Health Watch Flashers, floaters could portend trouble
Flashing lights and floaters at the corner
of the eye are a fairly common occurrence for aging adults. Flashers
and floaters can be benign and relatively harmless, or they can herald
a significant pathological process in the back of the eye, which left
unchecked can lead to loss of vision or major surgery. The only way to
know if flashing light or floaters in your field of vision are benign
or significant is to have a doctor dilate your eyes and examine them
thoroughly.
What's happening in my eye to cause
flashing light?
The inside of the eye, behind the pupil, is
filled with a clear, vitreous jelly. Normally this jelly is attached
to the inside lining of the eye, called the retina. Because the jelly
is clear we don't notice it; however, for various reasons the
consistency of the jelly may begin to change and start to pull on the
retina. This traction on the retina, which is painless, sends a
sensation of light to the brain that we see as flashers. People
typically describe these as non-colored sparkles of light in one
corner of the field of vision, usually affecting one eye.
When are flashers benign?
When the vitreous jelly inside the eye tugs
on the retina causing flashers, the preferred outcome is that the
vitreous lets go or detaches from the retina. When this occurs, people
often notice a floater in the eye.
What are floaters?
Floaters are made of dense pieces of
vitreous, clusters of glial cells that support the retina's health, or
blood cells. These tiny bits of matter float in the vitreous jelly,
casting a shadow on the retina, which the brain perceives as a
floater. As we move the eye, the floater moves. People describe them
as looking like little bugs, cobwebs, doughnuts, tadpoles or
fishhooks.
Floaters are an annoyance; they can drift
around in the field of vision for a long period of time. Most people
successfully learn to ignore them; eventually many floaters drop down
out of the field of vision. There is, at this point in time, no safe
procedure offered to remove floaters.
Who is at risk for vitreous detachments?
Risk increases with age because the jelly
inside the eye changes with the aging process. About 25 percent of
people between 60 and 70 years of age have vitreous detachments. In
the population over 70 years old, about 65 percent experience vitreous
detachments. Other risk factors for vitreous detachment include people
who are nearsighted and anyone who has suffered blunt trauma to the
eye or eye surgery.
When are flashers more serious?
Flashers in the eye can be quite
significant when the vitreous jelly inside the eye tugs on the retina
and instead of detaching from the retina, causes a tear in the retina.
This is serious because a tear can progress to full retinal
detachment, causing loss of vision.
How is a retinal tear treated?
If a retinal tear is discovered
immediately, before retinal detachment occurs, the ophthalmologist can
perform laser treatment in the office. This procedure, which is
painless, involves using a small laser beam to create scars around the
retinal tear. This seals and contains the tear and typically prevents
it from progressing to a full retinal detachment. When retinal
detachment occurs, major ophthalmologic surgery is required to attempt
to reattach the retina.
Do flashing lights in the field of vision
always indicate eye problems?
No, flashing lights are not always ocular
in origin. People experiencing a TIA (a transient ischemic attack,
which may be an early warning sign of impending stroke) sometimes
report flashing lights. Migraine headaches and other intracranial
processes can also cause light flashes in the field of vision.
If you do see flashing lights, don't be
overly alarmed because they are quite common and often benign. But do
see your doctor as soon as possible to rule out a retinal tear. He or
she will want to you again in a few weeks for a follow-up visit.
Dr. Schwartz is board certified in
ophthalmology and is fellowship trained in pediatric ophthalmology. He
is a member of the medical staff of Cayuga Medical Center and treats
both pediatric and adult patients. His practice is located at 2333
Triphammer Road in Ithaca and he can be reached at (607) 266-7600. Dr.
Schwartz graduated with distinction from Cornell and went on to the
Mount Sinai School of Medicine in New York, where he also graduated
with honors. Following his ophthalmology residency at Mount Sinai, Dr.
Schwartz went to Children's Hospital of Michigan for a fellowship in
pediatric ophthalmology. Health Watch appears on alternating Thursdays
in The Journal.
Originally published November 9, 2006
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