Flashes and Floaters

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 occasionally 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, a condition known as syneresis, 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.  Eye FloatersThese 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 eye doctor should be notified.

Another change as the vitreous body becomes more liquified is it may shrink and may pull away from the retina which lines the back surface of the eye. This separation may cause light to reflect off of the interface of the vitreous resulting in a person perceiving flashes of light.  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.   

Detached VitreousA posterior vitreous detachment itself is not typically a problem.  However, as the vitreous separates it  may cause a tear or hole in the retina.  This is a more serious condition and could result in a retinal detachment and permanent vision loss.  We advise anytime you notice flashes in your vision to consult your eye care provider for a dilated examination of the entire retinal surface.