Definition and Overview

Flashers and floaters are the streaks of light or murky images that appear in the field of vision. To be more specific, floaters are the ones that appear to be specks or threads. It may also feel as if the eyes are seeing cobwebs. Flashers, on the other hand, are sudden bursts of light that can be detected by the visual field.

A person can have both or one of them. Although they are usually considered harmless, they should not be taken for granted as they can be a sign of eye disease, as they relate to the vitreous membrane and may be affecting the retina.

To understand the role of the retina, it is essential to know how the eyes work. The eyes have a thin covering in the front. The cornea is also on the front part of the eyes and is responsible for bending the light to allow it to enter the eyes. The light then goes through more bending until it reaches the retina, which is found at the back of the eyes. The retina is composed of multiple layers of thin tissues. It also has rods and cones that convert the light into signals that can be interpreted by the brain.

Near the retina is the vitreous membrane, which is composed of more than 95% water, although it is often described as a jelly-like substance. It is also made up of layers of collagen, a type of protein that helps maintain the shape of the eyes.

When you have floaters, it means that you have clusters of cells that are literally floating inside, not on the surface, of the eyes. These cells create shadows that are detected by the retina, which is then interpreted by the brain in different shapes. Meanwhile, flashes occur once the gel begins to separate from the eye wall or rubs on the retina.

Causes of Condition

It is unclear what exactly causes flashers and floaters. The only explanation is that the vitreous membrane begins to pull away or detaches itself from the retina. However, there are major risk factors.

The biggest risk factor for floaters and flashers is aging. As a person ages, numerous changes can occur in the eyes. For example, macular degeneration is a common disease associated with age. In this situation, the macula of the eyes begins to get damaged that a person begins to lose central vision.

When it comes to floaters and flashers, the vitreous gel or membrane begins to shrink, and it normally begins once the person is already in the middle age. Aside from shrinking, it also slowly detaches from the retina. Sometimes the gel rubs on the retina, in which a person sees streaks of light or flashes.

The condition is also often diagnosed on people who are:

  • Nearsighted – also referred to myopia, it is a refractive error characterized by a person’s inability to see far objects clearly. It affects the cornea, in which it is elongated so the light is not properly focused on the retina.

  • Injury – An injury that affects the eyes can lead to the sudden tearing of the retina, which may then result in the patient seeing specks of dots or threads.

  • Inflammation – Inflammation can be caused by a number of factors including bacterial or viral infection, as well as injury to the eye.

  • Surgery – A person who has undergone cataract or laser surgery is also predisposed to flashers and floaters as it may cause injury including the detachment of the gel or the tearing of retina.

Key Symptoms

  • The appearance of dots, clouds, and different small shapes in the field of vision
  • Sudden appearance of a flash of light
  • Increased frequency of flashers and floaters
  • Increase in the sizes of the flashers
  • Sudden blurred or reduced vision
    Usually, the flashers and floaters appear intermittently. If they appear more frequently and you have any of the risk factors, it’s best if you approach an ophthalmologist immediately to ensure that there’s no tearing of the retina.

Who to See and Treatments Available

The best person to diagnose the problem is an ophthalmologist, primarily someone who subspecializes in vitreous or retina disorders.

During the consultation, the ophthalmologist will want to know:

  • The symptoms experienced
  • The degree of seriousness of the symptoms
  • The frequency of the symptoms
  • Whether the symptoms are sudden or occurring over time (when the flashers and floaters are sudden, it’s important that medical care is sought immediately)
  • History of eye disease or problems in vision
  • Surgeries undergone
  • Age and medical history
    The ophthalmologist will also determine the condition of the vitreous gel. The doctor will drop a special liquid on the eye to cause dilation. Using a special instrument, the doctor can then observe the retina and the vitreous membrane, which are found behind the eyes. Anyone who has dilated eyes should be accompanied by someone who can drive them home. If the result is inconsistent, the doctor may request an eye ultrasound.

When it comes to treatment, the following approaches may be undertaken:

  • Wait and see – In some cases, the ophthalmologist doesn’t do anything but closely monitors the issue regularly. This is because flashers and floaters can disappear on their own. There are also times when the doctor may consider the problem as harmless.

  • Surgery – A surgery known as vitreoretinal surgery is performed on the vitreous membrane. The surgeon removes the gel-like substance in the eyes to eliminate the object that may be obscuring the vision. The surgery can also be conducted to treat other eye diseases such as diabetic vitreous hemorrhage that can lead to the buildup of blood in the membrane, age-related macular degeneration, and detached retina.

  • Drugs – Drugs are usually given to treat the underlying conditions that are causing floaters and flashers. For example, if the doctor detected an increased pressure on a blood vessel, which may bleed and disturb vision, drugs in the form of eye drops may be used to reduce it.

  • Sebag J, Yee KMP. Vitreous:from Biochemistry to Clinical Relevance. In: Tasman W, Jaeger EA, eds. Duane's Foundations of Clinical Ophthalmology. 2013 ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2013: vol 1, chap 16.

  • Crouch ER Jr, Crouch ER, Grant TR Jr. Ophthalmology. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 41.

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