5 Steps to Take When You See Flashes and Floaters
Michael Ng
"I'm seeing flashes, floaters and spots.
Is it an emergency? What do I do?"
Step 1. Check if it is flashing in one eye or both. How often and where is the flash appearing? Flashes of light in one eye is a sign that the vitreous gel is separating from the retina. It could be separating naturally with age or from trauma, such as a fall or bump to the eye. If it’s both eyes and lasts for several minutes, that looks like lightning and rainbows, you may be experiencing a migarine with aura.
Step 2. Check if you have any *new* floaters, spots, cobwebs or lines in your vision. They are often translucent, grey or colourless, and usually moves with your eyes. Floaters can stay in your vision for many years, so it is important to differentiate new floaters from old.
Step 3. Check for missing vision or blurred vision. Cover each eye separately, and make sure you can see all four corners. Visual field loss usually occurs in the periphery and will almost always extend to your central vision. Any missing vision is an emergency.
Step 4. Seek an optometrist. Regardless, if you are experiencing changes with your vision, it is best to seek an optometrist to have your eyes dilated and examined as soon as possible. As symptoms can evolve over time, keeping a record of your findings will help your optometrist determine the cause. Floaters can be a normal occurrence with age, however, new flashes and floaters can be a serious sign of an emergency that can lead to a retinal detachment and permanent loss of vision.
Step 5. Waiting for an appointment. If immediate referral cannot be made, you should keep head movement to a minimal. Lie down flat with your head facing opposite to the missing field defect (or to the side of the detachment) to prevent it from getting worse.
So, what is a retinal detachment and how do we repair it?
If caught in its early stages by an optometrist, an emergency referral is made to an ophthalmologist (surgeon). Treatment can range from sealing the hole or tear by a laser or cryotherapy, which typically, has good visual prognosis and can save your vision from further loss. In late stages, visual recovery is guarded and often surgery is required. Successful reattachment doesn't guarantee your vision will come back. So, don't delay, get it checked early.
What are my risks?
I could be completely - Normal, natural vitreous detachment (with or without flashes and floaters) is rare before age of 40 (except for high myopes) but up to 40% will experience it by their 70s... and up 86% by 90 years old.
10-15% with symptoms develop retinal breaks.
Majority of retinal detachments occurs between 50-60 years old.
Those who have a hole or tear in their retina will almost always develop into a detachment if not treated even if they do not experience any symptoms
Not all will experience symptoms described above, so its always good to have your eyes checked.
Who are most at risk?
High myopes (nearsighted)
Any previous eye surgery or trauma
Previous retinal detachments (23% more likely to experience it in their other eye)
Family history of retinal detachments
