Most people notice a floater drifting across their vision at some point in their lives a small speck, strand, or cobweb shape that moves when you move your eyes. In many cases, floaters are harmless. But a sudden increase in floaters, especially when accompanied by flashes of light, can be a warning sign of a retinal tear or retinal detachment — conditions that require urgent care to prevent permanent vision loss. This article explains what flashes and floaters are, what causes them, and how to recognize the warning signs that mean you should see a retina specialist right away.
Key takeaway:
If you suddenly notice new floaters, flashes of light, or a shadow or curtain moving across your vision, contact a retina specialist immediately. At Retina Vision Consultants, we offer same-day appointments for retinal emergencies. Call us at (310) 269-8565.
What Are Flashes and Floaters?
Floaters are small shapes that drift through your field of vision. They might look like specks, dots, circles, lines, threads, or cobwebs. Floaters are actually tiny clumps of cells or gel inside the vitreous — the clear, jelly-like substance that fills the inside of your eye. What you’re seeing isn’t the clump itself, but the shadow it casts on your retina.
Floaters are usually most noticeable when you’re looking at a plain, bright background — like a white wall or a clear sky. They tend to move when you try to look directly at them.
Flashes appear as brief streaks or arcs of light in your peripheral vision, similar to a lightning bolt or a camera flash. Flashes occur when the vitreous gel pulls on or tugs at the retina. Your retina interprets this physical tug as a signal of light, even though no actual light is entering the eye.
Some people experience flashes only in a dark room or when their eyes are closed. Others see them throughout the day. Flashes can occur in one or both eyes.
What Causes Flashes and Floaters?
The most common cause is a natural age-related process called posterior vitreous detachment (PVD). As you age, the vitreous gel inside your eye gradually shrinks and becomes more liquid. Eventually, the vitreous pulls away from the retina — a process that happens to most people between the ages of 50 and 75.
During a PVD, you may notice a sudden increase in floaters or experience flashes of light. For most people, this process is harmless and the symptoms gradually become less noticeable over weeks to months.
However, in some cases, the vitreous pulls hard enough to tear the retina as it separates. A retinal tear can allow fluid to seep behind the retina, which can lead to a retinal detachment — a serious condition where the retina lifts away from the wall of the eye. Without prompt treatment, a retinal detachment can cause permanent vision loss.
Other causes of flashes and floaters include:
Eye inflammation (uveitis) — infection or autoimmune conditions can cause inflammatory cells to appear as floaters
Eye injury or trauma — a blow to the eye or head can cause new floaters or flashes Blog Post Copy 3
Diabetic retinopathy — bleeding from damaged blood vessels in the retina can create dark floaters or spots
Retinal vein occlusion — a blocked vein in the retina can cause sudden floaters from bleeding
Migraine aura — visual disturbances including flashing lights, zigzag lines, or shimmering patches that typically last 20
When Are Flashes and Floaters an Emergency?
Not all flashes and floaters require urgent care. A single, small floater that has been present for weeks or months and hasn’t changed is usually not concerning.
Contact a retina specialist immediately if you experience any of the following:
A sudden increase in the number of floaters — especially a shower of small dots or specks
New flashes of light, particularly in your peripheral (side) vision
A shadow, curtain, or dark area moving across any part of your vision
A sudden decrease or blurring of your central or peripheral vision
Floaters accompanied by eye pain (less common, but can indicate inflammation)
These symptoms can indicate a retinal tear or the early stages of a retinal detachment. Retinal tears can often be treated quickly in the office with laser or a freezing procedure to prevent them from progressing to a full detachment. But timing matters — the sooner a tear is treated, the better the outcome.
Vision Emergency?
If you experience a sudden onset of flashes, a shower of new floaters, or a shadow across your vision, call Retina Vision Consultants immediately at (310) 269-8565. We offer same-day appointments for retinal emergencies. If our office is closed, go to your nearest emergency room and request an evaluation by an ophthalmologist.
What Happens During an Emergency Retinal Exam?
If you come in with symptoms of flashes and floaters, your retina specialist will perform a thorough examination to determine whether a retinal tear or detachment is present. Here’s what to expect:
- Dilated eye exam. Your doctor will place drops in your eyes to widen (dilate) your pupils. This allows them to see a much larger area of your retina. Dilation takes about 20
- Slit-lamp examination. Using a specialized microscope, your doctor will examine the front and back structures of your eye in detail. This allows them to look for signs of vitreous detachment, inflammation, or bleeding.
- Indirect ophthalmoscopy. Your doctor will use a bright headlight and a handheld lens to examine the far edges (periphery) of your retina — this is where tears are most likely to occur. You’ll be asked to look in different directions so your doctor can examine the entire retinal surface.
- Diagnostic imaging. Depending on the findings, your doctor may perform additional imaging such as:
- OCT (optical coherence tomography) — a non-invasive scan that creates detailed cross-section images of your retina
- Fundus photography — high-resolution photographs of your retina to document any findings
- Ultrasound — used when the vitreous is too cloudy (from bleeding, for example) to get a clear view of the retina
The entire exam typically takes about one to two hours. Your doctor will review the findings with you the same day and explain any treatment that may be needed.
How Are Retinal Tears and Detachments Treated?
Treatment depends on whether you have a retinal tear, a limited detachment, or a full detachment.
Retinal tears are typically treated in the office on the same day they are diagnosed:
- Laser photocoagulation — a focused laser creates small burns around the tear, forming scar tissue that seals the retina to the underlying tissue and prevents fluid from getting behind it. The procedure takes a few minutes and is done in the office with local anesthesia.
- Cryopexy (freezing treatment) — a freezing probe is applied to the outside of the eye over the area of the tear. The resulting scar tissue seals the retina in place. This is also done in the office and is sometimes preferred depending on the tear’s location.
Retinal detachments require more involved surgical procedures. The choice of surgery depends on the type, size, and location of the detachment:
- Pneumatic retinopexy — a gas bubble is injected into the eye to push the detached retina back into place. Laser or cryopexy is then applied to seal the tear. This can sometimes be done in the office.
- Scleral buckle — a flexible band is placed around the eye to gently push the wall of the eye inward toward the detached retina. This is performed in an operating room under local or general anesthesia.
- Vitrectomy — the vitreous gel is removed and replaced with a gas bubble or silicone oil to flatten the retina back into position. This is the most common surgery for complex retinal detachments and is performed in an operating room.
Recovery time varies depending on the procedure. Your retina specialist will explain what to expect, including any positioning requirements (such as keeping your head in a specific position if a gas bubble was placed), activity restrictions, and follow-up visit schedule.
Can You Prevent Retinal Tears and Detachments?
There is no proven way to prevent posterior vitreous detachment or retinal tears — they are largely a natural part of aging. However, you can reduce your risk and protect your vision by:
- Getting regular dilated eye exams, especially if you are over 50, highly nearsighted, have diabetes, or have a family history of retinal detachment Blog Post Copy 6
- Wearing protective eyewear during sports or activities with a risk of eye injury
- Managing diabetes carefully — uncontrolled blood sugar increases the risk of diabetic retinopathy, which can cause retinal bleeding and traction
- Knowing the warning signs — the single most important thing you can do is recognize the symptoms described in this article and seek care immediately if they occur
Early detection is the key. A retinal tear that is caught and treated promptly with laser or cryopexy has an excellent prognosis. A retinal detachment that goes untreated, even for a few days, can result in permanent vision loss.
Protecting Your Vision Starts With Knowing the Signs
Flashes and floaters are common — and most of the time, they’re harmless. But the warning signs of a retinal tear or detachment are real, and acting quickly can make the difference between preserving your vision and losing it permanently.
If you experience sudden new floaters, flashes of light, or a shadow across your vision, don’t wait. Call Retina Vision Consultants at (310) 269-8565 for a sameday evaluation, or request an appointment online.
