General EYE ADVICE

Floaters, Spots and Retinal Detachment

Retinal detachment is not as common as the diseases discussed above, however, it is very important for the patient to recognize the symptoms of a possible retinal detachment as it can lead to severe loss of vision if left untreated. It is also important for the eye care practitioner to detect signs of early retinal detachment so that early treatment can be instigated.

The most common way that retinal detachment begins is by a small tearing of the retina that can occur without any obvious trauma to the eye. This is not common, usually occurring in a very small number of cases of vitreous membrane detachment. This is when the membrane that separates the retina (nerve layer in the back of the eye) from the vitreous (jelly within the eye) detaches itself from the retina and hangs loosely in the vitreous. This is relatively common, occurring in at least half the population over 60 years of age. Its symptoms are variable for different individuals. Many people notice the sudden appearance of a dark spot in their vision due to an opaque part of the vitreous membrane. In some people this is preceded by a showering of flashing lights that last only about a minute. Others see many other floaters or spots in their field of view as well. In some cases, one or a few parts of the vitreous membrane can be so adherent to the retina that flashing lights are repeatedly seen when the eyes are moved, due to the pulling on the retina. Over a period of several weeks, the symptom of flashing lights usually resolves as the adhesions weaken and the vitreous membrane pulls away from the retina.

Vitreous membrane detachment usually has no severe effects on vision. However, in a very small number of cases, a small retinal tear may be caused when the bulk of the vitreous membrane pulls away from the retina. This is almost always associated with multiple floaters and/or flashing lights. A retinal tear that is formed in this way may progress to a detachment of the retina from the back of the eye, mainly due to the tugging of the vitreous membrane on the torn retina. The detachment may only take a few days to affect the central part of the retina which is of greatest importance for vision. For this reason, it is safest to seek the opinion of an eyecare professional as soon as possible after witnessing any of the above symptoms e.g. sudden appearance of floaters or clouds in the vision, flashing lights etc. Immediate attention by a retinal specialist is needed if loss of vision or a dark veil over the vision of one eye is noticed.

It is also important to note that during the time when one notices flashing lights, which is often several weeks long, one should avoid heavy lifting, sudden bending or any other type of strenuous activity. One should also avoid activities that may result in jarring of the body, or eye or head trauma. When the adhesions of the vitreous membrane on the retina are loosened with time, this membrane will freely detach from the retina and the symptoms of flashing lights will cease. After this, one can resume normal activities. 

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