Floaters, spots and flashes

PDF version

Common visual disturbances

Floaters are those blobs and spots in your vision that you can sometimes see when you look at a white wall or plain light coloured surface.  They are the result of particles and impurities within the vitreous (the crystal clear gel-like substance that fills the inside of your eyeball) casting shadows on the retina.

Floaters can be annoying but are usually harmless.  However, they may also be indicative of eye disease or other health conditions and t his means it always pays to have them checked by your optometrist.

Floaters are relatively common

Most people see floaters at some time during their life.  With age the vitreous close to the retina shrinks and becomes more fluid, allowing the particles and impurities to move about more freely and become more noticeable.  

Many people aged forty or older will experience an event known as a posterior vitreous detachment.  Also know as PVD, this occurs when the vitreous separates from its normal attachment to the retina around the optic nerve head at the back of the eye.

After a PVD, a floater termed a “Weiss Ring” (although not always ring-shaped) may appear and be annoying and distracting in its appearance.

Should you experience the sudden onset of floaters (or notice a sizeable one that you hadn’t previously) you should consult your optometrist without delay.  Your optometrist will put drops in your eye to dilate the pupil as it is important to rule out any complications, such as a retinal detachment or a retinal tear. Dilation allows your optometrist to get the best possible view of the inside of your eye.

Different floaters have different shapesFloaters & Spots may appear like this picture

Floaters vary greatly in appearance. Some are barely noticeable (as faint blotchy spots) whereas others may be particularly disturbing to your vision as they drift across your line of sight.  They may appear as thread-like strands, fine cobwebs, or just as dull shadows.  You will see then most noticeably when looking at the sky or at a white page, wall or ceiling.

When you try to look at them, they dart away as your eye moves, and they may change position slightly with respect to each other after eye movement.

Act immediately if a shadow encroaches your vision.

Although common and usually harmless, floaters may indicate a serious eye problem, especially if the onset is sudden.  For example, a spontaneous haemorrhage from a ruptured retinal blood vessel into the vitreous may cause the sudden appearance of floaters.

On rare occasions a posterior vitreous detachment may be accompanied by, or lead to, a retinal detachment.  This is a painless event but is a medical emergency as too much of a delay in attending to a retinal detachment may lead to blindness of the eye.  Be alert for any of  “The 4 F’s” – flashes, floaters, “falling curtain”(a sense of a shadow encroaching in to the vision of the eye) or failing vision.
If you experience any one of these changes, particularly the “falling curtain” or shadow in your vision, contact your optometrist urgently.

Get flashing lights in your vision checked without delay

Light flashes in the eye are occasionally seen in dim light by people of any age, and usually this is nothing to worry about.  These flashes however can sometimes be a warning sign of incipient retinal detachment so you should consult your optometrist without delay if flashes start to occur (usually out to the side of your visual field, and usually involving only one eye).

These flashes are quite different to those experienced by migraine sufferers who often notice shimmery lights and zig-zag patterns in their vision, sometimes followed by blind areas, either to the left or right, or centrally.  A headache and a feeling of nausea may or may not follow such an episode.

In later life, migraine-like visual symptoms may be experienced by those with disease of the vascular system – in some cases they may be indicative of a TIA (transient ischaemic attack) which can indicate a risk of stroke.  Any such symptoms should be investigated and your optometrist will report to your GP if concerns are held after your eye examination.

Regular Eye Exams

The NZ Association of Optometrists recommends a regular eye examination every 2 – 3 years for healthy adults.  After age 65 more frequent exams are necessary to ensure early diagnosis and treatment of sight threatening conditions such as glaucoma and age-related macular degeneration (ARMD).