your pupils and a light to look into the back of your eyes
  • A visual field test, which uses spots of light to measure your central vision and how well you see things on all sides

How is it treated?

A scotoma that happens before a migraine headache is temporary and usually goes away within an hour.

If the scotoma is on the outer edges of your vision, it usually does not cause severe vision problems. If you have a scotoma in your central vision, it cannot be corrected or treated with glasses, contact lenses, or surgery. Your provider will recommend that you use aids to support your decreased vision. Tools that can be used to help include:

  • Large-number phone keypads and watch faces
  • Filters to reduce glare on computer screens
  • “Talking” clocks or scales
  • Audio books, magazines, or newspapers or machines that “read” printed material aloud in a computer voice
  • Using large type printed books or enlarging the type size in an eReader (electronic devices such as iPads, Nooks, or Kindle)
  • Personal computer hardware such as lighted keyboards, large type, and software that magnifies screens and converts text to speech for both computers and mobile phones
  • Closed CCTV systems that use video cameras and large TV screens to enlarge reading material, medicine bottles, or pictures
  • Magnifying eyeglasses, hand-held magnifiers, or stand magnifiers to enlarge your reading material or other objects

Reviewed for medical accuracy by faculty at the Wilmer Eye Institute at Johns Hopkins. Web site: http://www.hopkinsmedicine.org/wilmer/

What does it mean when you see stars?

The following are the most common causes of disruptions in the brain or retina that could lead to seeing stars:

1. A blow to the head

Share on PinterestA blow to the head may lead to seeing stars.

Cartoons have portrayed this phenomenon for years: if someone gets hit on the head, they see stars.

The brain is protected by a layer of fluid that usually prevents it from hitting the inside of the skull. A hard knock, such as from a sports collision or car accident, however, may result in the brain bouncing against the skull.

The back of the brain contains the occipital lobe, which is the part of the brain that processes visual information. If this area is knocked, it sends out electrical signals that the brain thinks are light.

Getting hit in the eye can also cause flashes of light because it bumps the retina. The retina is stimulated and sends light signals to the brain. Gently rubbing closed eyes is one way to experience this phenomenon without injury.

2. Migraines

Migraine headaches can cause changes in vision, including seeing stars, sparkles, or flashes. They can also cause spots, heat-like waves, tunnel vision, or zigzagging lines.

These changes occur in both eyes and are thought to be caused by abnormal electrical signals in the brain.

If these visual changes occur before a headache develops, it is called migraine with aura. Some people who get migraines may also experience the aura without a headache afterward.

A retinal migraine is a different type of headache that causes visual changes in one eye only. This is a rare condition and can be a symptom of something more serious. Like a migraine with aura, the visual changes happen before the headache hits.

The visual changes may include seeing stars, flashes, or dark spots, as well as temporary blindness. Retinal disturbances or decreased blood flow to the retina may cause these symptoms.

It is essential for people to contact a doctor right away if they experience retinal migraine symptoms.

Other typical migraine symptoms include:

  • throbbing and severe headache
  • sensitivity to light and sound
  • nausea
  • dizziness

3. Movement in the eye’s vitreous gel

The vitreous gel that is in front of the retina can move around, sometimes pulling on the retina itself. This causes the retina to send light signals to the brain.

Movement or changes in the vitreous become more common as people age and are typically harmless.

However, these flashes could signal a serious issue if:

  • they are happening frequently and regularly
  • they come on suddenly and severely
  • they are accompanied by other vision changes, such as new floaters or cloudiness

4. Retinal detachment or torn retina

Sometimes, the vitreous gel pulls on the retina hard enough to cause damage. It may tear the retina or detach it from the back of the eye.

If this happens, a person may see:

  • a sudden appearance of stars or flashes
  • floaters
  • blurred vision
  • loss of peripheral vision
  • a curtain or shadow across the vision

Risk factors for retinal detachment or tearing include:

  • being over age 40
  • a family history of retinal detachment
  • a previous retinal detachment or torn retina
  • being very nearsighted
  • previous cataract surgery
  • having another eye disease, disorder, or injury to the eye

A torn or detached retina needs emergency medical care. It may be corrected with surgery, but can lead to blindness if left untreated.

Do you ever see something drifting across the sky and discover that it’s actually drifting across your eye?

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That would be a “floater.” Floaters are bits of debris in the interior of your eye that appear when you look at something white or very bright. “People describe them as cobwebs, spider webs, bubbles or even ‘tadpoles’,” says ophthalmologist Rishi Singh, MD.

Dr. Singh sees patients with floaters and “flashes” every day. Flashes often accompany floaters and look like a camera flash going off when you close your eyes or wake up in the middle of the night.

When to see an ophthalmologist

Prompt appointments are especially important if you see many floaters — or if floaters are accompanied by flashes.

If you’ve had floaters for 40 years, you don’t have to see your ophthalmologist. But if you have ‘recent-onset’ floaters — if they weren’t there yesterday or last week — see an ophthalmologist that day or the next.

Flashes are more ominous than floaters, notes Dr. Singh, because they signal an irritation of the retina from tugging, tearing, inflammation or infection.

“When the retina is stimulated, the brain sees it as light because it only has photoreceptors,” he explains.

A mild tug can progress to a retinal tear, which can progress to retinal detachment — a medical emergency. Torn or detached retinas must be promptly repaired by laser surgery or another procedure to preserve vision.

Despite the fast action required, there is no need to panic, says Dr. Singh. Flashes and floaters are usually symptoms of a problem that turns out to be minor.

Causes for flashes and floaters

Flashes and floaters can be caused by:

  • Detachment of the jelly-like “vitreous” from the retina. Detachement of the innermost light-sensitive layer of the eye is the most common cause of floaters and flashes. Posterior vitreous detachment occurs naturally as we get older, typically around ages 55 to 60. When it occurs in one eye, it usually follows in the other.
  • Retinal tear or detachment. This is often a result of vitreous detachment, near-sightedness (myopia) or any kind of trauma or eye surgery
  • Hemorrhage, or blood leakage, from a tiny vessel in the retina. Hemorrhages can occur when a strong pull on the retina tears a blood vessel or when abnormal blood vessels develop in the eye in conditions such as diabetes. Small hemorrhages may disappear on their own, but larger hemorrhages that persist may require surgery.
  • Infection and inflammation. Infection, such as fungal infections, and inflammation, such as uveitis (involving the middle lining of the eye) can cause flashers and floaters.
  • Tumors of the eye. While rare, these must be ruled out, says Dr. Singh, an expert on ocular tumors.

How to take care of your eyes

Whether or not you have flashers or floaters, you can help preserve your eyes. Experts say:

  • Eat a balanced diet to be sure you are getting the nutrients your body needs to keep your eyes healthy.
  • Quit smoking (a huge risk factor for macular degeneration, a common cause of blindness in the elderly).
  • Wear sunglasses when in bright light for extended time to protect against UV light exposure.

What’s Causing My Kaleidoscope Vision?

Be careful of the confusing terminology, and make sure you understand what you have.

MS and migraine

Migraines are more common in people with multiple sclerosis (MS). One study of MS patients attending a clinic showed that they experienced migraines at a rate three times greater than the general population.

But the causal connection between migraine and MS isn’t fully understood. Migraines may be a precursor of MS, or they may share a common cause, or the type of migraine that occurs with MS may be different than that of people without MS.

If you have an MS diagnosis and experience kaleidoscopic vision, it’s possible that it’s the result of a visual migraine. But don’t rule out the other possibilities of TIA or retinal migraine.

Hallucinogens

Kaleidoscopic vision, as well as some of the other visual distortions known as migraine auras, can be produced by hallucinogenic agents. Lysergic acid diethylamide (LSD) and mescaline, in particular, can cause you to see very bright but unstable colored images that are prone to sudden kaleidoscopic transformation.

Seeing Spots

What is seeing spots?

Seeing spots, which are often called floaters, means that you are seeing objects that look like small specks, circles or strands floating in your visual field. These spots or floaters are located within the eye itself and generally move with your eyes, although they also drift on their own. The spots are most noticeable when you are looking at a plain background. In rare cases, eye complications of diabetes may cause spots in your vision, but such spots do not float or drift.

Spots or floaters originate in the vitreous, a gel-like substance that fills the back portion of your eyeball. The proteins in the vitreous sometimes form clumps that are perceived as spots or floaters. Although floaters may be present at any age, they become more common as you get older, as the vitreous gel shrinks and aggregates. The vitreous is attached loosely to the retina, the light-sensing layer at the back of the eye.

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The shrinkage of the vitreous may actually detach it from the retina. This condition, called posterior vitreous detachment, is very common in older people and is not harmful in itself. However, it increases the risk of retinal detachment, a sight-threatening condition in which the retina, the light-sensing layer of the eye, detaches from the blood vessels that supply it with oxygen and nutrients. Retinal detachment occurs painlessly, and its hallmark symptom is a sudden increase in seeing spots and flashing lights.

Seeing spots may also occur with migraines. Seeing spots or floaters generally does not interfere with your vision, although the floaters may be annoying or distracting. However, a sudden increase in floaters and seeing flashing lights may signal retinal detachment. Contact your health care provider if you suddenly start seeing more spots than usual.

The observation of spots or floaters generally does not indicate a serious medical condition. However, a sudden increase may signal retinal detachment, a life-threatening condition that requires urgent treatment. Seek immediate medical care (call 911) if you experience a sudden increase in the observation of spots or floaters, particularly if this is associated with flashes of light or the perception of a darkened area at the side of your vision.

Seek prompt medical care if your spots or floaters are persistent or cause you concern.

What other symptoms might occur with seeing spots?

Seeing spots most often occurs as a solitary symptom, though it occasionally accompanies other symptoms.

Other symptoms that may occur along with seeing spots

Seeing spots may accompany other symptoms including:

  • Headache
  • Seeing flashes of light

Symptoms that might indicate a serious condition

In some cases, seeing spots or floaters may occur with other symptoms that might indicate a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, are seeing spots or floaters along with other serious symptoms including:

  • Blind spots
  • Blurred or double vision
  • Dark, shadowy area in your peripheral vision
  • Sudden appearance of, or increase in, flashing lights in your vision
  • Sudden increase in floating objects or spots in your vision

What causes seeing spots?

Seeing spots or floaters is due to the clumping of proteins in the vitreous, a gel-like substance in the back portion of the eye. This process occurs most commonly as a result of aging, which causes shrinking of the vitreous and aggregation of its proteins. The shrinkage may lead to posterior vitreous detachment, which increases the risk of retinal detachment. However, clumps of protein in the vitreous may also be congenital or caused by eye injuries.

Common causes of seeing spots or floaters

Seeing spots or floaters may be caused by:

  • Diabetes (chronic disease that affects your body’s ability to use sugar for energy)

  • Normal aging

  • Posterior vitreous detachment

Serious causes of seeing spots or floaters

In some cases, seeing spots or floaters may be a symptom of a serious condition that should be immediately evaluated in an emergency setting. These include retinal detachment (detachment of the light-sensing layer inside your eye from the blood vessels that provide it oxygen and nutrients).

Questions for diagnosing the cause of seeing spots or floaters

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your seeing spots or floaters including:

  • How long have you been seeing spots or floaters?

  • Have you noticed any sudden increases in the amount of spots or floaters?

  • Are you observing flashes of light?

  • Are you seeing spots in both eyes or just one eye?

  • Are you taking any medications?

  • Do you have any other medical conditions?

  • Do you have other symptoms, particularly other symptoms affecting your eyes or vision?

What are the potential complications of seeing spots?

Seeing spots or floaters is usually a symptom of harmless shrinkage and protein clumping occurring in the vitreous, the gel-like substance in the back of the eye. This process occurs as part of normal aging. However, in some cases, seeing spots, and especially a sudden increase in spots, may be a symptom of more serious conditions such as retinal detachment or eye complications of diabetes. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including loss of vision and blindness.

Floaters & Flashers

At some point in their lives, many people see what looks like small specks of dust or wispy threads drifting across their vision. They notice, however, that blinking does not get rid of the specks or threads. And when the eye moves, the specks or threads move too. These are called floaters.

Why do people get floaters?

There are a few different types of floaters, and each has its own cause. In general, though, eyes that are injured, inflamed, or nearsighted (cannot see objects far away) are more likely to get floaters.

The jelly-like fluid in the posterior chamber, which is the space between the back of the iris and the front face of the vitreous, is surrounded by a very thin membrane. The fluid also contains many fibers that are usually invisible. This whole structure is called the vitreous body.

Sometimes the fibers in the vitreous body pull loose from where they are normally attached. When this happens, they can make shadows inside the eye. This is what causes the floaters that look like wispy threads.

Very rarely, something that looks like a floater turns out to be tiny droplets of blood from the inside lining of the eye. This could be caused by an injury or by several conditions of the eye. When there is bleeding, there is a greater danger of losing vision.

When are floaters dangerous?

There is no way of knowing the cause of floaters without a careful examination. This is why it is important for anyone who starts seeing floaters to schedule an appointment with their eye doctor as soon as possible.

Most of the time, floaters are not the sign of anything dangerous. Floaters caused by loose cells, for example, are usually not that bothersome and often go away on their own in a few weeks or months.

The floaters that look like wispy threads tend to be more visible, and in most cases they will also go away with time. In some cases, however, they can signal other problems.

The fibers that cause the wispy-thread type of floaters are usually attached to the inside of the back of the eye. This surface is called the retina, and it contains the special nerve cells that react to light.

When the fibers of the vitreous body separate from the retina, floaters in a small area of vision are usually the only problem. In some eyes, however, many of the attachments between the vitreous body fibers and the retina will be broken.

Most floaters are caused by a posterior vitreous detachment. This occurs when the jelly-like fluid in the eye liquefies with age.

Sometimes the vitreous body fibers can pull some of the retinal nerve cells with them, causing a retinal tear that can lead to a retinal detachment. This can cause significant damage to vision. (More information about this condition is available in the “Retinal Detachment” fact sheet from the Cole Eye Institute.)

Can floaters be treated?

Only after a careful examination can your doctor give advice about possible treatment for floaters. In many cases, the examination will confirm that the floaters are not a symptom of a more dangerous condition. The doctor might just recommend that the patient have eye examinations more frequently to make sure that the eye with floaters does not get any of the more serious conditions later.

Sometimes when vitreous body fibers pull on the retinal nerve cells, the eye has the sensation of a flash of light. This can be a small flash in just one spot, or it can be several flashes across a wider area of vision. It is not unusual for flashes and floaters to occur at the same time.

Are flashes a symptom of a more serious eye problem?

Flashes can be a symptom of a retinal detachment, which can damage vision significantly. Anyone who experiences flashes should see their eye doctor as soon as possible. If the flashes have been caused by a retinal detachment, the doctor will be able to give advice on possible treatment options.

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What should you do about those unpleasant eye floaters?

Debris in your vision is a nuisance, but you may have to live with it.

Published: October, 2017


Image: © Thinkstock/Thinkstock

Strings, blobs, and cobwebs: they all describe types of specks that may appear to float across your field of vision. These “floaters” are usually just a nuisance. “In many cases, floaters become less noticeable or more tolerable over time, and can even disappear entirely,” says Dr. Jeffrey Heier, an ophthalmologist and Harvard Medical School instructor.

But for some people, floaters are distracting to the point of interfering with vision.

Where do they come from?

As we age, the thick, jelly-like substance that fills the center of the eye — called the vitreous — starts to form dense “blobs.” Some of this debris may wind up floating around and blocking some of the light coming into your eyes.

Most floaters are small and don’t bother vision much. But one kind — called a Weiss ring — is larger and ring-shaped. It can interfere more with vision than other floaters. This larger type of floater is caused when the vitreous, which normally hugs the retina in the back of the eye, frees itself from the retina.

Treatment

Right now, Dr. Heier recommends only two approaches to dealing with floaters: ignore them, or in extreme cases, have surgery.

In the surgery, called vitrectomy, a surgeon removes the gel — along with its floaters — from the back of the eye. It’s effective, but it has risks, including cataracts (cloudy lenses) and retinal detachment. It’s usually a last resort for people whose floaters make it hard for them to see.

A laser zaps floaters?

Another treatment that’s not currently recommended — a laser procedure called YAG vitreolysis — has begun to get attention. YAG vitreolysis vaporizes floaters by heating them. “You can see the tissue turn into gas bubbles,” says Dr. Chirag Shah, a Boston ophthalmologist.

The procedure is controversial, mainly because some doctors have been offering it since the early 1990s without any solid evidence about its safety and effectiveness.

But Dr. Heier and Dr. Shah recently showed that YAG vitreolysis may deserve more investigation. They randomly assigned 52 people with Weiss ring floaters to receive either YAG vitreolysis or a sham laser treatment. Six months later, 53% of patients in the YAG group reported significant or complete improvement, compared with none at all in the sham group. The results were published July 20, 2017, in JAMA Ophthalmology.

The new study is important because it’s the first study of YAG vitreolysis in a randomized controlled trial, the gold standard for testing the effectiveness of a treatment. The results are also noteworthy because using the laser didn’t result in any tears or retinal damage within the six-month follow-up period. “This was certainly encouraging, but we need more studies,” Dr. Shah says.

Critics of the study point out that it involved only people with Weiss rings, as opposed to other more common types of floaters. Therefore, the effectiveness of the treatment for these more common floaters remains to be demonstrated.

Dr. Shah agrees: “Our results are not applicable to all patients.” He encourages other eye doctors to study YAG vitreolysis for all types of floaters.

Red flag floaters

A more serious condition that can be confused with floaters is a detached or torn retina, which can cause a sudden shower of floaters, flashing lights, or the appearance of a curtain coming over your vision. If that happens, you should immediately call your ophthalmologist (a medical doctor who specializes in eye care, not an optometrist) if you have one, or your primary care doctor. A detached or torn retina requires immediate diagnosis and treatment.

People at risk for retinal tears include those who

  • are older

  • are nearsighted

  • have a family history of a retinal tear or detachment

  • recently have had floaters that the eye doctor said was caused by the vitreous freeing itself from the retina

  • have had eye surgery.

What should you do?

Until we have better evidence for YAG vitreolysis — and Dr. Shah says several clinical trials are under way — your best bet is to ignore floaters, and simply watch for the sudden appearance of new ones. If you see them, call your doctor to report them.

  • And if the strings, blobs, or cobwebs are more than a nuisance, talk to your doctor about whether the benefits of surgery outweigh the risks. “You may be a candidate for surgery if you have floaters that keep you from performing daily activities or work,” says Dr. Heier.

Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Eye Floaters – Types, Causes, and Treatment

Vitrectomy

If your vision is seriously affected by the floaters, or they don’t get better over time, you may be offered a vitrectomy. This is a procedure for the removal of the vitreous humor from your eye- any debris causing you to see floaters is removed as well, and it is all replaced with a saline solution.

However, this is a rare course of action as eye surgery carries a number of risks, and vitrectomies aren’t always offered by the NHS. Side effects may include retinal tearing or detachment, and the procedure could also result in cataracts.

Laser treatment

Floaters may also be treated by laser surgery, where the laser is used to break them up or move them. While some think that this method is safer than vitrectomies, the treatment is rare and normally not available on the NHS, and there hasn’t been a lot of in-depth study into its effects.

Eye floater prevention

  • Always wear sunglasses to protect your eyes from the harmful rays of the sun.
  • Avoid straining your eyes.
  • Follow a healthy diet.
  • Do eye exercises.
  • Practice yoga.
  • Drink lots of water.

Your diet plays an important role in enhancing the health of your eyes. Let’s take a look at the foods that can accelerate recovery and even prevent the condition.

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