Floaters and Flashes
For us to see the world around us, light enters the front of the eye and passes through the vitreous before it’s focused on the retina. The vitreous is the clear gel-like fluid inside of the eye. The retina is the light-sensitive tissue lining the back of the eye. Frequently, tiny clumps of cells form inside the gel-like vitreous. The shadows these clumps cast on the retina are what we perceive as “floaters”.
They can appear as dots, circles, lines, clouds, or cobwebs in the field of vision. Floaters are more common as we reach middle age, a time in our life when the vitreous gel can start to thicken or shrink, forming clumps or strands. Sometimes, the shrinking of the vitreous can create tiny tears in the retina as it pulls away from the wall of the eye.
If these tears bleed, new floaters may appear. With “flashes”, the vitreous gel is rubbing or pulling at the retina, moving it slightly from its normal position lining the back of the eye. Flashes are flashes of light that appear in your vision intermittently and may be noticeable off and on for several weeks to months. Trauma to the eye can often cause floaters and flashes.
Also, migraine headaches can cause flashes. Floaters and flashes can also be caused by retinal detachment, a serious condition requiring immediate attention. Warning signs of a retinal detachment are: flashing lights, a sudden appearance of new floaters, shadows in the side or periphery of your vision, or a gray curtain moving across your field of vision.
These symptoms don’t always mean you’re experiencing a retinal detachment, but you should see your ophthalmologist right away!
A flexible band, called a scleral buckle, is placed around the eyeball to counteract the force pulling the retina out of place. Fluid may be drained from under the detached retina, allowing it to settle back into its normal position against the back of the eye. Or, a gas bubble may be placed in the eye to push the retina back in place.
With pneumatic retinopexy, a gas bubble is injected into the vitreous space inside the eye. The bubble pushes the retinal tear closed against the back wall of the eye. With this procedure, the patient must maintain a certain head position for several days after surgery. The gas bubble will eventually disappear. Laser or )therapy is also added to seal the retinal tear back into place.
Vitretomy is a surgery where the vitreous gel that is pulling on the retina is removed from the eye and replaced with a gas bubble. Over time, fluid naturally replaces this gas bubble. In select cases, silicone or oil is used instead of gas. This usually requires a second surgery to remove the oil once healing has occurred. A vitretomy is sometimes combined with a scleral buckle.