Angeles Vision Clinic
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FLOATERS, FLASHES
POSTERIOR VITREOUS DETACHMENT
Floaters, sometimes called spots, are small, semitransparent or cloudy particles that float within the vitreous, the clear, jelly-like fluid that fills the inner portion of the eye. Floaters are usually harmless and are seen by many of us at one time or another.
Floaters become visible when they fall within the line of sight and cast a shadow on the retina (the light sensitive portion in the back of the eye).
What are Floaters?
The
interior portion of the human eye is filled with a gelatinous substance called
vitreous. It occupies approximately 80% of the volume of the eyeball and is
formed by a network of transparent collagen fibrils. This gives the vitreous the
consistency of firm cold Jell-O. With time, the vitreous gel liquefies and
eventually pulls away or separates from the back of the eye where it is attached
to the retina. This process is called (PVD) POSTERIOR
VITREOUS RETRACTION and is a
normal event occurring in most people somewhere between 40-70 years of age.
Floaters and Flashes are commonly a result of this process (PVD). The debris
generated causes the floaters and the pulling on the retina causes the flashes.
If a retinal blood vessel is broken from this pulling, a vitreous hemorrhage can occur. A small amount of blood may be seen as a shower of spots. Larger hemorrhages can cause large dark blobs in the visual field or an overall decrease in vision. If the gel is abnormally adherent to the retina, or the retina is weak in a certain area, a retinal tear can occur. Once a retinal tear develops there is a significant risk of the liquid vitreous going through the break and detaching the retina. This is why a PVD is such a significant event. A PVD is the initiating event of many retinal detachments.
Awareness of the
symptoms of a PVD is the critical first step in preventing a retinal detachment.
If you have symptoms of a PVD (floaters, flashes, shower of spots or gray areas
approaching from the side) it is important to have a prompt and thorough
examination of the retina so a search can be made for any retinal
breaks. If a
retinal break is discovered it can be treated before turning into the more
serious retinal detachment. Finding a retinal break is important and requires a
very complete examination, by your eye
care provider of the peripheral retina where most tears occur. A
unique instrument called a Binocular Indirect Ophthalmoscope is used to view the
vitreous, retina, and other interior parts of the eye to determine the causes of
the flashes and/or floaters that you see.
If a retinal break occurs, prophylactic laser treatment is 95% effective in preventing the more serious retinal detachment. Fortunately the great majority of PVD's do not cause a retinal tear and not all tears will lead to detachment. In general, if a tear is associated with a symptomatic PVD it is at high risk for leading to a retinal detachment and should be treated. Sometimes a PVD, tear, and/or detachment can occur without symptoms while other times there are lots of annoying symptoms without a retinal break.
What happens to the floaters and flashes?
Once it has been determined there is no underlying retinal tear or detachment the floaters may be considered irritating but harmless. With time most floaters tend to become less bothersome and often disappear. If new floaters appear they need to be examined to determine if they are harmless or a symptom of the more serious retinal tear or detachment.
It is expected following a PVD that the floaters and flashes slowly diminish over a 3 month period. If the floaters and flashes increase, or gray areas appear to the side of your vision, this could be a sign of a retinal detachment developing. You will need to contact eye care provider for a retinal evaluation. Our office has 24 hour coverage 365 days per year.