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Floaters and Flashes

Sometimes people see small spot or specks moving in their field of vision or experience flashes of light. These occurrences are called floaters and flashes. Although annoying, floaters and flashes are generally of little importance. In some cases, floaters and flashes may be the symptoms of a more serious eye problems such as retinal detachment.

What are floaters?

You may sometimes see small specks or clouds moving in your field of vision, they are called floaters. You can often see the floaters when looking at a plain background, like a blank wall or blue sky. Floaters are actually tiny clumps of gel or cells inside the vitreous, the clear jelly-like fluid that fills the inside of your eye. While these objects look like they are in front of your eye, they are actually floating inside. What you see are the shadows they cast on the retina, the nerve layer at the back of the eye that senses light and allows you to see.
Floaters can have many different shapes: little dots, circles, lines, clouds or cobwebs.

What causes floaters?

A people age, the vitreous gel may start to thicken or shrink, forming clumps or strands inside the eye. The vitreous gel can pull away from the back wall of the eye, causing a posterior vitreous detachment. It is a common cause of floaters.
Posterior vitreous detachment is more common for people who:

  • are nearsighted;
  • have undergone cataract operation;
  • have had YAG laser surgery of the eye;
  • have had inflammation inside the eye.

The appearance of floaters may be alarming, especially if they develop suddenly. You should see an ophthalmologist right away if you suddenly develop new floaters, especially if you are over 45 years of age.

Are floaters ever serious?

The retina can tear if the shrinking vitreous gel pulls away from the wall of the eye. This sometimes causes a small amount of bleeding in the eye that may appear as new floaters.
A torn retina is always a serious problem, since it can lead to a retinal detachment. You should see your ophthalmologist as soon as possible if:

  • A new floater suddenly appears.
  • You see sudden flashes of light.
  • If you notice other symptoms, like loss of side vision, you should see your ophthalmologist.

How are floaters treated?

Although annoying, floaters are usually not vision threatening and do not require treatment. Often floaters diminish and become less bothersome with time. If a floater appears directly in the line of vision, moving the eye around will help. Looking up and down or back and forth will cause the vitreous fluid to swirl around and often allows the floater to move out of the way. With a complete eye examination, it can be determined if the floaters are harmless or the beginning of more serious problem.
In cases where floaters do indicate a more serious condition, a laser can be used to prevent vision loss. Laser Floater Removal (LFR) also known as Vitreolysis, is an out-patient, painless treatment and may prevent more serious conditions, such as retina detachment.

What are flashes?

Flashes appear as flashing lights of lightning streaks in the field of vision although no light is actually flashing. Flashes are similar to the sensation of “seeing stars” when one is hit on the head. Flashes are most often noticed at night or in the dark room.

What causes flashes?

Flashes are caused by the vitreous gel tugging on the retina. If the gel actually separates from the retina (posterior vitreous detachment), flashes of light may appear periodically for several weeks. As with floaters, flashes are usually the result of the aging process and do not indicate a serious vision problem. However, flashes which appear along with a large number of new floaters or with a loss of part of the field of vision may indicate retinal detachment, requiring an immediate eye exam.

Flashes and migraines

Flashes can also occur in association with migraine headaches. A migraine is caused by a spasm of blood vessels in the visual information center of the brain. Migraine related flashes distort central vision for ten to twenty minutes and appear as jagged lines or “heat wave” in both eyes.

How are flashes treated?

Unless they represent the symptoms of a more serious condition, flashes do not require treatment. Flashes which are a result of the vitreous pulling away from the retina will eventually stop. However, flashes may indicate retina detachment, which needs immediate medical treatment. Migraines, which are often accompanied by flashes, can be treated with medical therapy if they occur frequently and are debilitating.

Prevention is the best medicine

Although floaters and flashes are usually not considered serious vision problems, one should have a complete eye examination to determine their importance. In most cases, treatment is not necessary. However, early detection and treatment of serious problems such as retinal tears, can prevent permanent vision loss.

LFR Laser Floater Removal

Treatment of Eye Floaters

What is LFR?

Also known as laser floater removal or vitreolysis, LFR is a non-invasive procedure that can eliminate the visual disturbances caused by eye floaters. The goal of LFR is to achieve a “functional improvement”. That is, to allow you to return to “normal” day-to-day activities without the hindrance of floaters.

How does LFR work?

LFR involves the application of nanosecond pulses of laser light to evaporate the vitreous opacities and to sever the vitreous strands. During this process, the floater’s collagen and hyaluronin molecules are converted into a gas. The end result is that the floater is removed and/or reduced in size.

What happens during the procedure?

LFR is performed as an outpatient procedure at the ASC (Ambulatory Surgical Center). Prior to the procedure, your eye surgeon will administer anesthetic eye drops to provide mild anesthesia. A contact lens will be placed on your eye, with the laser light delivered through a specially designed microscope. During treatment, you will likely observe small, dark specks/shadows- signaling that the floaters are being evaporated into small gas bubbles. These gas bubbles quickly dissolve and reabsorb into the vitreous.

What can I expect after treatment?

After the treatment, your eye surgeon may treat your eyes with anti-inflammatory drops. You may observe small, dark specks in your lower field of vision immediately following treatment, but these small gas bubbles will quickly dissolve. It is also important to note that some patients may experience mild discomfort, redness or temporarily blurred vision directly following treatment. A treatment session typically takes 20-60 minutes to perform and some patients will need to undergo two treatment sessions in order to achieve a satisfactory result.

Complications & side effects

Reported side effects and complications associated with LFR are rare. Side effects may include cataract and intraocular pressure (IOP) spike. Retinal detachment has been reported rarely.

What if LFR doesn’t work for me?

Clinical studies have shown that LFR is a safe, effective treatment in the majority of patients. If floaters persist, however, your ophthalmologist may recommend surgery.