The back layer of the eye, the retina, is a thin layer of nerve cells that help us to process visual information and see. Just anterior to the retina, lies a large ball of jelly called the vitreous which is free floating but attached to the retina on its back side.
Floaters:
the shadows that the retina senses and we see when light bounces off of strands in the vitreous
Flashes:
the visual sensation that is created when the vitreous moves and pulls on the retina at its attachments
Causes:
- vitreous movement
- posterior vitreous detachment (PVD): during our lifetime, it is normal for the vitreous to separate from the retina, when this occurs, patients can experience a sudden onset of floaters
- retinal tear or detachment:
Symptoms:
- sudden onset of spots floating in vision
- blurry vision
- light sparks or spots often occurring in peripheral vision, last a few seconds at a time
Diagnosis:
A prompt eye exam involving vision testing, visual field testing, and dilation is very important in ruling out the more serious consequences of flashes/floaters. This is especially important if the patient is near-sighted as they are at increased risk of developing retinal complications. Your ophthalmologist should examine the entirety of the retina with a lens that allows them to locate a PVD or any retinal tear or detachment. |
Treatment:
PVD: if a vitreous detachment is found, it is important to ensure that a retinal tear or detachment did not occur simultaneously; if there is a PVD alone, only observation is recommended, and a dilated eye exam is repeated in 2-4 weeks
Retinal Tear:
If the traction from the vitreous has caused a small tear or hole to develop in the retina, prompt medical attention from a retina specialist is necessary who will use laser treatment in the clinic to seal the retina in the area of the tear to prevent detachment; this is done with anesthetic drops and usually takes less than 30 minutes to perform
Retinal Detachment:
The most serious consequence of vitreous traction on the retinal is a detachment. This occurs when fluid inside the eye has the opportunity to enter a hole or tear, track behind the retina, and pull it off of the very back of the eye. Without an intact retinal layer, the patient can not see. If this has occurred, retinal surgery is necessary in the OR and is carried out immediately or within a few days of the diagnosis. |
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