Retinal Tears and Detachment
When people reach middle age, the clear jelly-like fluid that fills the inside of your eye may start to liquify and shrink. The vitreous gel will eventually pull away from the back wall of the eye, causing a posterior vitreous detachment (PVD). This condition naturally occurs when people reach their late 50s or early 60s, but sometimes earlier or later in life. It can happen earlier in people who:
- Are nearsighted
- Have had cataract surgery
- Have had laser surgery
- Have had inflammation inside the eye
PVDs often cause symptoms of new floaters in the vision and flashing of lights. Sometimes these symptoms can indicate problems such as retinal tears or detachments.The appearance of flashing lights or floaters may be alarming, especially if they develop suddenly. While not all floaters and flashes are serious, you should have a medical examination by an eye care specialist to make sure there has been no damage to your retina.
What causes the flashing lights?
When the vitreous gel pulls on the retina, you may see what look like flashing lights or lightning streaks. The flashes of light can appear off and on for several weeks or months. If you notice the sudden appearance of unexplained light flashes, however, you should visit your eye care specialist immediately to see if your retina has been torn.
What causes floaters?
Sometimes you may see small specks or clouds moving in your field of vision. They are called floaters. You can often see them when looking at a plain background, like a blank wall or blue sky. Floaters are actually tiny clumps of debris inside the vitreous, 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 different shapes: little dots, circles, lines, clouds or cobwebs. Many people have subtle floaters for most of their lives. If you suddenly develop new or more prominent floaters, however, it can indicate a problem and should be evaluated by an eye doctor.
What can be done about floaters?
Floaters can get in the way of clear vision, which may be quite annoying, especially if you are trying to read. You can try moving your eyes, looking up and then down to move the floaters out of the way. While some floaters may remain in your vision, many of them will fade over time and become less bothersome. Even if you have had some floaters for years, you should have an eye examination immediately if you notice new ones. Rarely, floaters can be removed with surgery if they are significantly affecting the vision.
Are flashes and floaters ever serious?
Your retina can tear as 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 eye care specialist right away if you:
- Notice an increase in floaters or cobwebs
- See sudden flashes of light
- Experience a sudden loss of your central or side vision
If you are found to have a retinal tear there is a chance that your retina will detach, leading to potentially significant permanent vision loss. If necessary, retinal tears can be treated with laser in the clinic to reduce the chance of further vision loss.
Retinal detachments can cause significant vision loss. If you develop a retinal detachment you will likely need surgery. Most retinal detachments are treated in the operating room. Often, vision can be maintained or partially restored with surgery.
Visit the American Academy of Opthalmology’s webpage on Retinal Detachment.