Floaters, Spots, Strings and Flashes

Floaters, spots and strings in your vision may be annoying but are quite common with age especially after age 50. Although usually associated with the aging process, the condition can start at any time including as the eye develops in the womb.

You may experience the condition as dark specks or transparent strings that move with the movment of your eye and then move out of your line of vision. Most floaters are due to changes in the gel-like substance (vitreous) inside the eye, which begin to liquefy. This thinning of the gel results in it shrinking and pulling away from the interior surface of the eye causing it to clump and become stringy. The resulting microscopic fibers cluster together and create shadows on the retina, which are perceived in your vision as debris.

Floater should not cause you concern unless you notice a sudden increase in the number, suffer a loss of peripheral (side) vision or experience flashes of light.  These latter signs are indicative of a retinal tear or detachment, which can cause vision loss and require immediate attention.

Flashes of Light

Flashes are usually due to a pulling of the retina by the vitreous and can result in retinal detachment. Flashes can be experienced as jagged lines or heat-like waves. They can last as long as 20 minutes and can cause migraine headaches as blood vessels spasm in the brain. These are known as ophthalmic migraines.

Flashes may also appear together with a large number of floaters and other visual disturbances. If you experience these symptoms, you should contact us on an emergency basis.

Causes of Floater, Spots and Strings

Age related changes in the vitreous humor is the most common cause of floaters. Posterior Vitreous Detachment (PVD) is another common cause and occurs when the vitreous gel pulls away or detaches from the back of the eye.  Floaters are also more common in people that are nearsighted. Additional causes include:

  • Cataract surgery
  • Laser surgery
  • Diabetic retinopathy
  • Inflammation inside the eyes
  • Bleeding in the eyes
  • Tears in the retina
  • Eye trauma

Treatment Options

Floaters often go away on their own or become less bothersome as the vision adjusts. However, it is important to get routine eye exams to determine if the floaters are something more serious. During an eye exam, floaters can be detected even when you are unaware they exist.

Laser Treatment

In more extreme cases, laser therapy can be done to break up the floaters so they are less noticeable. This treatment has only mixed results and is not highly recommended. Risks of the therapy include retina damage.

Vitreous Surgery

Removal of the vitreous gel (vitrectomy) is an option only in the most extreme cases where floaters significantly interfere with the vision. The surgeon removes the gel and replaces it with solution, which the body later replaces with its own natural fluid. The procedure does not always remove all the floaters and new floaters can develop at any time. Risks of vitrectomy include bleeding and retinal tears.

If you are experiencing a new onset of floaters or have questions or concerns about them, call our office at 425.822.8253 to schedule an appointment. If you experience flashes of light, a loss of peripheral vision or a sudden increase in the number of floaters you normally experience, call us for an emergency consultation.