Sometimes you see what you think is a fly or cobweb in your vision or a flash of light in your side vision.  Is it something to worry about?  Let’s talk about:

 FLOATERS & FLASHES

First let’s take a short review of the anatomy of the eye.  Think of the eye as a hollow ball.  Behind the iris (colored part) is a large space that is filled with a clear gel-like substance called the vitreous humor.  Behind the vitreous is the retina, a light-sensitive layer of nervous tissue that lines the inside of the eye.  The retina is normally flat against the underlying tissue which provides nourishment for the retina.  Sometimes flecks of protein or other matter get trapped in the vitreous during the formation of the eyes before birth.  Other times cloudy specks or strands will form with normal aging of the vitreous.  These opacities form shadows on the retina that we see as grayish spots, strands or cobwebs.  Floaters are more obvious when looking at a bright background such as the sky or a white wall.  They change position or float as you move your eye.  As the vitreous ages or becomes more liquefied, the center of the vitreous can collapse and the outer more solid vitreous then pulls away from the retina.  This is called a vitreous detachment or degeneration.  Brief flashes of light can sometimes be seen as the vitreous pulls away from the retina.  These flashes will subside as the vitreous settles.  Vitreous detachments that do not tear the retina do not require treatment.

 Floaters and flashes can also occur in a retinal detachment or tear, in which part of the retina has become lifted or pulled from its normal position.  Bits of retina or blood cells can be floating in the vitreous and cast shadows on the retina.  The area where the retina is detached will no longer detect light. This results in loss of part of your vision. The detached or torn retina may be pulled by the vitreous causing a sensation of flashes or flickers of light.  

The most common cause of retinal detachment is a hole or tear in the retina that allows fluid to lift up the retina. In other detachments there is no retinal break, but inflammatory disease or injury causes fluid to leak underneath the retina.  In tractional detachments scar tissue on the surface of the retina shrinks and pulls the retina away from the underlying tissue. 

 Retinal detachments require emergency treatment by a retinal surgeon.  The longer the retina is detached, the more likely the visual loss is permanent.

 So what should you do if you have floaters?  If your floaters that have been present for years without change, these are just benign vitreous opacities and do not require examination.  If you suddenly see flashes of light and/or new floaters, call our office without delay (if calling after regular hours, listen to the message for directions).  From a description of your symptoms, we can determine if you require immediate evaluation.  On examination Dr. Yin can dilate your pupils with drops and look inside your eyes for any signs of retinal breaks or detachments.  If you require treatment, you will be referred to a retinal specialist for immediate repair. 

You are at a greater risk of developing a retinal detachment if you are highly nearsighted (-6.00 or greater), have had previous eye surgery such as cataract removal or have a family history of retinal detachment.  One reason we dilate at your routine examination is to detect retinal breaks that are not causing symptoms but may require treatment to prevent retinal detachment. 

For more information about floaters, vitreous detachments and retinal detachments, visit http://www.nei.nih.gov/ and type your search term in the upper right box.

SAFETY FIRST!

Prevent eye injuries such as retinal detachments by wearing protective eyewear for hazardous activities at home, work and play. With activities such as lawn care, baseball, home repair, automobile maintenance and housecleaning your eyes can be exposed to fast-moving foreign objects, blunt trauma and chemicals that can cause problems ranging from discomfort to permanent loss of vision. Now that prescription and non-prescription safety and sports eyewear are stylish and comfortable, there is no excuse for not wearing proper eye protection.  We are happy to help you with you and your family’s sports and safety eyewear needs.