Explanation - Flashes and floaters are the most common symptoms of a retinal tear or a retinal detachment. Most of the time, however, they are unrelated to any disease. Patients may complain of the acute onset of flashes, unassociated with headache, and are most noticeable in the dark. Floaters usually develop quickly. Both are painless. They may occur alone or together. A retinal tear may develop into a retinal detachment; a potentially blinding condition. The onset of new flashes and floaters should be assumed to be related to a retinal tear until proven otherwise. There is no way to determine if a tear is present without proper dilation of the pupil. A retinal tear may be asymptomatic.

Ophthalmic Management - as stated above, new onset flashes and floaters should be examined looking for a tear in the retina. Timing should be within 48-72 hours of onset. Examination should be performed by anyone confident and competent to perform a dilated eye exam. If a retinal tear is diagnosed, laser photocoagulation or cryotherapy may be used to treat the tear to prevent development of a retinal detachment. If a retinal detachment is diagnosed, prompt referral to a retinal specialist would be appropriate.

A common benign cause of flashes and floaters may be due to a posterior vitreous detachment (PVD). If a PVD is diagnosed and no tear is noted, re-examination should be performed if the symptoms become acutely worse and/or six weeks after the initial symptoms develop.

Other causes of flashes or floaters include migraine headache, uveitis or blood.

Written By Randall V. Wong, M.D., Retinal Specialist/Ophthalmologist, Fairfax, Virginia.

Source: www.randallwongmd.com

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