Illustrative stock photograph; not a CEI patient, treatment result or clinic equipment.
You’re lying on the dock, looking up at a big prairie sky, and you notice little specks or threads drifting across your vision. When you try to look at them, they dart away. Those are floaters, and almost everyone sees them at some point.
Most floaters are harmless. But a sudden change in floaters, especially with flashes of light, can be a sign of a retinal tear or detachment. That needs to be checked quickly. Here’s how to tell the difference and what to do.
Key Takeaways
- Floaters are common and usually harmless, especially if you’ve had the same few for a long time.
- A sudden shower of new floaters, new flashes of light, or a shadow or curtain over part of your vision can mean a retinal tear or detachment. Call an eye doctor the same day.
- A retinal tear found early can often be treated in the office. A detachment needs urgent specialist assessment and often surgery. Do not wait to see if it settles.
What Are Floaters?
The inside of your eye is filled with a clear gel called the vitreous. Over time, this gel becomes more watery and small clumps of fibres form. These clumps cast shadows on the retina, the light-sensing layer at the back of the eye. Those shadows are what you see as floaters.
Floaters can look like dots, cobwebs, squiggly lines or rings. They tend to move when your eye moves and are easiest to see against a bright, plain background, like a blue sky, a white wall or a computer screen.
What Causes Flashes?
The vitreous gel is attached to the retina in places. When the gel tugs on the retina, it stimulates the light-sensing cells, and your brain reads that as a flash or flicker of light. Many people describe it as a camera flash or lightning streak at the edge of their vision, often more noticeable in dim light.
Posterior Vitreous Detachment
As we age, the vitreous gel naturally shrinks and pulls away from the retina. This is called a posterior vitreous detachment, or PVD. It’s very common, especially after age 50, and it often causes new floaters and some flashes.
A PVD without a tear often needs observation rather than treatment. The concern is that, in some people, the gel pulls hard enough to tear the retina as it separates. A tear can let fluid seep underneath and lift the retina off, which is a retinal detachment. That’s why any new flashes or a sudden increase in floaters should be checked, even if it turns out to be a simple PVD.
You may be at higher risk of a retinal tear or detachment if you:
- Are very nearsighted
- Have had cataract surgery or other eye surgery
- Have had an eye injury
- Have had a retinal tear or detachment before, in either eye
- Have a family history of retinal detachment
Warning Signs: Call the Same Day
Call an eye doctor right away, the same day, if you notice:
- A sudden shower of new floaters, sometimes described as pepper, soot or a swarm of dots
- New flashes of light, especially if they keep happening
- A shadow, curtain or veil coming across part of your vision, from the side, top or bottom
- A sudden drop in vision in one eye
Retinal tears and detachments can be painless. A lack of pain is not reassurance; do not wait for symptoms to settle.
Where to Go
During office hours, call your optometrist or our Saskatoon office at 306-244-4111 and explain your symptoms so we can advise you on how soon you need to be seen. Ask for urgent assessment, not a routine future appointment. A curtain, sudden vision loss or rapidly increasing symptoms warrants immediate emergency care if an eye doctor cannot assess you promptly.
After hours, or if you cannot reach an eye care provider promptly, go to the nearest emergency department. You can also call CEI and follow the recorded instructions; Saskatoon City Hospital at 306-655-8000 can connect you with the ophthalmologist on call. Do not delay emergency assessment while trying phone numbers.
Your pupils will likely be dilated during the exam, so bring sunglasses and arrange a driver if you can.
What Happens at the Exam
Your eye doctor will put in dilating drops and examine your retina carefully with special lenses and lights. This lets them look all the way to the edges of the retina, where tears usually happen. Sometimes gentle pressure on the eyelid is used to see the far edges.
If It’s a PVD
If there’s no tear, you’ll usually be reassured and told which warning signs to watch for. Your eye doctor may want to recheck you within a few weeks, because tears can still develop as the gel continues to separate.
If There’s a Retinal Tear
A tear can often be sealed in the office with a laser or a freezing treatment. These create a scar around the tear that helps keep the retina in place.
If the Retina Has Detached
A retinal detachment needs surgery, usually urgently, to reattach the retina. The sooner it’s repaired, the better the chance of keeping good vision.
Living With Floaters
Floaters from a PVD often become less noticeable over the following weeks and months as they settle and your brain learns to ignore them. Most people don’t need any treatment.
Old, familiar floaters aren’t usually a worry. What matters is change. If your floaters suddenly look different, get them checked.
Frequently Asked Questions
Are floaters normal?
Yes. Most people have some floaters, and they become more common with age. A few long-standing floaters are usually nothing to worry about.
Can floaters go away?
They often fade or become less bothersome over time, though they may not disappear completely.
Are flashes always serious?
Not always, but new flashes should be checked promptly to rule out a retinal tear. Migraine aura can also cause visual patterns, but do not diagnose new flashes yourself. A new or changed pattern, especially in one eye or with floaters, needs medical advice.
Can I prevent a retinal detachment?
You can’t always prevent one, but wearing safety glasses for sports and work lowers the risk of injury. Knowing the warning signs and acting quickly is the best protection.
Should I see an optometrist or go to the emergency room?
During business hours, start by calling your optometrist or eye doctor. After hours, or if you can’t get through, go to the emergency department.
Book Your Consultation — or Seek Urgent Care Now
For routine eye-care questions, Book your consultation: call our Saskatoon office at 306-244-4111, Monday to Friday, 7 am to 4 pm. Conlon Eye Institute is in the Medical Arts Building, 341-750 Spadina Crescent East, Saskatoon, SK S7K 3H3. New flashes, a sudden shower of floaters, a curtain or vision loss are not routine booking issues: seek urgent assessment immediately. After hours or if care is not promptly available, go to the emergency department.
References
- National Eye Institute. Retinal detachment — warning symptoms, risk, dilated examination and treatment. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinal-detachment
- National Eye Institute. Vitreous detachment — background on PVD. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/vitreous-detachment
About the Author
Dr. M. Ronan Conlon has practised ophthalmology in Saskatoon since 1994. He completed fellowship training in ocular pathology at Harvard University and in oculoplastic surgery at the University of Iowa. In 1996 he brought laser vision correction technology to Canada from Germany, and he specializes in oculoplastic surgery, LASIK, ASL (PRK) and refractive cataract surgery. With the establishment of the Conlon Eye Institute, Dr. Conlon has drawn on decades of experience in LASIK, RLE surgery, refractive cataract surgery, and oculoplastic surgery. He has also served as Head of Ophthalmology and Chief of Staff with the Saskatchewan Health Authority.
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