WHAT ARE FLASHES & FLOATERS?

Eye floaters are those tiny spots, specks, flecks and "cobwebs" that drift aimlessly around in your field of vision. While annoying, ordinary eye floaters and spots are very common and usually aren't cause for alarm.

Floaters and spots typically appear when tiny pieces of the eye's gel-like vitreous break loose within the inner back portion of the eye.

When we are born and throughout our youth, the vitreous has a gel-like consistency. But as we age, the vitreous begins to dissolve and liquefy to create a watery center.

Some undissolved gel particles occasionally will float around in the more liquid center of the vitreous. These particles can take on many shapes and sizes to become what we refer to as "floaters."

You'll notice that these types of spots and floaters are particularly pronounced when you peer at a bright, clear sky or a white computer screen. But you can't actually see tiny bits of debris floating loose within your eye. Instead, shadows from these floaters are cast on the retina as light passes through the eye, and those shadows are what you see.

You'll also notice that these specks never seem to stay still when you try to focus on them. Floaters and spots move when your eye moves, creating the impression that they are "drifting."

RETINAL DETACHMENT & TEARS

A retinal detachment is a separation of the retina from its attachments to its underlying tissue within the eye. Most retinal detachments are a result of a retinal break, hole, or tear. These retinal breaks may occur when the vitreous gel pulls loose or separates from its attachment to the retina, usually in the peripheral parts of the retina. The vitreous is a clear gel that fills 2/3 of the inside of the eye and occupies the space in front of the retina. As the vitreous gel pulls loose, it will sometimes exert traction on the retina, and if the retina is weak, the retina will tear. Most retinal breaks are not a result of injury. Retinal tears are sometimes accompanied by bleeding if a retinal blood vessel is included in the tear.

Once the retina has torn, liquid from the vitreous gel can then pass through the tear and accumulate behind the retina. The build-up of fluid behind the retina is what separates (detaches) the retina from the back of the eye. As more of the liquid vitreous collects behind the retina, the extent of the retinal detachment can progress and involve the entire retina, leading to a total retinal detachment. A retinal detachment almost always affects only one eye. The second eye, however, must be checked thoroughly for any signs of predisposing factors that may lead to detachment in the future.

POSTERIOR VITREOUS DETACHMENT

The vitreous humor is a jelly-like substance filling the inside of the eyeball that gradually degenerates and liquefies with age. There are attachments of the vitreous to the retina at various points, including the macula and the optic nerve.

As the vitreous liquefies, it can detach from the macula and optic nerve. Posterior vitreous detachments occur in about 25 percent of people in their sixties, and in up to 65 percent of people in their eighties. Vitreous detachment is slightly more common in women.

© Copyright 2010 Richard S. Kalski, M.D.

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