Vitreous Eye Floaters and Flashes of Light
Author: Disabled World : Contact: Disabled World
Published: 2014-07-16 : (Rev. 2017-05-05)
Synopsis and Key Points:
Eye Floaters are deposits of various size, shape, consistency, refractive index, and motility within the eye's normally transparent vitreous humor.
Suddenly seeing eye floaters or flashes of light may indicate a serious eye problem that - if untreated - could lead to blindness, a new study shows.
Eye floaters are defined as deposits of various size, shape, consistency, refractive index, and motility within the eye's vitreous humour, which is normally transparent. At a young age, the vitreous is transparent, but as one ages, imperfections gradually develop. The common type of floater, which is present in most persons' eyes, is due to degenerative changes of the vitreous humour. The perception of floaters is known as myodesopsia, or less commonly as myodaeopsia, myiodeopsia, or myiodesopsia. Floaters can be a sign of retinal detachment or a retinal tear but in most cases (98% according to the National Health Service) it is simply age-related or due to natural change in the vitreous humour.
A 50 year old woman complains about little spots and fly like things floating in her vision and occasional flashing lights. After a complete eye and retinal exam it is found she suffers from Vitreous Floaters, a normal condition. This case scenario is played out many times every month, but should not be ignored if any one experiences these visual disturbances.
Eye Floaters are deposits of various size, shape, consistency, refractive index, and motility within the eye's normally transparent vitreous humor. They may be of embryonic origin or acquired due to degenerative changes of the vitreous humor or retina. They may appear as spots, threads, or fragments of cobwebs, which float slowly before your eyes.
Eye Floaters are particularly noticeable when looking at a blank surface or an open space, such as blue sky. Many of these specks have a tendency to sink toward the bottom of the eyeball, in whichever way the eyeball is oriented.
The most common cause of eye floaters is shrinkage of the vitreous humor, this gel-like substance consists of 99% water and 1% solid elements. The solid portion consists of a network of collagen and hyaluronic acid, with the latter retaining water molecules.
In most cases this is a benign condition, but can represent a much more serious condition. These bits of retinal tissue may have come from an area that left a small retinal hole or tear behind and the floater is the result of the tear. In all cases when there are floaters a complete dilated retinal exam must be performed as soon as possible. That is the only way to properly evaluate the retina.
When there are flashes of light present as well the level of concern goes up since that may also indicate traction on the retina and can be more serious. If a hole or tear is discovered then usually laser treatment must be done in order to seal the anomaly and prevent further damage.
In some cases vitreous fluid or blood will fill the area where the eye floater originated resulting in a retinal detachment. This is a much more complicated condition and frequently requires retinal surgery to correct the problem. If left untreated it can result in total blindness in that eye.
Most often, the floaters either dissolve or reattach themselves some where in the eye and are no longer a visual issue. The problem is that over the course of our lives new ones are constantly forming. Thus even if one goes away, a new one is starting.
Floaters are often readily observed by a doctor with the use of an ophthalmoscope or slit lamp.
However, if the floater is a small piece of debris and near the retina they may not be able to observe it even if it appears large to the sufferer.
Increasing background illumination or using a pinhole to effectively decrease pupil diameter may allow a person to obtain a better view of his or her own floaters. The head may be tilted in such a way that one of the floaters drifts towards the central axis of the eye. In the sharpened image the fibrous elements are more conspicuous. (If the pinhole is kept moving slowly in small circles, the same technique evokes an interesting entoptic effect known as the vascular figure, which is a view of the blood vessels within one's own eye.)
Treatment for Eye Floaters
Normally, there is no treatment indicated. Vitrectomy may be successful in treating more severe cases however, the procedure is typically not warranted in those with lesser symptoms due to the potential for complications as severe as blindness. Floaters may become less annoying as sufferers grow accustomed to them, even to the extent that they may no longer notice them.
There is also Suture-less Vitrectomy, as the standard vitrectomy involves cutting through the conjunctiva, or fleshy part of the front of the eye, and making openings in the pars plana area which require stitches at the end of the surgery. In the suture-less technique, small tubes or canulas or trochars are placed through the pars plana area and very tiny instruments are placed through these tubes. Once the surgery is complete, the tubes are removed and no stitches are needed. Only in certain cases can suture-less vitrectomy surgery be performed.
Vitrectomy may be successful in treating more severe cases, however, the procedure is typically not warranted in those with lesser symptoms due to the potential for complications as severe as blindness. Eye Floaters may become less annoying as sufferers grow accustomed to them, even to the extent that they may no longer notice them.
Another treatment is laser vitreolysis. In this procedure a powerful laser (usually a Yttrium aluminum garnet laser) is focused onto the floater and in a quick burst vaporizes the structure into a less dense and not as noticeable consistency.
In short, if an individual sees floaters he/she should see the eye doctor as soon as possible to rule out any retinal hole or tear. If there are flashes as well the level of urgency increases. A complete evaluation must include a dilated exam as well.
A Press Release from Queens University Stated
Researchers from Queen's University and Hotel Dieu Hospital in Kingston have discovered that one in seven patients with this symptom will have a retinal tear or detachment.
"If we detect a tear and laser it, we can save people from potentially going blind," says senior author of the study Dr. Sanjay Sharma, a professor of Ophthalmology and Epidemiology at Queen's and head of the Unit for Cost-Effective Ocular Health Policy at HDH. "But if fluid gets in under the retina and causes it to detach, it may be too late."
Because retinal tears can be extremely difficult to see, high-tech equipment and a thorough peripheral retinal examination are required to detect them, he adds.
The research, to be published online Tuesday Nov. 24 in the Journal of the American Medical Association , is partially funded by the Canadian Institutes of Health Research.
To perform their study, the team analyzed nearly 200 articles published in the peer-reviewed literature. They then performed a meta-analysis of 17 articles, and noted that a retinal tear occurred in 14 per cent of the cases of new onset eye floaters associated with an age-related change in the eye's jelly.
"If new floaters are associated with visual loss, a defect in the visual field, or the presence of blood or 'tobacco dust' in the eye jelly, the risk of retinal tear is significantly higher," says Dr. Sharma. "Since retinal tear can lead to detachment in up to 50 per cent of cases, new floaters and flashes is a medical condition that needs urgent assessment."
Also on the team, from Queen's and Hotel Dieu Hospital, are Drs. Hussein Hollands, Anya Brox, David Almeida, and research assistant Davin Johnson. Dr. David Simel is from Duke University.
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