The spots, floaters and flashes we sometimes see in our line of vision are part of a natural process. While they may be bothersome at times, in most cases these shadows and “light shows” are not harmful. However, immediate professional eye care attention is needed if there is a sudden increase in the number of spots and floaters, if light flashes continue, or if vision dims for too long.

Spots, floaters and flashes are all integral parts of the miracle of the inner eye and its life cycle.
Spots and floaters are semi-transparent, thread-like strands, specks or brilliant crystals that float inside the eye. When we see spots and floaters, we may have the impression that foreign objects are in front of our eyes, but find that the objects dart away when we try to look at them directly.

Spots and floaters come in many shapes and sizes. They may appear as tiny dots, round circles, long, thread-like strands, cobwebs or fuzzy clouds. We usually notice them when looking at a bright, blue sky or a blank, white wall. People of all ages see spots and floaters. But in most cases, even though they may be bothersome, spots and floaters are harmless and fade away with time.

Spots and floaters are found in the tear layer in front of the eye, in the iris (the colored part of our eye that controls its exposure to light) and in the vitreous (the white, gel-like substance that maintains the shape of the eye). They are a normal part of the process of growth and degeneration our eyes are destined to undergo.

In childhood and early adulthood, the spots and floaters most people see are pieces of blood vessels that were left suspended inside the vitreous of the eye when it was forming before birth. They may also be specks of pigment on the muscle fibers attached to the iris or particles caught in the tear layer in front of the eye. These tiny objects drift freely in the eye and cross our line of vision.

By the mid-forties, the vitreous starts to become more liquid. As this change takes place, a combination of liquid and clumps is present. The shadows cast by these crystal-like clumps are floaters. At this point in life, eyesight may also become hazier than in younger years.

By the time we reach our sixties and seventies, the vitreous usually begins to separate from the retina (where we “see”), at the back of the eye. At this point, a series of flashes may be seen. They are produced by the nerves in the retina as the vitreous pulls away from it and rubs against it. The brain is registering “light” because its light receptors are being stimulated, but no light is actually present. Although this process may be a little disturbing at first, it is perfectly normal and should subside after a few weeks or months.

Migraine flashes are brought about by blood vessel spasms in the brain called migraines. Flashes appear as straight or jagged streaks of lightning and give the impression of a heat wave. Although they may be bothersome, migraine flashes are usually temporary occurrences. They may or may not occur just before a migraine headache is about to begin.

If your floaters or flashes come from a retinal tear or detachment, laser surgery may be performed to repair damage as soon as possible. However, most spots, floaters and flashes are simply a fact of life, and there is no safe, reliable treatment to control or eliminate them.

In very rare cases, when vision is almost entirely clouded by spots and floaters, vitrectomies may be performed. In this surgical procedure, the vitreous of the eye is replaced with a saline solution to improve clarity of vision.

When everyday spots and floaters are bothering you, try looking up and down and from side to side. As you move your eyes, the vitreous fluid will swirl around, and floaters will often move out of your line of vision. Occasionally, during the natural process of the separation of the vitreous from the retina, blood vessels in the eye may leak, causing the retina to detach from the inner lining of the eye. Damage to the retina may also occur due to injury, disease, inflammation of the eye, macular degeneration or other health conditions.

When the retina is detached or seriously damaged, a rush of sparks or lightning flashes and showers of floaters may be seen, and part of the field of vision may become dim or black, as if a curtain has been partially drawn. No matter what the cause, if a sudden increase in spots, floaters and flashes lasts more than 20 to 40 minutes, it should be considered an emergency, and immediate professional eye care attention sought. Left untreated, retinal damage or detachment may result in permanent loss of vision.

It is important during your optometric exam to let your doctor know about your flashes and floaters so your doctor can determine whether these symptoms are normal or whether they are indicative of a more serious medical problem