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What is Posterior Vitreous Detachment (Floaters & Flashes)?

The inside cavity of the eye is filled with a gel-like material called vitreous. When people are young, this material is dense, like jelly. As part of the aging process, the gel begins to liquefy and become more like water. As this happens, the vitreous can shrink and pull away from the retina, the tissue that lines the inner surface of the eye. When the vitreous separates from the retina, this is called a posterior vitreous detachment. In addition to aging, a posterior vitreous detachment is especially common in people who have had cataract surgery or are nearsighted.

What are the symptoms of a Posterior Vitreous Detachment?

The most common symptoms are floaters and flashes. Floaters are small clumps of vitreous gel and collagen fibrils that float around inside the eye. Floaters can look like dots, circles, line, or cobwebs, and they move when the eye moves. Sometimes, when the vitreous pulls away from the retina, it causes a small amount of bleeding into the eye, and this can cause numerous, string-like floaters. People notice floaters more often when they are in bright light, such as on a sunny day, or in a bright room with white walls. Most people get accustomed to their floaters and are no longer bothered by them. Over time, the floaters will thin and move away from the central vision.

Flashes of light, or lightening streaks, can be seen when the vitreous separates from the retina. During this process, the vitreous pulls on the retina which causes the appearance of flashing lights (the retina has no pain sensors, so traction on the retina is represented by flashes of light). Usually, the process of a posterior vitreous detachment happens over the course of several weeks, and flashes of light can be seen during this period of time.

Is a Posterior Vitreous Detachment serious?

Usually, this is not a serious problem. However, when the vitreous is pulled away from the retina, it sometimes creates a hole or tear in the retina. A retinal hole or retinal tear can lead to a retinal detachment, which is a serious problem.

When is it necessary to see a Retina Specialist if you have floaters or flashes?

Without an examination by an eye doctor, there is no way for a patient to determine if floaters or flashes are serious. If you are having new onset floaters or flashes, or a significant increase or change of these symptoms, you should be examined by a retina specialist as soon as possible. It is necessary to have a complete, dilated eye exam with scleral depression to check for retinal holes, retinal tears, or a retinal detachment.