Posterior Vitreous Detachment: Everything You Should Know About Flashes and Floaters

What Floaters Can Look Like

Floaters come in all shapes and sizes. They can be clear, as seen in the picture, or they can be grey or even black.
Floaters come in all shapes and sizes. They can be clear, as seen in the picture, or they can be grey or even black. | Source

Floaters and flashes are a common problem the majority of the population will suffer at some point in their lives. Generally, they are completely normal and a part of the natural aging process. But on rare occasions they can be a warning sign for a vision threatening condition - retinal detachment.

What is the Vitreous?

The vitreous is a gel-like fluid in the back of the eye, behind the iris and lens. It gives the eye its rigidity and keeps the retina pressed against the back wall of the eye. The vitreous is attached to the retina in two places: the optic nerve, and the ora seratta but may stick to the retina in other places as well.


The vitreous gets its consistency from being 99% water. The other components are vitrosin (a type of collagen), phagocytes, hyalocytes of Balazs and hyaluronic acid.

Phagocytes are white blood cells (part of the immune system) that clean the vitreous of any foreign debris, and the hyalocytes of Balazs recycle the hyaluronic acid. There are no blood vessels feeding the vitreous. All blood vessels in the back of the eye are contained within the retina.

About the Author

Melissa Flagg is an ophthalmic technician with over 20 years of experience working with patients in the eye care field.

She has had rigorous training under the supervision of an ophthalmologist and specialized in the cornea, cataracts, and retina as well as how systemic disease affects the eye. She is certified by JCAHPO as an OSC (ophthalmic scribe certified).

How Age Affects the Vitreous: Flashes and Floaters

As we age, the vitreous liquefies and loses its gelatinous consistency due to the break down of the vitrosin (collagen) and the hyaluronic acid.

When the collagen breaks down, it sometimes forms chunks in the form of strings, worms, blobs, cobwebs and other shapes that float in the watery vitreous.

These “floaters” can be annoying, obstruct the vision, and are most noticeable against a white or solid background like the sky. They are sometimes accompanied by flashes of light, resembling a camera flash, in the periphery of the vision.

These flashes are caused by the vitreous collapsing and tugging at the retina, which causes the nerves to fire, registering a flash of light in the brain. This collapse is called a posterior vitreous detachment.

Slit Lamp View of a Retinal Detachment

A horse-shoe tear that led to a retinal detachment and hemorrhage.
A horse-shoe tear that led to a retinal detachment and hemorrhage. | Source

Occasionally, the vitreous can pull too hard on the retina and cause it to rip, leading to a retinal tear. These tears, if not treated, will allow fluid to build up underneath the retina (the typical immune response to injury) and create a retinal detachment.

Flashing lights and floaters do not necessarily mean you have a retinal detachment, and can often be mistaken with an ocular migraine. If you have these symptoms, you should see your ophthalmologist as soon as possible. The ophthalmologist will be able to catch a retinal tear before you can see it in your vision.

Do you, or someone you know, have floaters and flashes?

  • Do I have what now?
  • Yes, I've had floaters for years
  • I just got my first floater!
  • I've had floaters and flashes for eons
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Have you, or someone you know, ever had a posterior vitreous detachment, or a retinal detachment?

  • I've had a vitreous detachment
  • I've had a retinal detachment
  • Nope, no clue what you're talking about
  • I've heard of these but never had it and don't know anyone who has
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Treatments for Floaters

There are two treatments currently available for floaters. The first is a vitrectomy. This procedure is done on patients who have a retinal detachment, or large floaters that completely obstruct a portion, or all, of their vision when it floats into view.

The vitreous is removed and the vitreous cavity is filled with silicon oil. In the case of retinal detachment, a gas bubble is placed in the eye.

This surgery is not recommended for minor or annoying floaters. There is a long recovery time, and vision may not improve for three to six months after surgery.

The procedure is also quite invasivel, carrying a large risk for infections such as endophthalmitis, a nasty infection that can cause permanent vision loss in less than 24 hours. Most surgeons will only perform a vitrectomy on a patient with a vitreous hemorrhage or retinal detachment due to the surgery's invasive nature and risks of permanent vision loss.

The second treatment for floaters is laser treatment. There is only one surgeon in the US that has the experience to treat floaters with laser. He is the one who developed the technique, Dr. John Karickhoff.

He is located in Virginia and his experiments with using a YAG (Yttrium, Aluminium and Garnet) laser to vaporize the floaters. The technique takes about 20 minutes and two treatments are usually needed

The most important thing to remember is if you have just one or two floaters and flashes occasionally, there is really no reason to worry. If you notice a sudden increase in floaters, your one or two floaters turn into considerably more, and you notice the flashes have become more frequent, you should see your ophthalmologist right away.

© Copyright 2012 - 2016 by Melissa "Daughter of Maat" Flagg ALL RIGHTS RESERVED

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Comments 16 comments

Daughter Of Maat profile image

Daughter Of Maat 4 years ago from Rural Central Florida Author

That device with the probe is called a B-scan, it's basicaly an ultrasound of the eye that lets the doctor look at the retina and see if it is detached or not. Most retina specialists don't do this as a routine procedure, so you must have had a PVD that the doctor thought might rip the retina, especially if he saw you every week for four weeks. They can be scary! Are you nearsighted (myopic) by chance?

Thanks for commenting, and I'm very happy to hear your PVD is gone! Our sight is so precious!

peoplepower73 profile image

peoplepower73 4 years ago from Placentia California

About two years ago, I was driving in the desert and I noticed something that looked like rain on the windshield. Except it was not raining. I went to an opthamologist the next day and he sent me to a retina specialist. The retina guy told me I had a PVD. I had to see him once a week for four weeks. He attached something to my eye that was connected to a computer and he probed my eye as I moved it around all the positions of a clock. After the fourth week of this, it went away and I have never been troubled since then. Although at first, I did get the flashes of light at night. I had my eyes checked aboout two weeks ago and the doctor said there is not a trace of the PVD.

Daughter Of Maat profile image

Daughter Of Maat 4 years ago from Rural Central Florida Author

I actually got it from wikipedia! I know it's a great image, simulated but still! It looked just like my floaters. The film on your eyes may be coming from dryness, not necessarily the floaters, although you can't rule them out. My hub on dry eyes might help if the film you see is hazy or cloudiness.

Thanks for commenting, and I'm glad the hub reassured you a bit. The majority of my patients always started with, "I don't think I'm crazy but..." before they described their floaters.

Daughter Of Maat profile image

Daughter Of Maat 4 years ago from Rural Central Florida Author

Thank you Au fait. Please let your friend know that if she ever sees a veil or curtain come over her vision to see an ophthalmologist right away, insurance or not. A veil or curtain could mean retinal detachment and if not treated can lead to permanent blindness. If your friend has any health problems like diabetes or high blood pressure, her symptoms could be a sign of something else. I would urge her to go to the doctor as soon as she possibly can. Most clinics worth their weight will work with a patient financially, all the eye clinics I've worked for were willing to make financial arrangements with patients especially in emergency situations.

Thanks for commenting and sharing, and my best wishes for your friend.

dragnhaze profile image

dragnhaze 4 years ago

Great information and thanks for sharing it. This past year I had recently noticed the floaters, it's only occasionally, but it seems my vision has been more blurry since I noticed them, almost like I have a film on my eyes.

Maybe I'll set up an eye appointment now that I know the floaters are not just my imagination.

Hope you don't mind me asking but I just gotta know where you got such a great picture of the floaters? Voted up and useful, and again thanks for sharing.

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