Flashers and Floaters are something that most people experience due to deterioration of the vitreous gel inside the eye.  This can result in a vitreous detachment, which can be perfectly normal or a surgical emergency.

Floaters or black dots floating in the vision is something that most people experience.The vitreous is a clear gel-like substance, which fills the central two thirds of the eye. Due to time [aging] and sunlight damage the vitreous deteriorates.

The vitreous has many functions including:

1) maintenance of the shape of the eye
2) a shock absorber
3) allowing transmission of images and light to the retina and
4) supporting the retina.

The vitreous is normally in contact with the retina.


Anatomy of the eye


It is located between the lens and the optic nerve.



In time, the vitreous will pull away from the retina and shrink in to the central part of the eye. This event constitutes a posterior vitreous detachment (PVD) and is an aging process. The vitreous provides a measure of structural stability to the eye and particularly the retina.  When the vitreous detaches, there may be a stronger attachment as is shown in the above picture.  The vitreous traction with the traction can cause the retina to rip and tear and this is a surgical emergency.




Light Flashes, Vitreous Floaters, Retinal Concerns


What are the Symptoms ?


1) Floaters:

The appearance of floaters can be very alarming. They are shadows from debris floating inside the vitreous.


Vitreous jelly broken free from adhesion to retinal surface can cause floaters, lines and flashing lights


The debris can be from the normal aging changes of the vitreous. It can also represent bleeding and even a retinal detachment.


2) Lightning Flashes:

Lightning flashes are from the vitreous tugging on the retina. The retina is stimulated by tension which results in light flashes.




3) Decreased Vision:

Can occur secondary to bleeding inside the eye or retinal detachment. Early on, central vision may be normal but slowly some patients note a progressive “curtain, veil, or fog” which may obscure peripheral then central vision.




Will I have a Posterior Vitreous Detachment-PVD ?

Most people will have a posterior vitreous detachment. It commonly happens in healthy eyes.




Additional events, which may lead to a PVD include

1) a history of eye surgery,

2) myopia

3) inflammation,

4) injury to the eye, and

5) bleeding inside the eye.



Light Flashes, Vitreous Floaters, Retinal Concerns:  Posterior Vitreous Detachments Dangerous?

For the majority of those who have a PVD, there is no danger involved.

Up to 15% of those with a symptomatic PVD have an associated retinal tear.

Up to 50% of patients with one or more risk factors and a symptomatic PVD will develop a retinal tear.

A retinal tear can lead to a retinal detachment.



Unfortunately, the symptoms of a vitreous detachment without an associated retinal tear are often the same as those with a tear. The diagnosis of a retinal tear is only made with a dilated retinal examination.



When is it important to be examined?

If a retinal tear does occur , it usually happens at the same time that one begins to experience symptoms. It is important to be examined shortly after these symptoms begin.

A small percentage of patients may develop a retinal tear many weeks after the onset of symptoms.



For this reason, Dr. Duplessie will request that you return for a repeat examination.



If a PVD has occurred without a retinal tear, no treatment is necessary. The floaters will usually become less and less noticeable. With time, most people’s symptoms disappear entirely.


If a retinal tear has occurred, Dr. Duplessie will recommend treatment which may include laser treatment and or surgery. The prognosis is excellent with early diagnosis.