 Central Florida Retina Institute, Specializing
in diseases and surgery of the retina, macula, and vitreous,
 877-245-2020
Retina FAQs | Glossary
of Ophthalmologic Terms | Description
of a Retina | Diabetic
Retinopathy | Epiretinal
Membranes | Flashers &
Floaters | Macular Degeneration
| Macular Holes | Retinal
Detachment | Retinopathy
Of Prematurity | Clinical Trials
Q: What causes light flashes?
A: Light flashes are sometimes
caused by mechanical stimulation of the retina, often referred
to as "pulling", "forces", or "traction".
Q: What can cause this pulling on the retina?
A: A variety of conditions can
cause it, including:
• posterior vitreous separation,
• retinal tears (breaks), and
• scarring on the surface of the retina.
Q: Symptoms of Flashes
A: Some macular disease patients
experience flashes in the central field of vision (straight ahead
vision). Patients with successfully repaired retinal tears and
detachments may have flashes for many months.
Migraine can cause a jagged
and flickering area of blocked vision with bright borders. It
typically starts near the center of the vision and progresses
to the peripheral vision before disappearing after about 30 minutes.
This phenomenon is followed by a headache in only 50% of cases.
Although patients describe this as occurring in one eye, in fact
it occurs in the corresponding sides of the visual field in both
eyes, as can be determined by covering one eye followed by the
other when these are occurring.
Q: I thought that only retinal breaks cause
light flashes. Not true?
A: Actually the most common
cause is the vitreous humor pulling away from the retina. This
happens in over 70% of the population as part of the normal aging
process, or for other reasons that are not well understood at
this time. It is usually accompanied by "floaters",
which represent condensations of the vitreous jelly. By comparison,
retinal breaks occur in approximately 6% of the population, and
retinal detachments in about 0.06%. Light flashes occur in all
three conditions.
Q: Can light flashes be caused by forces
not related to the retina of the eye?
A: Yes.
Migraines are thought to be
caused by blood flow disturbances to the visual part of the brain.
Blood flow problems can also occur with cervical spine problems,
inflammation of the optic nerve, and hardening of the arteries,
as well as very low blood pressure. Low blood pressure can cause
people to see stars or specks of light, particularly if they
change position quickly. An example would be standing quickly
from a sitting position or rising quickly after stooping or bending
over. Pregnancy related high blood pressure (pre-eclampsia) can
also cause light flashes.
Q: Description for Floater
A: Floaters are relatively transparent,
vague, usually curved objects that are seen best when looking
at a white piece of paper, blue sky, light colored ceiling, or
wall. They sometimes look like cobwebs, worms, rings, dots, or
specks. Eye movement makes floaters more visible as they swirl
about like seaweed in the ocean surf.
Because flashes and floaters
are sometimes caused by retinal breaks, both eyes should have
a dilated retinal examination as soon as possible when flashes
or floaters develop in either eye.
Q: Symptoms of Floaters
A: Floaters are usually not
detectable by visual testing unless they are very severe.
Q: What is the most common cause of floaters?
A: They are usually caused by
a clumping of pre-existing vitreous fibers in the eye. Therefore,
doctors usually refer to them as vitreous condensations.
Q: Can floaters cause total blindness?
A: No, only a slight blockage
of the vision at worst.
Importantly, floaters can be
related to retinal detachment or a variety of vascular conditions
such as diabetic retinopathy, which can result in blindness if
not treated.
Q: Can light flashes cause total blindness?
A: No, but flashes can be related
to retinal tears (breaks) or detachment, which can result in
blindness if not treated.
Q: How common are flashes and floaters?
A: Very common. Over 70% of
the population experiences these problems.
Q: What are some of the other causes?
A: Some floaters are red blood
cells or blood clots on the surface of the retina or floating
in the vitreous. Blood cells in the vitreous may occur with some
retinal tears but do not necessarily indicate a tear. Occasionally,
the vitreous can pull on a blood vessel on the surface of the
retina and cause bleeding without causing a tear of the retina.
Vascular disorders such as diabetic retinopathy and sometimes
vein occlusion can cause bleeding in the back of the eye.
Rarely, floaters may be inflammatory
in origin. Diseases such as pars planitis and uveitis can cause
the formation of clumps of white blood cells (cells that the
body produces when there is inflammation).
In 5-30% of cataract surgery
procedures a thin layer of tissue forms behind the intraocular
lens implant causing a decrease in vision. A YAG laser is then
used to make an opening the lens capsule which usually results
in better vision, but can also cause floaters.
Q: Are eye strain, nutrition, general health,
smoking, or emotional stress related to flashes and floaters?
A: No, there is no known relationship
between flashes or floaters and any of these problems.
Q: If one eye develops flashes or floaters
will the other develop them as well?
A: Very likely: in the case
of a posterior vitreous separation, it is very common for the
same condition to occur in the second eye within a year.
Q: What is the treatment for flashes and
floaters?
A: If light flashes are due
to a posterior vitreous separation and no retinal breaks (tears)
are found on careful examination with the pupil dilated, no treatment
is necessary. If tears are found by the doctor, laser or occasionally
freezing (cryo) treatment is needed.
A vitrectomy can be used to
remove floaters but is very rarely indicated.
Q: What are the criteria for vitrectomy
to remove floaters?
A: Marked persistence of blocked
vision may very rarely indicate a need for a vitrectomy. The
vast majority of patients with floaters do not need vitrectomies.
If the doctor makes the patient
aware of the problem but the patient does not notice any major
visual difficulties, vitrectomy is definitely not indicated.
If the problem significantly
affects the patient's ability to work, drive, read, see medicine
labels, or other critical activities, vitrectomy may be considered.
The doctor must make certain
that there is no other cause of visual loss such asmacular degeneration,
macular hole, nearsightedness, farsightedness, astigmatism, Epiretinal
membranes, cataract, amblyopia ("lazy eye"), previous
retinal detachment, or circulatory problems.
Q: Is there a medication or eye drop for
the treatment for flashes or floaters or is vitrectomy the only
option?
A: No, there is no medicine,
eye drop, vitamin, herb, or diet that is beneficial to patients
with flashes or floaters.
Q: Is there a laser treatment for floaters?
A: No, only vitrectomy can remove
floaters. YAG and other lasers have been used to treat floaters
but there is no scientific evidence that laser treatment is safe
or effective.
Q: Do floaters ever disappear without vitrectomy?
A: If the floaters are due to
blood cells, they will typically disappear.
Most floaters are condensed
vitreous collagen fibers and never completely disappear but they
become much less obvious over time.
Q: How long does a vitrectomy take?
A: The procedures take about
twenty minutes.
Q: Is the vitrectomy performed on an inpatient
or outpatient basis?
A: The vitrectomy is performed
on an outpatient basis in all cases unless there is a medical
reason to be in the hospital.
Q: What is the success ratef for removal
of floaters by vitrectomy?
A: The success rate for removal
of floaters by vitrectomy is over 98%
Q: Are there any complications?
A: There can be: there is a
significant incidence of cataract progression after vitrectomy.
Some doctors believe that patients with an absolutely clear lens
develop cataracts as a result of vitrectomy. The vast majority
of patients requiring vitrectomies for floaters already have
nuclear sclerotic cataracts (yellowing of the center of the lens),
which usually worsens after vitrectomy.
Retinal detachment can occur
after vitrectomy and other eye surgery performed for any reason,
including floater removal. Opinions vary widely on the frequency
of retinal detachment after vitrectomy for removal of floaters
but 1% is a reasonable estimate.
If you have
any further questions about the service provided by Central Florida
Retina Institute or if you would like to make an appointment,
please call (863) 682-7474 or call toll-free at 877-245-2020.
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