What are those pesky little black spots and cobwebs that float within your vision? Where are those flashes of light coming from? Are you imagining things? Do these changes indicate a serious problem with your eyes? If you have wondered these questions, you are not alone. Many people have experienced “floaters” in their vision or occasional flashes of light. But what are they? And do they signify a problem?
The back interior compartment of the eye between the crystalline lens and the retina is filled with a thick gel called the vitreous. It is a clear, colorless gel that is composed 98-99% of water. The remaining 1-2% is made up of proteins and collagen. Despite its low volume of collagen, the density of the vitreous is substantial enough to fill the eye and give it a spherical shape.
The collagen fibers within the vitreous are held in perfect formation by electrical charges. As we age, the charges diminish and the collagen fibers tend to clump together. Similarly, the vitreous may also liquify, allowing cells and other organic clusters to float freely within the vitreous. Any changes in the consistency of the collagen may cast a shadow onto the retina as the light enters the eye and be perceived as a spot floating within the vision. These spots are known as “floaters.” Floaters can take on many shapes and sizes from small spots to cobwebs or large strands. Although floaters can be annoying they are typically harmless. However, a sudden increase in the number of floaters, or stationary spots that do not float within the vision, may indicate a more serious retinal problem and your ophthalmologist should be notified.
Another change that may occur as the vitreous body becomes more liquified and condenses due to age and normal wear and tear, it may shrink and pull away from the retina, the light-sensing nerve layer at the back of the eye. This condition is known as a posterior vitreous detachment (PVD). Although more common in elderly patients, people who are myopic (nearsighted) more than 6 diopters, may experience a PVD at any age.
A posterior vitreous detachment itself is not typically a problem. However, if the vitreous separation does not progress gently, gradually, and uniformly, it may cause a tear or hole in the retina or a retinal blood vessel. This is a more serious condition and could result in a retinal detachment or epiretinal membrane, which can result in permanent vision loss. However, about 85% of patients who experience PVD never develop complications and in most cases, the flashes and floaters subside within 3 months. We advise anytime you notice flashes in your vision to contact your ophthalmologist for a dilated eye examination.