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Vitreous Opacities (Flashes & Floaters)

The vitreous is a gel-like substance that fills the back of the eye. It helps give the eye form. In the early decades, the vitreous is transparent. However, in later years, the vitreous develops pockets of fluid and the gel may collapse on itself. This may result in fibers that now become visible within the transparent gel.

As a result, small opacities may be seen in the vision of one or both eyes. These spots generally move with eye movement and may take the form of dots, irregular lines or circles. As the process continues, the vitreous gel may separate itself from the posterior underlying retina. However, some of the vitreous strands may remain adherent to the retina. As the eye moves, traction is placed on the retina and this triggers the electrical circuit involving the visual cells and results in flashing lights. These are more visible at night. While this may be a normal process of aging, it cannot be ignored and must be examined to determine if any tears of the retina have occurred. A detachment of the vitreous also may be precipitated by trauma.

Retinal Tears & Detachment

Vitreous strands that are too firmly attached to the retina may result in a retinal tear. This is usually accompanied by a sudden onset of additional floaters and flashing lights. When the retina is torn, fluid begins to seep through the tear and separate the layers of the retina. As this increases, a retinal detachment develops and a patient may notice a curtain- like blind area in the vision of the affected eye. If this detachment continues and affects the central macular area, a sudden drop in vision occurs. The prognosis for repair and return of good vision becomes guarded once the macula is detached. A retinal tear may be repaired by a freezing technique or by laser coagulation. A retinal detachment repair requires a more extensive procedure.

Therefore, it is very important that you communicate with your ophthalmologist regarding all new episodes of significant floaters and flashing lights.