Flashes and Floaters – Signs of a Retinal Detachment?

The most common symptoms preceding a retinal detachment are flashes and floaters. These symptoms may be a sign of a retinal tear. Retinal tears can lead to retinal detachments. A detachment of the retina is potentially blinding.

Flashes and floaters are the most common symptoms of a tear in the retina. Though usually benign, there is no way of telling if a tear is associated with new onset of symptoms. Only an eye doctor can properly diagnose a retinal tear. They can also be asymptomatic.

Commonly, a posterior vitreous detachment occurs causing the symptoms of flashes and floaters. A posterior vitreous detachment is a normal physiologic event and happens, eventually, to everyone. The incidence of a “PVD” increases with age and nearsightedness, that is, it is more likely to occur as you age and with increasing myopia (nearsightedness).

Rarely, trauma may cause a retinal tear. In my experience as a retinal surgeon, severe blunt trauma, severe enough to cause loss of consciousness, can sometimes cause a retinal tear.

The retina is the light sensitive tissue that lines the inside of your eye. It is analogous to wall paper. A tear in the retina (or a retinal hole) allows vitreous fluid to travel underneath the retina, causing this delicate tissue to “detach.”

If a tear is identified, but before a retinal detachment has developed, laser treatment may possibly “fix” the tear and prevent a retinal detachment. If a retinal detachment has developed, surgery is required. There are various ways to repair a retinal detachment.

Pneumatic retinopexy, vitrectomy and scleral buckles are different methods to repair this potentially blinding problem. Often, they are successfully repaired, but permanent loss of vision is still possible.

It is recommended by the American Academy of Ophthalmology that new flashes and floaters be examined with 48-72 hours after initial onset. If a posterior vitreous detachment is present, but no tear, re-examination is recommended at 6 weeks. Additional flashes and floaters should be re-examined if they develop.

Retinal surgery can be an emergency. The key is to diagnose a retinal tear before a retinal detachment develops. If a detachment has occurred, operating to preserve the central vision is of utmost importance.