Diagnosis and treatment

Treatment for flashes and floaters

Generally, people should not be concerned about seeing one or two floaters in their vision if they’ve been there for some time. However, if you see the sudden onset of floaters that have not been there before, especially if they are accompanied by flashing lights, you should seek an urgent review from an eye specialist.

Treatment for eye floaters is rarely required and over time, as your brain adjusts to their presence, eye floaters will become less noticeable, and flashes will disappear. Sometimes dark glasses for eye floaters may be useful in minimising them if they are becoming an annoyance. In some cases, after PVD or secondary to an eye condition, floaters can become persistent, annoying and obstruct the vision, especially in some lighting conditions such as using the computer or driving on a sunny day. In these cases you may want to consider treating the floaters.

You should only seek eye floaters treatment if they start to affect your vision. If this is the case, you should consult an ophthalmologist, optometrist or visit your GP. They will be able to check your eyes to see if you require further treatment or tests.

Eye conditions related to floaters in the eye

Posterior vitreous detachment (PVD)

Posterior vitreous detachment (PVD) is usually the result of changes that occur to the vitreous humor of the eye, as the eye gets older. PVD is a common condition that occurs in about 75% of people over 65.

With age, the central part of the vitreous humour becomes more liquid, and the outer part, known as the cortex (which contains more collagen) starts to shrink away from the retina. Eye floaters develop as a result of the collagen thickening and clumping together.

As well as floaters, flashing can be another symptom of PVD. Flashing may occur when the outer part of the vitreous humor pulls on the light sensitive tissue of the retina. The pulling stimulates the retina, causing your brain to interpret it as a light signal. This creates the sensation of flashing lights.

Retinal tears and vitreous hemorrhage

In approximately half of all people, the vitreous humour has separated from the retina by the time they are 60. This doesn’t usually cause any problems, and most people aren’t even aware that it has happened.

In a few cases of PVD, when the vitreous humor pulls on the retina, it can cause the tiny blood vessels on the surface of the retina to burst and bleed into the vitreous. The red blood cells may appear as tiny black dots, or they may look like smoke. This is called a vitreous hemorrhage. In most cases the blood is reabsorbed spontaneously, and the floaters that are associated with the bleed tend to disappear over the course of a few months.

In rare cases, the vitreous humor remains strongly attached to parts of the retina during the PVD. These points of attachment can lead to tears in the retina as the vitreous pulls away. Retinal tears can be associated with bleeding (seen as a ‘shower’ of dots or flies), increase in floaters in the eye and, flashes of bright, white light in your vision that look a little like lightning streaks. If you have these symptoms, you need to be reviewed by an eye specialist and have retinal tears excluded. If the retinal tear is present it needs urgent retinal laser surgery.

It is important to be aware that flashes in your vision are not necessarily a sign of retinal tears, or retinal detachment (see below). They may have another cause, such as a migraine with aura (a headache with a ‘zig-zag’ pattern across your field of vision).

Floaters and flashes do not usually cause long-term visual impairment, but if you experience them it is important that you visit an eye care specialist, such as an optometrist, in order to have an eye examination.

Retinal detachment

If you have retinal tears, you will need to be treated as soon as possible because tears can lead to retinal detachment. Retinal detachment occurs when the retina separates from the wall at the back of the eye. If this happens, it can damage your sight.

After the light has passed through the eye and reaches the retina, the retina changes the light into meaningful electric signals. The signals are sent through the optic nerve to the brain, where they are translated into the images that you see. If the retina is damaged or detached, the images that are received by the brain become dark, or may be lost completely. Urgent surgery or retinal laser treatment is required to rectify retinal detachments.

How much does treatment cost?

Initial consultation

From £300

This includes an initial consultation and a visual acuity assessment.

If further outpatient tests and investigations are required, they will be charged at an additional rate. The most commonly required test is an OCT scan. Your consultant will discuss this with you at your consultation.

Treatment

The cost of onward treatment will be provided after initial consultation, based on your personalised treatment plan.

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