Floaters and Flashes: Understanding Vitreous Changes and When to See a Doctor

Have you ever looked up at a clear blue sky and seen tiny dots, threads, or cobwebs drifting across your vision? Or maybe you’ve caught a quick flicker of light in the corner of your eye, like a camera flash, even when you’re in a dark room? If so, you’re not alone. These are called floaters and flashes, and they’re among the most common visual complaints people over 40 experience. Most of the time, they’re harmless. But sometimes, they’re a warning sign - and waiting too long to get checked could cost you your vision.

What Are Floaters and Flashes?

Floaters are small shadows that drift across your field of vision. They look like specks, threads, or cobwebs that move when you move your eyes. They’re most noticeable against bright backgrounds - like a white wall, a computer screen, or the sky. Flashes are brief bursts of light, often seen at the edge of your vision. They can look like sparks, streaks, or lightning, even in the dark.

These symptoms aren’t caused by something wrong with your eyesight. They’re caused by changes inside your eye - specifically, in the vitreous. The vitreous is a clear, gel-like substance that fills the space between your lens and retina. It’s made mostly of water, but it also contains a network of collagen fibers that hold it together. As you age, that gel slowly breaks down. It becomes more liquid, shrinks, and starts to pull away from the back of your eye. This process is called posterior vitreous detachment (PVD).

Why Does This Happen?

Your vitreous doesn’t stay the same forever. Around age 40 to 50, it begins to liquefy - a process called syneresis. Over time, the collagen fibers clump together and cast shadows on your retina. That’s what you see as floaters. When the shrinking vitreous tugs on the retina, it stimulates the light-sensitive cells there. Your brain interprets that as a flash of light - even though no actual light is present.

This isn’t a disease. It’s a normal part of aging. About 75% of people over 65 have noticeable floaters. Nearly two-thirds of those over 70 experience PVD. People who are nearsighted tend to get these changes earlier - sometimes in their 30s - because their eyes are longer, which puts more stress on the vitreous.

When Are Floaters and Flashes Dangerous?

Most floaters and flashes are nothing to worry about. But there’s a small chance they signal something serious: a retinal tear or detachment. That’s when the retina - the light-sensitive layer at the back of your eye - gets pulled away from its normal position. If left untreated, it can lead to permanent vision loss.

Here’s how to tell the difference:

• Benign PVD: You notice a few new floaters, maybe one big one that looks like a cobweb. You might see a few flashes over a day or two, then they stop. Your vision stays clear. No dark curtain or shadow covers part of your sight.
• Retinal tear or detachment: You suddenly see a shower of new floaters - dozens, maybe hundreds. Flashes keep coming, especially in clusters. You feel like a curtain is being pulled across your vision - starting from the side and moving inward. Your peripheral vision gets blurry or blocked.

The key warning signs are sudden changes. If you’ve had floaters for years and they’ve stayed the same, it’s probably fine. But if you wake up one morning and your vision is filled with new dots and streaks - that’s not normal.

What Does a Doctor Look For?

If you’re concerned, you need a dilated eye exam. That means the doctor will put drops in your eyes to widen your pupils. Then they’ll use a special light and lens to look at the back of your eye - including the retina and vitreous.

They’re checking for:

• Signs of retinal tears - small holes or breaks in the retina
• Vitreous hemorrhage - bleeding into the vitreous, often from a torn blood vessel
• Detached retina - where the retina has pulled away from the eye wall

If you have PVD without complications, you’ll likely be told to wait and watch. But if they find a tear, treatment needs to happen fast - often within hours or days. Laser surgery or freezing treatment can seal the tear before it turns into a full detachment.

Who’s at Higher Risk?

Not everyone who gets floaters and flashes is at risk. But some people are more likely to develop complications:

• People over 65
• Nearsighted individuals (myopia)
• Those who’ve had eye surgery, like cataract removal
• People with diabetes or inflammatory eye conditions
• Anyone who’s had a previous eye injury

If you fall into one of these groups and suddenly notice new floaters or flashes, don’t wait. Even if you’ve had them before, new symptoms mean new evaluation.

What Should You Do Right Now?

Here’s a simple guide:

1. If you’ve never had floaters or flashes before - and now you’re seeing them suddenly - get checked within 24 to 48 hours.
2. If you’re seeing many new floaters, or flashes that keep coming in a short time - call your eye doctor today. Same-day evaluation is critical.
3. If you notice a dark shadow spreading across your vision - like a curtain - go to the emergency eye department immediately. This is a medical emergency.
4. If you’ve had floaters for months and they’re not getting worse - no need to panic. But if they change in number, shape, or start coming with flashes, get rechecked.

Can Floaters Be Treated?

For most people, the answer is no - and that’s okay. Your brain learns to ignore them over time. Most floaters settle down within six months. They don’t disappear completely, but they become less noticeable.

There’s a procedure called laser vitreolysis that uses a laser to break up large floaters. But it’s not widely recommended. It’s expensive, often not covered by insurance, and doesn’t always work. It also carries a small risk of damaging the retina. For now, observation is the standard approach.

Surgery to remove the vitreous (vitrectomy) is possible but only done in rare cases - like when there’s heavy bleeding or a retinal detachment. The risks of surgery usually outweigh the benefits for simple floaters.

Can You Prevent This?

No, you can’t stop aging. PVD is a natural part of getting older. But you can reduce your risk of complications:

• Manage diabetes - high blood sugar damages blood vessels in the eye and increases the chance of vitreous hemorrhage.
• Wear protective eyewear during sports or work that could cause eye trauma.
• Get regular eye exams, especially after 50. Even if you feel fine, a yearly checkup can catch early problems.

What Happens If You Ignore It?

The biggest danger isn’t the floaters - it’s the silence. If you delay seeing a doctor after sudden flashes and floaters, you risk missing a retinal tear. Once the retina detaches, vision loss can happen fast - sometimes in hours. And while treatment can save vision in 90% of cases when caught early, the success rate drops sharply after 24 to 48 hours.

Many people wait because they think it’s just aging. Others are afraid of bad news. But the truth is, most people who get checked find out it’s just PVD - and they leave relieved. The ones who wait too long often end up with permanent damage.

Real People, Real Experiences

One patient in Aberdeen, 68, noticed a single floater after reading in bed. He thought it was just tired eyes. Two days later, he saw flashes. He waited another week before calling his optometrist. By then, he had a small retinal tear. He had laser treatment the next day. His vision is fine now.

Another woman, 72, woke up with a shower of new floaters and flashes. She called her eye doctor immediately. They saw a tear and treated it the same day. She says she’s grateful she didn’t wait.

On the flip side, someone else I know waited three weeks because she didn’t want to "bother" anyone. By the time she went in, part of her retina had detached. She lost peripheral vision on that side. It’s permanent.

Final Thought: Don’t Guess. Get Checked.

Floaters and flashes are common. But they’re not something you should ignore or self-diagnose. Your eyes are delicate, and the difference between harmless aging and vision-threatening damage can be as small as a few hours.

If you’re over 50 and you notice new floaters or flashes - especially if they’re sudden or accompanied by a shadow - don’t wait. Don’t hope it goes away. Don’t assume it’s just age. Call your eye care provider. Get your eyes checked. It takes 20 minutes. It might save your sight.