Flashes, Floaters and Posterior Vitreous Detachment
What is the Vitreous?
The vitreous is a jelly-like substance that fills the inside of the eye. The vitreous is normally connected to the retina, which is situated at the back of the eye. The retina is a specialized layer of nerve cells that allows vision to be carried to the optic nerve, and ultimately, to the brain for interpretation.
What is a Posterior Vitreous Detachment?
As we age, the vitreous, which is made of a collagen protein structure, slowly changes from a primarily gel-like consistency to more of a liquid-like consistency. Sometimes, this change in consistency can cause the vitreous to pull away from the retina, referred to as a posterior vitreous detachment (PVD). PVDs can also occur in response to trauma, inflammation in the eye, or in younger patients who may be very near-sighted. Typically, when PVDs occur we see this as intermittent flashing lights, floaters, cobwebs and sometimes a shower of black spots.
It is important to note that a PVD, or posterior vitreous detachment, and a retinal detachment are NOT the same. A PVD occurs when the vitreous pulls away from the retina. When a PVD occurs, bleeding can possibly occur and as the vitreous gel pulls away, it might cause holes or rip tears in the retina. A retinal detachment occurs when the retina is separated from the back of the eye wall. This will occur when a retinal hole or a retinal tear allows the fluid to pass behind the retina. A good way to describe this is when water gets under a sheet of wallpaper, it peels the wallpaper off the wall. A retinal detachment is a very serious sight-threatening condition often requiring a major surgical procedure to repair. In many cases, this is an emergency that requires urgent treatment.
What are floaters?
Floaters may look like small dots, clouds or lines moving around in your field of vision. These “floaters” are actually small clumps of cells floating inside your eye, within the vitreous. Floaters are usually most noticeable when you are looking at a plain background such as a clear blue sky or a blank computer screen.
What are flashes?
Flashes may appear like streaks of lightning across the field of vision. When the vitreous tugs at the retina, it can cause disorganized visual signals to be sent to your brain. We interpret these disorganized signals as seeing light. Flashes, in contrast to floaters, are usually most noticeable in dim lighting.
What are the treatments for a PVD?
Currently, there are no treatments for Posterior Vitreous Detachments. Most of the time, PVDs are not concerning, unless they develop an associated retinal tear. Associated retinal tears only occur about 10-15% of the time and are concerning because they can increase the chance of developing a retinal detachment with resulting damage to the vision. Therefore, once you have been diagnosed with a PVD, it is important to undergo complete retinal exams to screen for retinal tears. A laser treatment may be offered, which can be done in the office to seal down the tear.
Do floaters or flashing lights go away?
Floaters and flashes are often more bothersome than they are dangerous. Because they can get in the way of seeing things clearly, flashes and floaters can become quite annoying. Most of the time, however, they resolve or become less noticeable over time. Even if you undergo laser treatments, these do not change the presence of flashing lights or floaters.