Floaters and Flashes

Floaters are small moving spots in one's vision resulting from shadows cast on the retina by cells or opacities in the vitreous gel.

Floaters can have different shapes, such as dots, circles, or cobwebs. Often, floaters develop later in life when the vitreous gel begins to shrink and pull away from the back of the wall. This is called a posterior vitreous separation.

Continued shrinkage of the gel can cause a tugging or traction on the retina producing an intermittent flash of light. Any patient with sudden new onset of floaters or flashes of light should have their retinas examined in search of the cause.

Sometimes, continued pulling of the vitreous gel can damage the retina, producing retinal tear or retinal detachment.

Alternatively, sometimes the onset of new floaters is secondary to vitreous hemorrhage (bleeding in the central cavity of the eye). Advanced diabetic retinopathy is often the cause of this phenomenon, although several other retinal conditions could present similarly.

Again, it is best that a thorough retinal examination is performed in order to determine the cause of any new floater(s), and ensure that proper management is instituted.

Metamorphopsia (distortion of vision)

The macula is the center of the retina and is responsible for our fine vision, which we used to read and recognize faces. Many conditions affect the macula, such as age-related macular degeneration, diabetic macular edema, macular hole, and macular pucker.

Very often, the earliest symptom produced by these conditions is a distortion of the vision, rather than visual loss. For example, a telephone pole might look curved or bowed rather than straight. A retinal specialist should evaluate new onset metamorphopsia as soon as possible. One can test themselves for metamorphopsia by using an Amsler grid at home.

Decreased Central or Peripheral Vision

Any sudden drop in one's visual ability could be a symptom of any number of retinal diseases. If the disease process were located centrally in the retina, one would notice an inability to use the eye for reading or other fine tasks.

Alternatively, if the retinal pathology was in the corner of the retina, one would experience a gray or black veil or curtain obscuring any part of one's side vision. This later symptom is especially important if the area of peripheral vision loss appears to be moving towards the center, because such a symptom could be caused by retinal detachment.

Prompt retinal evaluation would be recommended.