Floaters are the specks, threads and cobweb shapes that drift across your vision, most noticeable against a bright wall or a clear sky. Flashes are brief arcs or sparks of light, usually at the edge of vision and often more apparent in a dark room.

Both are extremely common and are frequently harmless. They are also the classic warning signs of a retinal tear — and the two situations cannot be told apart without a dilated examination.

When to seek care the same day

Contact an eye care provider immediately if you experience:

  • A sudden shower or noticeable increase in floaters
  • New flashes of light, particularly repeated ones
  • A shadow, curtain or dark area entering your peripheral vision
  • Any sudden loss or dimming of vision

A retinal tear that is identified before the retina detaches can usually be treated in the office. Once a detachment occurs, the situation typically requires surgery. That difference is why the timing of the examination matters more than the severity of the symptom.

If you are experiencing these symptoms, call (602) 613-5473. Outside office hours, seek emergency care rather than waiting.

What is actually happening inside the eye

Most of the eye is filled with vitreous, a clear gel that is attached to the retina at the back. With age the vitreous liquefies and shrinks, and small clumps of collagen form within it. Those clumps cast shadows on the retina — the floaters you see. Because they are suspended in gel, they drift when the eye moves and settle when it is still.

As the vitreous shrinks it eventually pulls away from the retinal surface. This is a posterior vitreous detachment, a normal age-related event that most people experience. As it separates, traction on the retina can stimulate the retina mechanically, and the brain interprets that stimulation as a flash of light.

In most people the vitreous separates cleanly. In a minority it pulls hard enough at a point of firm attachment to tear the retina, and a tear can allow fluid underneath, leading to a retinal detachment.

What the examination involves

The purpose of the visit is to inspect the full extent of the retina, including the far periphery where tears most often occur. Pupils are dilated, and the physician examines the retina with a bright light and lens, often while gently indenting the outside of the eye to bring the far edge into view. This part can feel like pressure but is brief.

Optical coherence tomography and widefield photography may be used to document findings. If no tear is found, the examination itself is the reassurance — there is no blood test or scan that substitutes for looking.

Because symptoms can evolve, patients are frequently asked to return for a repeat examination several weeks later even when the first examination is normal, and to return sooner if symptoms change.

If a tear is found

A retinal tear identified before detachment is generally treated in the office the same day. Laser retinopexy places small laser marks around the tear; as they heal they form a seal that helps prevent fluid from passing underneath. Cryotherapy, which uses freezing rather than laser, achieves a similar result and may be chosen depending on the tear’s location.

Both are performed with the eye numbed. Patients typically go home the same day, though activity restrictions are usually advised for a period afterward.

If the retina has already detached, treatment is surgical — see detached and torn retina for what that involves.

Living with floaters that are not dangerous

When examination confirms that floaters are due to normal vitreous change and no tear is present, no treatment is required. Most people find that floaters become less intrusive over months as the clumps settle below the line of sight and as the brain learns to disregard them.

Surgical removal of floaters is possible but is reserved for unusual cases where floaters genuinely impair function, because it carries the risks of intraocular surgery. It is a conversation to have with a retina specialist rather than a routine option.

What does not change is the guidance to return promptly if the pattern shifts: a new shower of floaters, new flashes, or any shadow in the periphery warrants a fresh examination even if you have been told your floaters are benign.

Flashes and floaters: what patients ask

A sudden increase in floaters, new flashes, or a shadow in your side vision should be examined promptly — ideally within a day or two, and immediately if a shadow or curtain is present. Floaters that have been stable for years and have not changed are far less concerning, though they are still worth mentioning at a routine visit.

Usually not. The large majority of floaters result from normal age-related changes in the vitreous gel and do not threaten sight. The reason they are taken seriously is that a small proportion accompany a retinal tear, and that possibility can only be excluded by examination.

Flashes caused by vitreous traction on the retina are more noticeable in low light because there is less competing visual information. Seeing them mainly at night or in a dark room is common and does not by itself indicate whether they are serious.

Laser vitreolysis is offered in some settings, but evidence for its benefit is limited and it is not appropriate for most floaters. Any procedure aimed at floaters should be weighed carefully against the risk involved, since the underlying condition is usually harmless.

If the symptoms are unchanged, floaters persisting after a normal examination is expected and not a reason for concern. Return promptly if the character of the symptoms changes — more floaters, new flashes, or any dark area entering your vision.

No. Floaters originate from physical changes in the vitreous gel and are unrelated to screen time, reading or eye strain. They may simply be more noticeable when looking at a bright, uniform background such as a white screen.

New flashes or floaters? Do not wait.

A retinal tear caught early can often be treated in the office. Call (602) 613-5473 for a prompt dilated examination at our Scottsdale office. If you are seeing a shadow or curtain across your vision outside our hours, seek emergency care.