Retina

Retina flashes and floaters

Flashes and floaters are symptoms that commonly occur due to age-related changes to the vitreous gel. When we’re newly born, the vitreous is firmly attached to the retina and is a thick, firm substance without much movement. As we age, the vitreous becomes thinner and more watery and tissue debris that was once secure in the firm gel can now move around inside the eye, casting shadows on the retina.

Flashes in vision result from pressure on the retina in the back of the eye, causing patients to see flashing lights or lightning streaks. Floaters occur when fibres move across the vitreous and into your field of vision, causing shadows on the retina that appear as specks, strands, webs or other shapes. These are most visible when looking at a plain, light background.

Although flashes and floaters are common, especially as we age, it’s important to see your doctor as they may indicate a retinal tear or hole. Your doctor can distinguish between harmless flashes and floaters and those requiring treatment for an underlying condition. Most flashes and floaters become less noticeable with time as patients adjust their vision.

Retinal detachment

Retinal detachment is an uncommon and serious eye condition where the retina separates from the inner lining within the eye, often associated with holes or tears. When the retina detaches, it separates from its nourishing blood supply and falls into the posterior cavity of the eye resulting in loss of vision. If not treated early, retinal detachment may lead to partial or complete loss of vision.

Retinal detachment causes

There are many causes of retinal detachments and most do not have any clear precipitating factor. Retinal detachment usually occurs after tears develop in the retina. Fluid passes through these openings and separates the retina from the other layers of the eye.

They are more common among patients with myopia (near sightedness) and those with a family history of retinal detachment. Myopia increases the risk of retinal detachment, as it leads to thinning of the retina and increased risk of developing holes or tears. Family history may contribute to the risk. Another risk factor is after surgery for cataracts. Retinal detachments can also be caused by other diseases in the eye such as tumours, severe inflammation or as a complication from diabetes.

Retinal detachment symptoms

Retinal detachment itself causes a sudden loss of part or all of the vision in the eye. It does not cause any pain. In many cases, retinal detachment is preceded by floaters and flashing lights. A visual field defect can usually be noticed as a “curtain” or “shadow” appearing in the peripheral vision – such a symptom should be taken seriously.

Retinal detachment treatment

All retinal detachments are different; the characteristics of the detachment determine the type of surgery. Surgery is usually performed under a local anaesthetic although a general anaesthesia may be preferable in certain circumstances.

Common treatments include:

  • Laser photocoagulation, which uses a laser to seal retinal tears at the early stages.
  • Freezing or croypexy, which involves freezing the sclera behind the retinal tear. This is usually done in conjunction with scleral buckle surgery.
  • Scleral buckle surgery surgical repair, which involves supporting the retinal breaks with a silicone band which goes round the eye.
  • Vitrectomy for complex cases of retinal detachment. Vitrectomy involves removing the vitreous (the jelly-like substance in the eye cavity) and filling the eye with gas or oil.

Over 90 per cent of all retinal detachments can be reattached by modern surgical techniques. Occasionally, more than one operation may be required.

 

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