Adult eye - floaters and flashes

Understand Your Changing Vision: Floaters and Flashes

Nan Kathryn Fuchs PhD

My father was an optometrist, and I grew up hearing him say, “Take care of your eyes. They’re the only pair you’ll ever get.” I did. I read with good lighting and used eyeglasses faithfully (contacts, now) for my nearsightedness.

Several people in my family have had macular degeneration and detached retinas, so I now supplement my diet and multivitamins with a formula of vitamins and herbs to nourish my eyes and a diet high in antioxidants. So I was both surprised and frightened to suddenly see a large floating shadow move across my vision accompanied by flashing lights.

It was dusk on a Friday evening and I was driving. From the right hand corner of my vision I saw an arc of light that flashed whenever I turned my head in a particular direction. It wouldn’t stop, and it disturbed me. The shadow and the flashes continued through the weekend. On the following Monday morning, I spoke with my optometrist who insisted on seeing me immediately. “It’s probably nothing serious,” he told me, “But I just want to make sure.” After dilating my eyes and thoroughly examining them, he told me I did, indeed, have a large floater along with flashes.

A Look at Floaters
Floaters look like grey or black specks in front of our eyes that move when our eyes move. When eyes start or stop, the floaters usually drift a bit. Floaters may be tiny or large enough to be annoying. They’re commonly a sign of aging eyes.

Our eyeballs contain a jelly-like substance called the vitreous humor that fills most of the space between the lens and retina. It is mostly water with some collagens and a nutrient called hyaluronic acid (HA). As we age, the vitreous humor begins to break down — more frequently with nearsighted people like me. It can also happen from an injury or inflammation in your eye, or if you get struck in the head. Lifting heavy objects, straining from constipation, coughing, or rubbing our eyes can all cause changes to the vitreous.

Floaters commonly occur when some of the vitreous separates from the retina. Bits of material accumulating in the vitreous humor cast a shadow on your retina — the floater. Most of the time they are not only common, but safe. Occasionally, they’re not.

A floater that becomes larger and looks a little red or purple may be due to a hemorrhage caused by a tear in the retina. Multiple floaters accompanied by a loss of vision may be a sign of inflammation. A sudden increase in floaters can also signal a deterioration of the vitreous. Always have an ophthalmologist check your eyes immediately if you experience any of these changes to rule out a more serious underlying condition requiring treatment.

Flashing Lights
Flashes are tiny bright lights caused by a pulling on the retina. They occur in more than 70 percent of adults and are just annoying once you understand them. But if they increase, it may be from a tear that can lead to a detached retina. Fortunately, only a small fraction of people with retinal tears progress to detached retinas. If you have flashes that have been checked out and suddenly change in number or frequency, see an ophthalmologist immediately. Flashes that come from retinal tears may require laser treatment or freezing to repair the retina. The more common flashes from tugging on the retina need no treatment.

Flashes From Migraines
People who get migraines may see flashing lights, but these are different from the flashes I’ve talked about. Migraine-associated lights are usually shimmering lights that remain for 15 minutes or longer. A throbbing headache, often on one side of the head, appears when the lights disappear.

Permanent or Temporary?
Floaters often stabilize and disappear after a few weeks to a month. Some remain and we get used to them, noticing them less. Flashes disappear as soon as the piece of vitreous humor completely separates from the retina. I’ve known cases where flashes are resolved in a few weeks and others where they have remained for a year or longer.

A Remedy to Consider
Our eyes shrink as we age from a loss of HA — a nutrient that keeps water in the vitreous humor. Optometrists and ophthalmologists say there’s no treatment for floaters and flashes and suggest we just live with them. They may be right. But I know of some people who have found that taking 150-300 mg of oral hyaluronic acid and drinking plenty of water reduced or eliminated their floaters. I’m not one of them. My floater and flashes continue after taking HA for five months.

Still, taking HA makes sense for your eyes and a number of other conditions such as arthritis. You can buy HA from Purity Products, Inc (800-769-7873). The supplement, Ultimate H.A. Remedy, contains a month’s supply of hyaloronic acid (at 150 mg a day). How long should you take it? No one really knows, but I like to give any supplement a three-month trial. If, after this time, there’s no change in your floaters, you’ve at least given your body a few month’s worth of an important lubricant.

Along with the hyaloronic acid, get plenty of antioxidants like bilberry, quercetin, vitamin C, grape seed, and glutathione. Your eyes contain the B vitamin riboflavin that’s needed to help you see light. Along with making your eyes more sensitive to light, riboflavin produces free radicals.

By taking good antioxidants, like the Sharper Vision formula (800-728-2288) I use, you can inactivate the negative effects of riboflavin while getting its benefits. There are some people who believe that high amounts of riboflavin without enough antioxidants could contribute to floaters, although I haven’t been able to locate any studies that indicate this is so. Still, I believe in erring on the side of caution — so always take extra antioxidants in your diet and supplementation program for healthy eyes.

Protecting Your Eyes
Drink plenty of water. Since floaters and flashes occur with changes in the vitreous, and vitreous is 99 percent water, drink plenty of water. Dehydration could be a factor in the vitreous separating from the retina. My own floater and flashes occurred after six weeks of persistent diarrhea from parasites. Although I was aware of needing plenty of fluids, it was difficult to be completely hydrated with daily watery stools, and I may well have been dehydrated. To prevent dehydration, drink half a glass of water an hour whenever possible.

Wear sunglasses. Protect your eyes when you’re outdoors, even when it isn’t a sunny day. Ultraviolet (UV) rays are present on overcast days, and UV helps break down hyaluronic acid. Get in the habit of wearing lightly tinted sunglasses with UV protection when you’re outdoors.

I’ve gotten used to my floater, and the flashing lights no longer disturb or frighten me. I expect that some day they will disappear. But whether or not they do, they have been a reminder to me of the importance of taking especially good care of my eyes as the years progress.

Robert Abel, Jr, MD, The Eye Care Revolution, Kensington Books, 1999.

Bill Sardi, Knowledge of Health, Inc., personal communication

Joseph W. Sowka, OD and Alan G. Kabat, OD. “How to make sense of flashes and floaters,” Review of Optometry OnLine, June 15, 2000.

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Written by Nan Kathryn Fuchs PhD

Explore Wellness in 2021