Flashes of light, “floaters”, tears and retinal detachment

• 01 September 2016

WHAT ARE “FLOATERS”?

Floaters are tiny pieces of material formed inside the vitreous, a gelatinous liquid which fills the eye cavity. “Floaters”, generally, consist in heaps of condensed proteins, which circulate in the vitreous. These cells, usually, originate in the destruction of an eye membrane, “the hyaloid artery”, which is done, during the embryogenesis that is: the formation of the foetus. These particles therefore, float in the eye for life. They can have the appearance of tiny flies or cobweb.

They can easily be seen, when we look at them on a plain background, like a white wall or towards a blue sky. They can be seen because they create a shadow on the retina which is the membrane picking up the light, at the back of the eye.

Although, they may interfere with the vision, “the floaters” generally do not present any danger to the eye and are more upsetting when they disturb the vision. Most of the time, “these floaters” don’t indicate a serious ocular problem, but it’s not always the case.

WHAT CAUSES “FLOATERS”?

Besides the residues of the “hyaloid artery”, they are present in the eye for life, other “floaters” appear as a result of aging. As we grow older, the vitreous contracts itself, leading to the separation of the membrane surrounding the vitreous at the back of the eye. Then, a large “floater” is, usually, perceived, resembling a cobweb. This is often, associated with the perception of a bright flash since the vitreous pulls on the retina. This process is called: “detachment of posterior vitreous”. When, this normal age related phenomenon of the eye happens some tears can occur in the retina and lead to a much more serious problem, such as: “retinal detachment”. An early detection and treatment of tears can prevent this retinal detachment.

The perception of very large “floaters” and/or in a very important number, can indicate more serious problems as, an haemorrhage in the vitreous, a retinal detachment, an inflammation or other problems. So, if you have a great deal of “floaters” or if new floaters appear, you should, without delay, make an appointment with your optometrist. At this appointment your specialist will dilate your eye.

BRIGHT FLASHES

Bright flashes, that last for a few seconds can occur in your vision when the vitreous gel pulls on the retina. This, naturally, can happen with the age or suddenly if you receive a violent blow on the head or the eye. Usually, these flashes are noted more easily when it’s dark.

The bright flashes, appearing like zigzags in both eyes, a few minutes to 30 minutes are generally sign of a migraine. The flashes caused by migraines are often noted in a luminous environment. These flashes are not symptomatic of an ocular problem.

The appearance of new bright flashes for a short period at night, especially if they come with many new floaters, a shadow over a part of your vision field, may indicate a detachment or retinal tear.

WHAT MUST WE DO WITH “FLOATERS” OR BRIGHT FLASHES?

The only way to be sure that the floaters or flashes are not symptomatic of a serious ocular problem, is to talk to your optometrist. If, according to your visual exam, you develop new floaters in large quantities, which seem to worsen with time, we recommend to have your eyes re-examined.

When the “floaters” appear in your line of vision, move your eye up and down also from left to right. This movement creates a displacement of the vitreous body in the eye and can move from the “vision axis”, the importunate, floaters.

TEAR AND RETINAL DETACHMENT

The retina is a delicate membrane which covers the inside of the eye. It converts the visual image in a signal which is transmitted towards the brain. If the retina becomes damaged, the quality of these images, is affected. Vision can be lost if the damages are severe and the treatment is delayed.

Retinal detachment, often occurs on patients with myopia, those who already had eye surgery, had an eye traumatism or have a family history of retinal detachment. Middle to advanced age people are more at risk than a younger population. This condition, also, has more chance happening to patients who already had previous retinal detachment.

Retinal detachment, commonly, begins with one or more holes/tears in the retina. This allows fluid inside vitreous to seep underneath and weaken the attachment so that the retina then becomes detached.

WHAT ARE THE ALARMING SIGNS OF THE RETINAL DETACHMENT AND TREATMENT?

The sudden appearance of floaters, also bright flashes, more perceptible at night, which last a few seconds and usually occur in the periphery or the vision field.

A retinal tear untreated, can progress towards a retinal detachment. If it happens, the vision is lost, in the zone where the detachment occurs. Some patients describe the detachment as a shadow or curtain over the field of vision. If it progresses, the central vision may be lost and all the retina can be affected, leading to complete blindness. It is essential to immediately, consult your optometrist or your ophthalmologist. The treatment for a retinal tear consists in using a laser, to voluntarily create scars around the fissure. Cryotherapy (using below-freezing temperatures) can also provoke the formation of scars which will seal the tear. A retinal detachment requires a surgery done by a retinologist, with the intention of, essentially prevent the detachment to pursue its progression. Surgery doesn’t give back, the vision to the part of the retina that was detached.

REGULAR EXAMS: A PRIORITY TO PRESERVE YOUR VISION

To protect your vision, if you have risk factors as: high blood pressure, diabetes or a glaucoma family history, a macular degeneration, retinal detachment, an annual exam is recommended or people at risk, should have regular and closer exams, according to your optometrist’s recommendations. When you have visual symptoms that aren’t normal or unexpected, don’t hesitate: talk to your optometrist: it could save your eye sight!