Floaters are those specks or lines that sometimes drift into one’s field of vision. While typically harmless, floaters that occur suddenly and are accompanied by flashes of light or impaired vision can signal a potentially serious eye problem, particularly among older adults.
If floaters in combination with flashes do appear, it is important to consult with an ophthalmologist in a timely manner to determine if the symptoms are produced by a condition called vitreous detachment or indicate a more serious condition, such as a tear or detachment of the retina.
“After the age of 50, about 40 percent of the population already has a vitreous detachment. The more nearsighted the person is, the higher the chance for them to have this condition happen to them,” says Gad Heilweil, MD, an ophthalmologist at Doheny Eye Center UCLA. “By itself, we don’t consider vitreous detachment a disease.”
In most people, vitreous detachment is harmless and causes no symptoms, says Pradeep Prasad, MD, assistant professor of ophthalmology at UCLA Stein Eye Institute. As people age, the gel-like substance in the eye, called the vitreous, begins to liquify and contract, he explains. As the vitreous contracts, it peels away from the retina, the light-sensitive tissue that lines the back of the eye. In some patients, as the vitreous pulls away from the retina, a retinal tear or detachment may occur. This can be vision-threatening and requires urgent medical attention, Dr. Prasad says.
“It’s impossible for a patient to be able to distinguish between a vitreous detachment, which is bothersome, and an associated tear or detachment,” Dr. Prasad says. “That’s why it’s so important to see an ophthalmologist and have the symptoms evaluated.”
To evaluate the condition, an ophthalmologist dilates the eye to examine it and make sure there is no retinal tear or detachment. In 90 percent of cases, no problem exists and patients are reassured that the floaters and flashes will eventually go away without treatment. But it takes an examination to know that, Dr. Heilweil says.
“Everyone knows that with chest pain and other types of symptoms, you need to see your doctor right away,” he explains. “But people don’t realize sudden floaters or flashes in one eye is also a reason to call your doctor that same day. About half of people come in too late. It’s a pity because they’ve had symptoms for a week or two and they think the symptoms will go away.”
A tear in the retina can almost always be successfully treated with a laser, the doctors say. The outpatient procedure requires only a topical anesthetic and is painless. “The types of lasers we use today are very precise. They are just as efficacious but gentler on the eye,” Dr. Prasad says. A detached retina, on the other hand, requires surgery. There is a 90 percent or greater chance the retina can be reattached, Dr. Heilweil says.
“But sometimes vision is permanently affected,” he adds. “So the take-home message is: If, all of a sudden, you experience floaters or flashes or a combination of these two, contact your doctor or see an eye doctor as soon as possible.”
