Overview: Floaters / Flashes
Floaters refer to the appearance of small specks, hair-like strands, or cobwebs moving in a patient’s field of vision. The majority of floaters are not harmful and represent clumping of the vitreous. Flashes are a related entity that occurs when the vitreous tugs on the retina. Although both are usually not serious, floaters and flashes can sometimes be a sign of a retinal tear or detachment, a condition which requires urgent treatment.
Diagnosis is aided by the history from the patient and a thorough dilated exam. It is especially important to assess the periphery of the retina to ensure no tears or detachments exist.
Any patient with new onset floaters/flashes, a sudden worsening of previously existing floaters/flashes, or floaters/flashes newly associated with decreased vision should have a dilated exam promptly to make sure a retinal detachment has not occurred.
Assuming no retinal tear or detachment exists, most floaters are simply observed for resolution. Some patients experience symptomatic improvement over time, although some do not. For patients with debilitating floaters that do not improve, possible options include laser floaterectomy and vitrectomy surgery.