Flashes and Floaters? Call your Optometrist!

Every time I dilate a patient (or the patient declines to be dilated for that matter) I talk about the 3 things that require an immediate call to me:

• sudden onset flashes of light (like lightening blots across your vision)
• sudden onset floaters (whether it is a large floater or a swarm of small floaters that obscure your vision)
• or vision suddenly going dark (even if it is just one little area!)

These are the signs and symptoms of a Retinal Detachment!

LATTIC DEGENERATION: retinal thinning
can best be visualized with a dilated examination
It puts you at a slightly higher risk for a detachment

Optometrists talk so much about flashes, floaters, and a "veil" or shadow over your vision because retinal tears and detachments can cause PERMANENT vision loss.  A retinal tear can happen without warning, even while you are sitting on the couch watching TV.  They commonly are associated with head injuries, but I have had many patients with tears that occurred  seemingly at complete random.  Your eye doctor will tell you if you are at a higher risk for retinal tears at your annual comprehensive examination.  Risk factors include patients who are highly myopic (or near sighted) or have thinner areas of your retina (a condition called lattice degeneration) to name a few.  

Floaters can be normal, but a retinal tear has abrupt, large, disruptive floaters that are constant.  Almost everyone starts getting normal floaters around age 20 as the vitreous (a jelly-like substance that fills the globe of the eye) begins to liquefy and deteriorate.  This type of normal floater looks like a black spot or transparent string, and is annoying but harmless.  We can also experience floaters and other visual phenomenon with migraines (even without a headache, which is called an ocular migraine!).  These migraine related visual changes will last for a few hours, and then resolve.  A retinal tear will have large, persistent floaters that greatly disrupt vision.  A persistent phenomenon like this warrants an immediate call to your doctor!

Retinal tear with detachment coutesty acponline.org

Why it is important to call as soon as possible

Retinal detachments can be repaired, but there is a certain time limit for repair to get the best possible vision after surgery.  The sooner the tear is caught, the sooner any fluid seeping under the tear can be stopped, which will prevent further detachment of retinal tissue.  Acting in a timely fashion can make a huge difference in your visual outcome.  Your eye doctor will treat your complaints of the 3 symptoms above as a medical emergency, and work you in as soon as possible for a dilated examination.  If a tear is spotted, you will be promptly referred to a surgeon for repair.

Please don't wait weeks or months to see if your symptoms resolve.  The sooner you tell your doctor could make the difference between regaining vision and being permanently blind out of the damaged eye!

A near total retinal detachment with poor potential for vision even after repair.  Photo from  retinagallery.com
Do not wait until your eye looks like this inside to call your doctor!  It is always better to be safe and have a dilated examination performed if you experience the 3 signs and symptoms of a retinal detachement!