This is a common complaint in patients.
Cause: The cavity of the eye is filled with a jelly like material called the vitreous. During the ageing process this material liquifies and shrinks and eventually collapses like scaffolding in the cavity of the eye.
This leads to the symptoms:
This is of split second duration and is often described as an “arc” of light. It is more pronounced under dim light conditions or when a patient moves from light to dark conditions or dark to light conditions. Eg. Turning on the light switch.
This describes little shapes in the visual field. They may be solitary or multiple floaters. Common descriptions include: cobwebs or veil, fly or insects, hair.
This occurrence will occur to all of us over time. In 90% of cases when it occurs, there are no problems that arise. In 10% o cases, the vitreous is firmly attached to the retina. (This is the layer of the eye that captures light and tells you what you are seeing). When it collapses it tugs on the retina leading to a hole or tear on the retina. This can lead to fluid entering the tear and detaching the retina from the wall of the eye (retinal detachment). Untreated, a retinal detachment can lead to blindness.
Risk Factor for Retinal Detachment:
- Myopia: short sightedness is a risk factor. The greater the degree, the greater the risk.
- Family History: A family history of retinal detachment increases the risk.
- Trauma: Blunt injury to the eye increases the risk/
- Retinal Tear or Detachment in Other Eye: If there is a previous history of a retinal tear or detachment in the other eye, then the risk is greater.
Take Home Points:
- Most patients (>90%) will not have problems from this.
- A small percentage can develop retinal tears. Early detection and laser treatment can
- prevent a retinal detachment occurring.
- Early detection and treatment of retinal detachment has been shown to improve visual results.
- The flashes should diminish over time. In some cases this can take months. If the flashes occur under dim light conditions only, then there is little to worry about.
- Floaters on their own will usually not compromise your vision. They are of “nuisance” value. In most cases, patients become less aware of them over time. In selected cases where it is significant and remains a problem, surgery to remove the floaters can be arranged.
- Your eye specialist will examine your eye closely after pupil dilatation. If no tears or bleeding are found he will schedule another look in 4 to 6 weeks. If this examination is normal, then the risk of further problems is minimal.
- Retinal Tear: If a retinal tear is found, then laser surgery is required. A laser is used to “spotweld” the retinal. This causes scarring around the tear thus preventing fluid passing through which could lead to a retinal detachment. Laser does not reduce the number of floaters present.
- Retinal Detachment: If this is present, then surgical repair will be required. This is performed as a day surgery procedure.
Retinal Detachment Symptoms:
Patients describe a defect in their visual field. This is described as a “shadow” and often involves the peripheral field initially and is fixed.