Flashes and Floaters When Should You Seek Urgent Eye Care
A few long-standing floaters can be common, especially as the eye changes with age. A sudden shower of new floaters, new flashes of light, or a shadow in your vision is different. These symptoms can occur when the vitreous gel inside the eye changes, but they can also be associated with a retinal tear or retinal detachment. Prompt assessment matters because only an eye examination can determine the cause.
What are eye floaters
Floaters may look like dots, threads, cobwebs, rings, or translucent shapes that drift as your eyes move. They are usually caused by tiny structures within the vitreous casting shadows on the retina. They may be easiest to notice against a bright, plain background such as a clear sky or white wall.
What are flashes of light
Flashes may appear as brief streaks, sparks, or arcs of light, often toward the side of the vision. They can occur when the vitreous pulls on the retina. Visual symptoms can have other causes as well, including migraine aura, so the pattern and examination findings are important.
When flashes and floaters need urgent assessment
Seek urgent eye care if you experience a sudden increase in floaters, new flashes, a curtain or shadow over part of your vision, missing side vision, or sudden blurred or reduced vision. Symptoms after an eye injury also require prompt assessment.
Do not wait for pain. A retinal tear or detachment can occur without pain. If you cannot reach an optometrist promptly, or if vision loss is sudden or substantial, go to an emergency department.
Why retinal tears can happen
As people age, the vitreous naturally becomes more liquid and may separate from the retina. This is called a posterior vitreous detachment. Many posterior vitreous detachments do not cause a retinal tear, but traction during the separation can sometimes create one.
Risk may be higher in people who are very nearsighted, have had cataract or other eye surgery, experienced eye trauma, or have a personal or family history of retinal tear or detachment. A previous problem in one eye can also be relevant. However, urgent symptoms should be assessed even when none of these risk factors apply.
What the eye examination checks
Your optometrist will ask when the symptoms began, whether they affect one or both eyes, and whether they are changing. The assessment may include vision testing, pupil responses, eye pressure, and a dilated examination of the retina. Dilation helps the optometrist examine the peripheral retina, where tears can occur.
Retinal photography or OCT may provide useful additional information, but imaging does not replace a careful dilated retinal examination when a tear or detachment is suspected. If a retinal tear, detachment, or another urgent condition is found, your optometrist can arrange the appropriate referral.
What if the examination is normal
A normal initial examination is reassuring, but symptoms can evolve. Follow the optometrist’s instructions about monitoring and follow-up. Return urgently if you develop more flashes or floaters, a new shadow or curtain, or any reduction in vision.
Do not ignore a sudden change
Most people with floaters will not have a retinal detachment, but symptoms alone cannot safely rule one out. If the change is new or sudden, contact an eye care professional for advice about how quickly you should be assessed.
For sudden flashes, new floaters, a curtain or shadow, or vision loss, call the nearest Asgarpour Optometry clinic and describe the symptoms. If timely eye care is not available, seek emergency medical attention.
Frequently asked questions
Are eye floaters always an emergency?
No. Stable floaters that have been present for a long time are often not urgent. A sudden onset, a marked increase, flashes, a shadow, or vision loss needs prompt assessment. However if you have longstanding floaters you should still see an optometrist for a routine examination to rule out any ocular disease.
Can a retinal detachment hurt?
It is often painless. Warning symptoms may include flashes, new floaters, a curtain or shadow, and reduced vision.
Can OCT rule out a retinal tear?
Not by itself. OCT is excellent for detailed imaging of selected retinal structures, especially the central retina, but suspected retinal tears generally require a dilated examination of the peripheral retina.
