Floaters and Retinal Detachment

Floaters
The jelly-like substance filling the space between the crystalline lens and the retina is called vitreous humour. The vitreous humour begins to degenerate and liquefy as we age. This process can cause us to see some small specks or lines that float around in our field of vision, known as floaters. Floaters vary in size and shape, appearing as dots, circles, lines, or spider webs.

Physiological floaters are usually few in number, occurring when looking at bright homogenous backgrounds such as a white wall or the blue sky. Typically, they remain unchanged over time, and these are normal physiological changes of the vitreous humour as part of ageing. 

Flashes, Acute Posterior Vitreous Detachment and Retinal Detachment 

Pathological floaters appear suddenly and may occur in great numbers. They may suggest bleeding within the vitreous humour, inflammation of the uvea, or separation of the posterior vitreous humour from the retina due to dehydrating and shrinking. This condition is called acute posterior vitreous detachment (PVD). Flashes are caused by the vitreous humour pulling on the retina. Both floaters and flashes can be symptoms of a retinal tear. If accompanied by visual field defects, they may indicate retinal detachment. Therefore, whenever there is a sudden onset of floaters or flashes, an urgent dilated eye examination by an ophthalmologist is essential to determine the cause. If not treated promptly, a retinal tear may evolve into retinal detachment.

Who Are at Risk of Retinal Detachment? 

• Middle-aged persons with PVD which causes retinal tear
• Eyes with retinal lattice degenerations, atrophic holes or horse-shoe tears
• High myopes (higher than –6.0 Dioptres)
• Ocular or orbital trauma (including eye surgery)
• Certain inherited diseases (e.g. Marfan Syndrome, Stickler Syndrome)
• Family history of retinal detachment
• Diabetic retinopathy
• Retinopathy of prematurity, etc.

Symptoms of Retinal Detachment 

• Increased floaters
• Increased flashes
• Visual field loss
• Visual distortion or disturbance

Diagnostic Tests 

If you experience any symptoms, it is important that you seek urgent medical attention as soon as possible. Testing may include

• Dilated eye examination by ophthalmologist
• Optical coherence tomography (OCT)
• B scan

Treatment for Retinal Detachment
Retinal degenerations or tears can be repaired with a laser, while retinal detachment is treated with surgery. There are two main types of retinal detachment surgery. The first type is scleral buckle, which is performed around and outside the eyeball. The second type is vitrectomy with gas or silicone oil injection, which is performed inside the eyeball. Both surgeries include cryotherapy or laser treatment. 

Regular Eye Examinations Can Preserve Vision
Please schedule regular eye examinations with your ophthalmologist.