Medway & Millis November 2018

Page 12 Medway & Millis Local Town Pages www.localtownpages.com November 2018
Living Healthy
Flashes and Floaters
By Roger M. Kaldawy, M.D.,
Milford Franklin Eye Center
Many patients will be aware
of small flying “black spots”
in the field of vision in one or
both eyes. These are called floaters
and may be associated with
flashes of light. Flashes and floaters
may have serious implications
on the vision.
What are floaters?
Floaters are small black shadows
in the vision of one or both
eyes, especially when looking at a
specific surface like a white page,
a bright sky or perhaps when
walking on the beach. These
black spots are impurities in the
fluid that fills the back cavity of
the eye. This jelly fluid is called
the “vitreous” and is a thick fluid
which has a consistency similar
to egg white. This vitreous fluid is
present in the eye from birth, and
is not replaced or exchanged during
life. It is initially attached to
the surface of the retina, which
is the light sensitive nerve tissue
layer that lines the back surface
of the wall of the eye. It is important
to note that it is not necessarily
abnormal to see black spots in
the vision. The size and number
of floaters seen is variable; some
patients (especially short sighted
people) will be aware of numerous
floaters, while others may
never be aware of the symptom
at all. Some floaters can interfere
severely with vision, while others
are barely noticeable. Although
annoying, floaters are usually
harmless, and come and go over
the years.
What are flashes?
Flashes are usually caused by
the vitreous body tugging on the
retina. This tugging occurs when
the vitreous body shrinks as a
normal part of the aging process.
Flashes may last for a few
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seconds or several minutes, and
can occur on and off for weeks or
months. They are usually seen at
night or in poor lighting.
Eye migraine can cause the
perception of similar light flashes
although often these flashes of
light may have numerous colors.
The abnormal light flashes seen
with migraines are usually very
different, appearing as jagged
lines blocking an area of vision
or moving slowly across the field
of vision in one or both eyes.
People who suffer from migraine
headaches will often know the
familiar pattern of these visual
experiences, often occurring
just before the headaches begin.
These migraine flashes are unrelated
to the vitreous body and its
attachment to the retina.
What causes flashes and
floaters?
The vitreous is composed of
collagen, and this undergoes
structural changes with age,
and will become more liquid
like and watery in later life. At
some point, the chemical bonds
that link the vitreous fluid to the
surface of the retina will become
weaker and the vitreous jelly will
separate from the retina. This
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process is called posterior vitreous
detachment or PVD and is
a normal consequence of aging.
Approximately half of us will
have a PVD in one or both eyes
by the age of 60. PVD will often
cause us to notice the sudden
onset of new floaters, often associated
with flashes of light. Unfortunately,
the vitreous body is
sometimes more firmly attached
to the surface of the retina and
may pull away a piece of the
retina or tear the retina as it
separates. This can cause fluid to
escape, pushing the retina off the
inside of the eye. This is known
as retinal detachment, which is a
serious threat to sight. Surgery is
needed to reattach the retina if a
retinal detachment occurs.
When should I seek help?
See your ophthalmologist if
new floaters appear, with or without
sudden light flashes. Any loss
of peripheral (side) vision should
be investigated without a delay.
Your ophthalmologist will give
you a complete eye examination.
Drops are put in the eyes to enlarge
the pupils and determine
whether PVD, retinal tear, retinal
detachment or bleeding is present.
If you have occasional floaters
and flashes, you should have
an annual eye examination.
Symptoms of a PVD most
often occur in one eye at a time.
Even though your ophthalmologist
will check both eyes at the
first visit, it is important to realize
that if similar symptoms are
experienced in the other eye, you
should see your ophthalmologist
again with the onset of new
flashes or floaters as you could be
having a PVD in this eye.
Is there any treatment for
flashes and floaters?
Flashes and floaters are usually
just annoying, not harmful.
However, they can be signs of serious
problems (like a tear on the
retina) and, for this reason, must
not be ignored. For most people,
treatment is not necessary. Floaters
and flashes usually subside
over time, causing no permanent
deterioration to vision.
At Milford Franklin Eye Center,
we use state-of-the-art laser
technology to treat a variety of
eye problems, including retinal
tears with full evaluation of
flashes and floaters. When those
are associated with a retinal tear,
we have in our practice a dedicated
retina specialist specializing
in the treatment of retinal
eye disease. Our retina specialist
is an internationally known expert
in his field and is on staff at
Harvard Medical School. We are
the area’s leading eye care practice,
and we continue to bring
you world class eye care closer to
home.
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John F. Hatch, M.D.
Roger M. Kaldawy, M.D.
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Milford, MA 01757