Retina
Floaters and retinal detachment: what is urgent and what is not
Almost everyone sees the odd floater. But a sudden shower of new floaters, especially with flashes of light, needs an in-person examination within hours. This guide explains why.
By Dr Idaira Sánchez Santos, ophthalmologist · Nº 390905425
Last reviewed: · Patient information. It does not replace a medical consultation.
Where floaters come from
The inside of the eye is filled with a gel called the vitreous. With age it becomes more liquid and eventually separates from the retina: this is a posterior vitreous detachment, very common after 50 and earlier in short-sighted people. As it separates, floaters, cobwebs or a floating ring appear, sometimes with flashes of light.
When they can be a problem
In some cases the vitreous pulls on the retina as it separates and causes a tear. If not treated with laser, fluid can pass through the tear and lift the retina: a retinal detachment, noticed as a shadow or curtain spreading from one side of your vision.
That is why new floaters and flashes need a dilated retinal examination to rule out a tear. This cannot be done over video.
How it is treated
- Tear without detachment: laser or cryotherapy in clinic to "seal" the retina.
- Retinal detachment: surgery. Depending on the case, vitrectomy with gas or silicone oil, scleral buckle or pneumatic retinopexy.
After surgery with gas you need to keep a specific head position for some days and you must not fly or go to high altitude until the gas has gone.
When an online consultation helps
- You have already been examined and told there is no tear, but the floaters worry or bother you a lot.
- You have had detachment surgery and have questions about recovery, positioning, gas or silicone oil.
- You want a second opinion before a vitrectomy or about removing silicone oil.
- You live far away and want to discuss with a retina specialist whether to have surgery in Santander.
Which tests to send the doctor
- Report of your retinal examination and surgery, if any
- Macular OCT
- Retinal photographs or ocular ultrasound
- List of eye drops you use
Many new floaters, flashes of light or a shadow or curtain in your vision need an urgent in-person examination the same or next day. Go to an eye emergency department.
Frequently asked questions
Do floaters go away?
Many become less noticeable over weeks or months, as the brain adapts and the vitreous settles. If they remain very bothersome, there are treatment options to be assessed case by case.
Can a video call tell me whether I have a tear?
No. Ruling out a tear requires examining the retina with the pupil dilated. An online consultation is useful before or after that examination, not instead of it.
How long does vision take to recover after surgery?
It depends on whether the macula was detached and for how long. With gas, vision is very blurred at first and improves as the gas is absorbed.