Posterior Vitreous Detachment
Flashes and floaters are usually related to normal changes in the clear, jelly-like portion of the eye (vitreous). As one grows older, the vitreous changes– from a firm, thicker consistency, to a softer, more fluid gel. With these changes, the vitreous may separate from the inner lining of the eye (retina), and produce a PVD (posterior vitreous detachment).
When the vitreous ages, or a vitreous detachment occurs, you may notice flashes, because the retina is being stimulated. The flashes will usually go away over a few days, but the floaters stay around for longer. Most people can function perfectly well with floaters, but in some cases, they can block the vision and become more of a persistent problem, in which case treatment may be considered.
Vitreous Detachments can Cause Retinal Tears
While most cases of flashes and floaters are usually related to a posterior vitreous detachment and can simply be observed, some cases may be related to a more urgent problem. If the posterior vitreous detachment pulls off the retina with enough force, it can tear a piece of the retina (retinal tear). If the vitreous detachment involves one of the many blood vessels of the retina, bleeding can also occur (vitreous hemorrhage).
If there is a vitreous hemorrhage, you may need an ultrasound– a simple test in the office that helps the eye doctor see what is going on behind the blood.
The only way to tell a simple vitreous detachment from a retinal tear is by careful examination by an experienced retina specialist. If it occurs, a retinal tear should be treated, because it can cause a bigger problem, called a retinal detachment.
Treatment for Floaters
While most cases of floaters will simply resolve over time, some cases may interfere with the vision more than others. Under certain circumstances, treatment may be considered. While different treatment options have been described, a procedure called a vitrectomy, performed by a fellowship-trained retina specialist, probably offers the safest and most effective option. A vitrectomy is a method the remove the vitreous, and by doing so, clearing the floaters.
A vitrectomy is typically done as an outpatient procedure, so the patient is in and out of surgery the same day. A vitrectomy for floaters typically lasts less than 30 minutes, and usually requires just local anesthetic.
Following a vitrectomy, a patient goes home the same day with a patch over their eye, which is removed the following day.