These are common questions and concerns we hear from patients whenever they have something new in their vision. There are several different ways the eyes are affected by these spots or “floaters.” People will notice small transparent floaters from time to time when looking at a bright background (such as the bright sky or a computer screen). But when there is a sudden change in the appearance of the floater or an increase in the number of floaters in your vision, a quick and early diagnosis of the cause is important.
While there are many different causes for these spots in your vision, one of the more serious issues can be a retinal detachment or tear on the retina. The retina is the wallpaper of the inside of the eye which absorbs light to allow us to see. This tissue is very thin and extremely fragile. It is important to have your eyes dilated if you’re noticing these symptoms so the doctor can look at the retina closely. If you are able to catch a retinal tear early before a detachment, then there is a lower likelihood of vision loss. When you are dealing with a retinal tear, imagine gluing back a small piece of wallpaper; however, a retinal detachment is like re-attaching the entire wallpaper and trying to match its original form.
Another cause of these flashes of light or new floaters is from the jelly that fills the inside of the eye—it is called the vitreous. The vitreous becomes more water-like with time and so the jelly begins to shrink. This puts tension on the retina where the vitreous is attached, then the retina sends a light signal which appears like a flash of light. As the vitreous shrinks, it begins to get little folds and they cast a shadow on the retina which can appear as a floater. However, there is no way to know without dilating the eye whether a tear has occurred. Therefore, your doctor should dilate the pupil to look for any possible tears.
Your doctor will be able to evaluate the retina with dilation to determine a likely cause for the changes in the floaters. There is a surgical procedure that can be done if the floaters are extremely debilitating; however, the surgery is rather invasive and often the risks outweigh the benefits. While these new floaters can be disturbing, often they are more of a nuisance once we can rule out more serious conditions. If there is no retinal tear/detachment, our brain starts to ignore these spots or they move from our central vision making them less noticeable.