Flashes and Floaters in Your Eyes: When to See the Doctor

Do you ever see something drifting across the sky and discover that it’s actually drifting across your eye?

That would be a “floater.” Floaters are bits of debris in the interior of your eye that appear when you look at something white or very bright. “People describe them as cobwebs, spider webs, bubbles or even ‘tadpoles’,” says ophthalmologist Rishi Singh, MD.

Dr. Singh sees patients with floaters and “flashes” every day. Flashes often accompany floaters and look like a camera flash going off when you close your eyes or wake up in the middle of the night.

When to see an ophthalmologist

Prompt appointments are especially important if you see many floaters — or if floaters are accompanied by flashes.

If you’ve had floaters for 40 years, you don’t have to see your ophthalmologist. But if you have ‘recent-onset’ floaters — if they weren’t there yesterday or last week — see an ophthalmologist that day or the next.

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Flashes are more ominous than floaters, notes Dr. Singh, because they signal an irritation of the retina from tugging, tearing, inflammation or infection.

“When the retina is stimulated, the brain sees it as light because it only has photoreceptors,” he explains.

A mild tug can progress to a retinal tear, which can progress to retinal detachment — a medical emergency. Torn or detached retinas must be promptly repaired by laser surgery or another procedure to preserve vision.

Despite the fast action required, there is no need to panic, says Dr. Singh. Flashes and floaters are usually symptoms of a problem that turns out to be minor.

Causes for flashes and floaters

Flashes and floaters can be caused by:

• Detachment of the jelly-like “vitreous” from the retina. Detachment of the innermost light-sensitive layer of the eye is the most common cause of floaters and flashes. Posterior vitreous detachment occurs naturally as we get older, typically around ages 55 to 60. When it occurs in one eye, it usually follows in the other.
• Retinal tear or detachment. This is often a result of vitreous detachment, near-sightedness (myopia) or any kind of trauma or eye surgery
• Hemorrhage, or blood leakage, from a tiny vessel in the retina. Hemorrhages can occur when a strong pull on the retina tears a blood vessel or when abnormal blood vessels develop in the eye in conditions such as diabetes. Small hemorrhages may disappear on their own, but larger hemorrhages that persist may require surgery.
• Infection and inflammation. Infection, such as fungal  infections, and inflammation, such as uveitis (involving the middle lining of the eye) can cause flashers and floaters.
• Tumors of the eye. While rare, these must be ruled out, says Dr. Singh, an expert on ocular tumors.

How to take care of your eyes

Whether or not you have flashers or floaters, you can help preserve your eyes. Experts say:

• Eat a balanced diet to be sure you are getting the nutrients your body needs to keep your eyes healthy.
• Quit smoking (a huge risk factor for macular degeneration, a common cause of blindness in the elderly).
• Wear sunglasses when in bright light for extended time to protect against UV light exposure.