When patients experience and see "dots" or "lines" or "spiderweb" like symptoms in their vision, or see bright lights in the shape of an arc in their peripheral field of vision, it is called floaters and flashes, respectively.

Floaters and flashes can be due to a normal aging process of the vitreous gel in the eye, called syneresis or posterior vitreous detachment. However, a more serious condition called a retinal tear or retinal detachment can also cause the same symptoms. Inflammation inside the eye, called iritis or uveitis can also cause floaters. Bleeding inside the eye, called vitreous hemorrhage, can also cause floaters.

The center of the eye is filled with a gelatinous material called the vitreous. As we age, structural changes occur in the vitreous gel, where pockets of the firm gel change to a more liquid like quality (syneresis).

As this process continues, the layer of the gel which is attached to the back part of the retina separates causing sudden symptoms of floaters or flashes in many patients, this is called posterior (back part of the eye) vitreous detachment (not retinal detachment – as this differentiates the layer that separates and carries a much different prognosis and treatment management), aka PVD. PVD occurs in all eyes but symptoms can vary from eye to eye and from person to person. Although the PVD itself is not harmful, in some cases the vitreous gel pulling away from the retina can cause a retinal tear or detachment, which is very serious due to the high risk of vision loss. Therefore, it is important to have a retinal exam when symptoms of PVD occur.

Some patients experience floaters, described as little circles or strands that appear in your vision. These are tiny cells inside the vitreous gel body. Some floaters are benign and caused by natural structural changes that occur in the vitreous gel. However, it is important to determine the cause of the floaters, as these can be signs and symptoms of serious retinal or uveitis conditions, requiring prompt attention and treatment.

Common Questions

Yes. In a majority of patients, these signs occur due to a natural aging process in the eyes. The vitreous gel starting to separate from the retinal layer can cause these symptoms. However, a more serious condition called a retinal tear or retinal detachment, as well as several other causes, also occurs with the same symptoms. Therefore, it is very important to have your eyes examined right away for these symptoms.

Floaters attributable to structural changes in the vitreous gel are benign and can appear less bothersome over time - varying from 1 month to over 6 months in some individuals. This occurs due to neuroadaptation, where our brain "tunes out" the floaters and pays less attention to it. It can also occur as the floater settles away from the central area to more peripheral areas.

However, floaters due to other causes, such as bleeding inside the eye (vitreous hemorrhage), or retinal tear or detachment, or due to intraocular inflammation (uveitis) need immediate attention and treatment.

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