You may have heard your eye doctor ask you about flashes and floaters. Why is this question asked at nearly every exam? Flashes–flashing lights like camera flashes or lightning bolts in your vision– and floaters –moving black or grey spots/orbs that change position as you move your eyes– are both signs that there may be a retinal problem.
The retina is the sensory tissue within the back of the eye that absorbs light, allowing you to see. The retina is a very thin tissue, therefore it is possible for holes and tears to form in the retina, which may cause the retina to detach from its attachment point to the back of the eye. If a retinal detachment occurs, there is a significant risk of severe permanent vision loss if not detected and treated promptly.
Most people see floaters. It is a normal, common phenomenon that occurs as we age. The vitreous–the gel-like substance within the eye ball– becomes more liquefied over time. This process of liquefaction results in proteins floating around within the eye. These proteins are what we see as floaters. So, when are floaters considered an issue? There is increased concern for retinal issues with sudden onset floaters, appearance of large cobweb-like floaters, dozens to hundreds of new floaters occurring over a short period of time, or floaters accompanied by flashing lights or a change in the clarity of vision.
Flashing lights occur due to the vitreous pulling on the retina, resulting in traction on the retina. This traction may cause holes, tears, or detachments to form. Flashes are also a common symptom associated with ocular migraines. While some migraines occur with headaches, some patients will experience the visual aura without ever developing a headache. Flashes associated with migraines frequently appear more colorful and last from about 15 minutes to 1 hour. Flashes associated with retina issues tend to appear as white camera flashes or lightning bolts and occur intermittently throughout the day.
Sometimes it may be difficult to determine if your flashes and floaters are related to retinal issues, migraine issues, or the normal aging process. When in doubt, it is best to contact your eye doctor to determine if prompt assessment is warranted.