Alamo City Eye Physicians
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Alamo Physician Optical :: Our office provides a complete optical shop to fill the needs of our patients.
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Floaters, Flashes, and Retinal Detachment


You may at some point have seen tiny little gray to black specks or lines that seem to float around in your field of vision. These are appropriately called floaters, as they are indeed clumps of cells or gel that float around inside the eye within the vitreous fluid. They may appear as dots, cobwebs, strings, or even clouds and are often more noticeable against a light background. Floaters may be present early in life but are more common with age. They are more common in people who are nearsighted, have undergone previous eye surgery, or who have had inflammation inside the eye (uveitis).

The vitreous is a clear gel/fluid that fills the inside of the eye. With age the vitreous begins to condense, shrink, and separate from the retina – the thin layer of nerve tissue that responds to light and lines the inner wall of the back of the eye. When this occurs it is called a posterior vitreous detachment (PVD). A PVD may go unnoticed without symptoms or may produce new floaters or even flashes of light, like lightning bolts. Flashes are caused by a pulling of the vitreous on places of attachment to the retina.

Floaters and flashes can be considered as warning signs for a retinal tear or detachment. Although a PVD alone is not problematic, the process of vitreous separation from the retina may cause a retinal tear. A tear in the retina allows vitreous fluid to flow through and separate the retina from underlying tissues, a condition known as a retinal detachment. This is a sight-threatening emergency and must be addressed immediately to preserve vision.

Retinal Detachment

Retinal tears, if caught early, may be treated with laser surgery in the office. The laser seals the retina around the tear to the underlying tissue, preventing the flow of fluid through the tear and underneath the retina. A retinal detachment in the early stages may also be treated before vision is affected, depending on the size and location of the detachment. Delayed treatment may result in permanent severe vision loss. A detachment may be treated with laser, surgery, or a combination of both.

Some factors may leave a patient more at risk for a retinal detachment. These include nearsightedness (myopia), previous eye surgery, eye trauma, certain retinal conditions, advancing age, and a family history of retinal detachment.

Posterior vitreous detachment is a very common occurrence. It is estimated that the prevalence of PVD under age 50 is less than 10%, compared with greater than 63% over age 70. The risk of a retinal tear from a PVD causing symptoms is about 10-15%, and only a minority of tears leads to a detachment. Nevertheless, the stakes are high and so the onset of new floaters, sudden flashes, or a dark spot or shadow in your vision requires a prompt visit to your ophthalmologist to rule out a retinal tear or detachment.

Retinal tears may be difficult to visualize in the early stages, and some may develop after the initial examination. Therefore, you can expect multiple examinations over weeks to months to assure that no tears develop. Even after your ophthalmologist has determined there are no tears, patients should be on alert for any change or increase in their symptoms.