On Floaters And Flashes

 

THE THREE MAJOR SYMPTOMS OF MACULAR DEGENERATION

 

29% VISUAL DISTORTION

22% BLURRINESS OF VISION

13% "SPOT" IN FIELD OF VISION

 

 

 

On Flashes & Floaters

(nearly NEVER related to symptoms of age related macular degeneration)

 

 

 

Contact your eye care professional immediately if you notice any of these warning signs:

 

	Flashing lights
	Sudden onset of new floaters
	Gradual shading of vision from one side (like a curtain being drawn)
	Rapid decline in sharp, central vision

 

 

Seeing things?  Usually it’s just the harmless “stuff” of age-related eye changes, but occasionally it’s a sign of something more serious.

 

The eyes change as we grow older.  Some changes set the stage for serious eye problems, such as macular degeneration and glaucoma.  But others are more annoyances than medical problems.

 

Many older people notice visual phenomena called floaters...   shapes like dots, clouds, threads or cobwebs...   drifting across their line of vision.

 

Occasional flashes of light are also common.  Floaters and flashes are usually harmless, but occasionally, they indicate a retinal tear or worse, a retinal detachment, which can lead to vision loss.

 

An egg white-like substance called vitreous humor or fluid (or simply the vitreous) fills about 80 percent of the eyeball, a space called the vitreous cavity, and helps to maintain its round shape.  Floaters are tiny clusters of cells, flecks of protein or bits of gel lodged in the vitreous.  What you actually see is the shadow these little clumps cast on the retina.  Floaters move as your eyes move and seem to dart away when you try to look at them.  Most tend to settle below the line of sight, although they don’t go away completely.  They’re usually most noticeable when you’re looking at something bright.  The vitreous is a gel made mostly of water held together by an arrangement of collagen fibers and hyaluronic acid molecules.  Some floaters are remnants of embryonic vitreous, but most arise from normal changes that occur with aging.  Over time, the vitreous shrinks, tugging on the retina and stimulating photoreceptors that cause flashes.  The pulling may also cause tiny amounts of bleeding, which appear as floaters. Sometimes the vitreous becomes separated from the retina, an event called posterior vitreous detachment.  A PVD can trigger a new onset of floaters and sometimes flashes in the peripheral vision.  PVDs are uncommon before age 50 but occur in more than 60 percent of people over age 70.  They are also more common in people who are nearsighted (myopic) or who have had cataract surgery, an eye or head injury or inflammation within the eye. Vitreous detachments usually take a week or more to develop.  Usually they don't threaten vision, but in 15 percent of cases, they lead to a retinal tear, which in turn may cause a retinal detachment; so if you suddenly see flashes and notice a new onset of floaters, see your eye care professional for a thorough eye exam.  Even if he or she finds no problems, your eyes should be re-examined in four to six weeks...   earlier, if symptoms increase.

 

When the vitreous pulls with enough force to cause a tear in the retina, vitreous fluid can then leak through the hole, detaching the retina from the underlying tissue that nourishes it.  A retinal detachment is quite serious, so it’s important to recognize the symptoms.

 

Retinal tears don’t always cause symptoms, and fortunately, those that don’t are less likely to lead to retinal detachment.  But when they do (as they may with PVDs), early treatment is important to prevent the development of a full-blown retinal detachment.  Studies suggest that such detachments occur in 30 to 55 percent of people who have a symptomatic tear and that preventive treatment reduces the risk to 1 to 12 percent.

 

An ophthalmologist will check for retinal tears by dilating the pupil and examining the internal surfaces of your eye with an indirect ophthalmoscope.  Because the underlying problem can cause a tear in the other eye as well, he will want to examine both eyes.

 

Retinal tears can be repaired in the office with one of the following techniques:

 

Laser photocoagulation:  In this procedure, the ophthalmologist numbs the eye with topical anesthesia (usually anesthetic eye drops) and uses pinpoints of laser light to create tiny burns around any small holes or tears in the retina.  The resulting scar tissue forms a barrier, welding the retina to the back wall of the eye so that it’s less likely to become detached.  Patients can return to normal activities in about four days.

 

Cryopexy:  This is a freezing treatment, which works as spot welding for the eye and is also performed under topical anesthesia.  It creates an adhesion that reduces the chance a tear will turn into a detachment.  It can be used when the tear would be difficult or impossible to teach with a laser.

 

 

 

 

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