Do you occasionally see small, floating shapes or spots of light, perhaps out of the corner of your eye? When you move your eyes, turn your head, or blink, are they still there? According to Cleveland Clinic, occasional eye floaters and flashes usually aren’t anything to be concerned about, but seeing a lot of them could signal a serious problem.*

What are eye floaters and flashes?

In the middle of the eye is a chamber that houses a clear, thick gel-like fluid called vitreous humor. Floaters form when bits of vitreous humor solidify. These particles are very common as we age and the amount of vitreous humor starts to shrink. Floaters become visible when they drift in front of the macula at the center of the retina, which allows us to see.

The shape of floaters may vary, appearing as squiggly lines and spots to small, shadowy shapes, and often happen in one eye at a time. They don’t require emergency action, but can be annoying until they settle to the bottom of the eye and out of your line of sight, where they usually remain harmless.

Eye flashes generally appear as bright spots, resembling camera flashes, fireworks, or streaks of light, or jagged lightning bolts. They are likely to occur first thing in the morning or in a dark room. 

When are floaters not normal?

On occasion, however, floaters and flashes can sometimes indicate retinal detachment or a retinal tear. These heritable, and more serious, eye conditions occur when the shrinking vitreous pulls on, and away from, the retina. “If you suddenly have more floaters than normal or are experiencing flashes (bursts of light across your field of vision),” warns Cleveland Clinic, “you should reach out to your eye care provider right away.”

Risk factors for eye floaters and flashes

Age is a chief cause of eye floaters and flashes. Less common causes of floaters include:

• Blood in the eye
• Inflammation (uveitis)

Diabetes-related retinopathy can cause retinal blood to leak into the vitreous, which may appear as streaks or dark spots in your vision.

People at higher risk for eye floaters are those over age 50 (age 50-70 is usually when they begin appearing). Other risk factors include:

• Nearsightedness
• Diabetes
• Previous eye issues
• Prior cataract surgery

Diagnosis and treatment

Eye floaters are usually diagnosed during an eye exam. The doctor dilates the eyes for a clear view of any eye floaters and the retina to be sure there is no retinal damage. If floaters are found, regular eye exams may be needed to monitor the vitreous shrinkage. Your doctor will likely want as many details as you can provide concerning your vision, so writing down your visual experiences can help.

The most common practice is not to treat floaters. If there are a lot of them, however, and your vision is negatively impacted, two kinds of surgery are available to remove them. Laser surgery can break up clumps of floaters. Vitrectomy replaces the vitreous fluid with a similar solution. Both procedures have benefits and risks.

Eye flashes related to migraines, retinal detachment, or retinal tearing can be treated by addressing the underlying headache or retinal damage. These are serious conditions that require immediate attention. Contact your healthcare provider right away if you’re seeing new or more flashes than usual.

Checking with your doctor

Harmless floaters can be confused with signs of more serious conditions. For instance, large spots in your vision could be a sign of:

• High blood pressure,
• Stroke,
• Multiple sclerosis, or
• Diabetes.

Cleveland Clinic recommends getting your eyes checked right away if you experience sudden visual changes, especially if you have a history of diabetes, high blood pressure, etc.

*Cleveland Clinic. (2020, August 20). Eye Floaters & Flashes. https://my.clevelandclinic.org/health/articles/14209-floaters–flashers