Flashes Floaters are they a sign of a retinal detachment

Lots of people, particularly older people, get floaters and flashes. They’re usually caused by a harmless process called posterior vitreous detachment (PVD), where the gel inside your eyes changes.

Are flashes and or floaters a sign of a retinal tear or break ?

Flashes and or floaters can be a sign of a retinal detachment or retinal tear which can lead to serious vision loss, however some are harmless. We can examine your eyes locally and thoroughly with the aid of a modern Optos retinal camera.

How an Optos camera works, click here.

We have one of the few Optos cameras in North East Essex available in the high street. Eye drops are rarely needed, the flash from the camera is similar to a flash from a normal domestic camera. Depending on the results you may still need to have eye drops for further checks.

The alternative is to be examined at an Eye Clinic in the hospital. 

The examination will be covered by the NHS, please ask for details.

ultra wide optos image for detection of peripheral retinal posterior vitreous detachments
ultra wide optos image showing a horse shoe tear in upper part of the retina

What Are The Likely Causes Of Flashes or Floaters?

Flashes and Floaters in your eyesight are usually caused by the vitreous changing in shape. This is a normal aging process, however  this change in shape may cause traction on your retina, which in turn may cause the retina to tear.

If you have a retinal tear or hole, liquid may pass through the hole or tear and find its way behind your retina. In that case you would have a retinal detachment. Retinal detachments need urgent detection and repair. The sooner they are detected and repaired the less stress it will cause you. Small tears can be detected early, these can be treated by laser, definitely less stressful than eye surgery.

Nearsighted patients are more likely to suffer a retinal tear as their retina is more stretched / thinner. However, in most cases the retina does not tear and the vitreous just changes shape. 

Some flashes in your vision are caused by vascular problems and can be associated with migraines.

eye floaters against bright sky
Eye floaters seen against a bright sky (can also be seen against a ceiling)

Can Eye Floaters be Treated ?

Eye floaters are in the vitreous of the eye, some clinics suggest the vitreous can be surgically removed thus removing the floaters too. Eye floater surgery has been done for Mr Phillip Schofield by Ophthalmologist Mr Balaggan. Others suggest YAG laser may be able to break the strands into smaller parts which are then less visible. There are also micronutrition VitroCap tablets available for eye floaters. 

Below is a video of normal floaters in the vitreous of the eye, you can see how they float around with eye movement. Mostly this is normal, however the vitreous may pull at the retinal and cause a tear:

Below is a video of a retinal tear in the eye, the retina is now further forward than normal and thus shows as green on the Daytona camera from Optos:

optos image showing a large retinal tear and detachment with floaters
Optos image showing a large retinal tear and detachment

What is the vitreous?

The vitreous is a gel-like substance, which fills the cavity in the middle of the eye between the retina (“the photographic film of the eye”) and lens. The vitreous is important during the growth of the eye but in adult life it serves no useful purpose. During life the vitreous becomes more liquid-like with clumps of thickened gel in between pools of liquid, this is called syneresis. These appear to you as floaters – these are very common and most people have some.

What is a Posterior Vitreous Detachment?

In middle age (or earlier in short sighted people) the vitreous gel can become so liquid like that it collapses away from the back of the eye (this is called a ‘posterior vitreous detachment’ or ‘PVD’). The vitreous adheres lightly to the retina. As the vitreous pull back from the retina i causes traction on the retina.

What are the symptoms of a Posterior Vitreous Detachment?

When a ‘PVD’ occurs, more floaters than normal (often larger than before) suddenly appear in the vision and flashing light, photopsia, effects can occur. You may also see blurred patches in the vision, some patients not a veil in the vision. However it is important to be seen as soon as possible to be checked for a possible retinal tear. If you notice the above call us today or see A&E. The appointment will be covered by MECS, MECS is an enhanced Optometric service in Essex, provided by Primary eycare Ltd

Is treatment required?

A ‘PVD’ is a very common condition. If the retina is not damaged, then no treatment is required. You may be aware of floaters in your vision but the vision should not get worse. With time you will probably find that the floaters become less noticeable and the flashes of light stop. Floaters can be very annoying but unfortunately there is no simple way to remove them.

Is a Posterior Vitreous Detachment linked to a Retinal Detachment?

A vitreous detachment is different from retinal detachment. However, occasionally a vitreous detachment can cause a retinal detachment by tearing the retina as the vitreous gel pulls away from the retina. You will therefore need a careful examination of your eyes to assess whether any tears in the retina have occurred and if treatment is needed. Generally tears in the retina form when a posterior vitreous detachment first occurs. If there are no tears or holes in the retina when you are seen you should be fine. However if you have futher symptoms, e.g. flashed, floaters or decreased vision you need to seek professional advise urgently, call a MECS Optometrist the same day you notice this change in your vision. If there is no local MECS provider available please call or see A&E.

What to do after retinal detachment surgery:

Eye surgeons places the loose retina back against the inside of the eye wall during the repair. At this stage the still loose retina is only held in place with air or oil. After the relocation of the retina to the back of the eye, scarring is induced between the still loose retina and the choroid at the back of the eye. The scarring takes 6 days to properly fix the retina to the back of the eye.
If the retina moves away from the back of the eye before the scarring has occurred fully the treatment to fix the retina fails. For this reason posturing and avoidance of bumps and sudden movement is very important. A recent lecture by a Moorfields consultant suggested posturing for six days.

Causes Of Flashes / Floaters

Lots of people, particularly older people, get floaters and flashes.

They’re usually caused by a harmless process called posterior vitreous detachment (PVD), where the gel inside your eyes changes.

Sometimes they can be caused by retinal detachment.

This is serious and can lead to permanent vision loss if not treated.

Floaters and flashes can also happen for no obvious reason.

When To See Simon Kleyn Optician - Optometrist

Make an appointment for an eye test / examination if you notice any changes in your vision. If you develop sudden vision changes, such as double vision or flashes of light, sudden eye pain, or sudden headache, call us straight away. 

Simon Kleyn Opticians
Optometrist In Frinton On Sea & Earls Colne
Skopticians Frinton On Sea
Skopticians Earls Colne