Flashes and Floaters
What You Should Know About Vitreous Detachment

By Lindsay Kottmann
At one time or another, most people have noticed dark specks, like bits of dust, floating in their field of vision. The squiggles and dots move away when you try to look at them directly, and they eventually disappear.

These specks are caused by a gel-like substance inside your eye cavity. The substance, called vitreous, forms in the eye before birth and causes the eye to grow, but changes in consistency as we age. The floating specks are tiny shadows cast on the inside of the eye by the vitreous as it changes and moves.

Between the ages of 50 and 70, this jelly begins to pull away from its attachment to the retina, the light-sensitive layer at the back of the eye that sends visual signals to the brain. This process is what doctors call “vitreous detachment.” Symptoms of vitreous detachment, which, according to the National Eye Institute, are common after age 50 and very common after age 80, include seeing a lot more floating specks, as well as flashes of light as the vitreous moves and stimulates the retina.

“People will often call first with flashing lights. They look like little light bulbs,” says Dr. Jean Marie Noll of Tristate Centers for Sight. “It’s usually after those start that they start to notice the floaters.”

The flashes (“photopsia” is the medical term), are often magnified just before the vitreous separates from the retina, Noll says, and they can appear on and off for several weeks before and after the separation. “In most people, nothing happens when the jelly separates,” she explains. “In other situations, it remains adhered to the retina, so when it separates, it tears the retina.”

A retinal tear occurs in between 5 and 10 percent of people who experience vitreous detachment, Noll says. Such a tear is dangerous, because fluid can get into the hole and lift the retina from the eye, a sight-threatening condition called “retinal detachment.” Only a small percentage of tears lead to retinal detachment, but fortunately, tears can be treated fairly easily with a laser at your doctor’s office.

Symptoms are the same whether the detachment is benign or causes a retinal tear, Noll says. That’s why she advises patients to come in and get checked when they start seeing flashes and floaters.

If you are experiencing these symptoms, your doctor will dilate your eyes and conduct a thorough search for the tear, which usually takes 15 minutes after the eye is fully dilated. “Once you find out where the tear is, you just apply laser around where it is. It takes around 15 minutes,” Noll says. “What you’re trying to achieve is a scar on the retina, which takes seven to ten days to form.” The scarring then seals the tear.

While vitreous detachment will happen to everyone eventually, it is more common in nearsighted people and after head injuries or cataract surgery, and can happen to young people in some cases. “A lot of people are bothered by it,” Noll says. “It’s a really common reason people come in.”

A lot of people are bothered by vitreous detachment. It’s a really common reason people come in.

The Aging Eye
Why Now is the Best Time to See Your Eye Doctor
By Don Holmes, Vice President of Marketing and Business Development, Cincinnati Eye Institute
It’s estimated that millions of Americans over the age of 40 experience changes in their vision, ranging from decreased focusing power to poor night vision to an increase in the need for light. And these are just the noticeable symptoms. Many serious, vision-threatening eye diseases have no symptoms at all.

A recent survey conducted by the American Academy of Ophthalmology found that vision loss was on the rise due to cataracts, glaucoma and diabetic eye disease. At the same time, it’s also reported that Americans ranked vision loss low on their list of health concerns. Even more alarming, less than one-third of participants had an eye examination in the past year.

The fact is that as our population ages, vision loss is rapidly becoming a national health concern. Eye doctors are in agreement and recommend annual examinations after age 40 to establish a baseline and watch for subtle changes that, when detected and treated early, can save your sight.

Cataracts are the leading cause of poor vision in America. It’s estimated that 20.5 million Americans have cataracts. The word “cataract” comes from the Greek word for “waterfall” and is the progressive clouding of the normally clear lens of the eye. This clouding, typically a result of the aging process, interferes with light passing through to the back of the eye. Cataracts become worse over time.

Currently, there are no medications, eye drops, exercises or lasers that can treat cataracts. To achieve clear vision, the cataract must be removed surgically. Cataract surgery is one of the most common and successful procedures performed in the United States today, restoring clear vision in 96 percent of cases.

Glaucoma is another leading cause of blindness affecting millions of Americans over the age of 35. Glaucoma is called “the sneak thief of sight” because the disease typically has no symptoms, until irreversible damage to your eyesight has occurred. It is estimated that half of the population with glaucoma are not even aware that they have this vision threatening disease.

Glaucoma is a condition where elevated pressure inside the eye causes damage to the optic nerve. No one is sure why this happens, but unless the pressure is controlled, permanent vision loss occurs. Without treatment, glaucoma will continue to progress, affecting both peripheral and central vision, and eventually causes total blindness. Although anyone can develop glaucoma, there are certain factors that may put you at greater risk. Individuals with a family history of glaucoma, who have diabetes, or are of African American or Hispanic descent, are at higher risk and should be seen regularly by an eye care professional.

Diabetic eye disease is another leading cause of vision loss with 12,000 to 24,000 cases of new blindness reported every year. This statistic is particularly frightening to eye care professionals, as diabetes is on the rise in both children and adults in the United States. In fact, diabetes is often diagnosed during an eye examination due to changes seen in the blood vessels in the back of the eye. There are no symptoms in the early stages of the disease, but with early detection, and treatment and management of blood sugar levels, vision loss can be prevented.

Treating Dry Eye
By Dr. Zaiba Malik, Comprehensive Ophthalmology, LLC

Tear production normally decreases as we age, and the lack of those tears often results in stinging, burning and scratchiness — a condition called “dry eye.” Although dry eye can occur in both men and women at any age, women are most often affected, especially after menopause.

Symptoms of dry eye also include stringy mucus, excessive irritation from smoke and wind, discomfort from wearing contact lenses, and blurry vision when you blink. Watering eyes are also a symptom; it may seem illogical, but if tears do not keep the eye lubricated, the eye becomes irritated, which prompts the tear gland to release a large volume of tears.

Although dry eye cannot be cured, there are a number of steps that can be taken to treat it. Use artificial tears (available without a prescription), or other moisturizing eye drops or ointments. Avoid smoking and exposure to secondhand smoke. Avoid direct exposure to wind or air conditioning. Use a humidifier in your home, particularly during the dry winter months. Also, be aware that a wide variety of common medications, both prescription and over-the-counter, can cause dry eye by reducing tear secretion.

If you have severe dry eye, it is important to discuss treatment options with an ophthalmologist. There is a prescription eye drop called Restasis that helps your eyes increase their own tear production with continued use. Another option is temporary punctual occlusion, a painless procedure in which a plug is inserted into the tear drain of the lower eyelid to help preserve existing tears.

Experts recommend getting a baseline eye disease screening at age 40. Catching eye diseases early often leads to better outcomes in treatment. There is no need to suffer through the winter months with dry eye symptoms. Schedule an appointment with your eye doctor today. Go to www.myohioeyedoc.com or call (513) 791-2114 to schedule an appointment and learn more about your risks.