Floaters and Flashes: When Should You Call the Eye Doctor the Same Day?

You should call your eye doctor the same day if you suddenly notice a lot of new floaters, new flashes of light, or a shadow or curtain over part of your vision. Old floaters that drift around and haven't changed are usually harmless, but a sudden change can be a sign of a retinal tear or detachment, and that needs to be checked right away.

I tell patients this all the time: the floaters you've had for years don't worry me. The new ones do.

What are floaters, exactly?

Floaters are little specks, threads or cobweb shapes that drift across your vision. They show up best against a bright sky or a white wall, and they slide away when you try to look at them.

The inside of your eye is filled with a clear gel called the vitreous, which gives the eye its shape. Over time, that gel turns more watery, and tiny strands inside it clump together. Those clumps cast shadows on the retina, the light-sensing layer at the back of the eye. Those shadows are your floaters.

Why do floaters get worse with age and nearsightedness?

Age. The vitreous gel naturally breaks down as we get older, so most people notice a few floaters by middle age.

Nearsightedness. If you're nearsighted (blurry far away), your eye is usually a bit longer than average, and the gel in a longer eye tends to change earlier. Eye surgery and eye injuries can also speed things up.

What is a posterior vitreous detachment?

The name sounds scarier than it usually is. As the vitreous gel shrinks, it eventually pulls away from the back wall of the eye. That's a posterior vitreous detachment, or PVD. It happens to most people as they age, and it's not a disease.

When a PVD happens, you might notice:

• A sudden new floater, sometimes a large ring or cobweb shape
• Flashes of light, often at the edge of your vision, that are easier to see in a dark room
• More floaters than usual for a few days or weeks

Usually the gel lets go cleanly, and the floaters fade as your brain learns to ignore them.

Why can new floaters and flashes mean a retinal tear?

Sometimes the vitreous is stuck tightly to the retina in one spot. As the gel pulls away, it can tug hard enough to tear the retina. Those flashes of light you see are actually the retina being pulled on. The retina doesn't feel pain, so it sends a signal your brain reads as light.

A retinal tear can bleed a little into the gel, which shows up as a sudden shower of tiny dots or "pepper" in your vision. If fluid gets under the tear, the retina can start to peel away from the back of the eye. That's a retinal detachment. It often looks like a dark curtain, shadow or veil moving across part of your vision.

A retinal detachment is an emergency that can cause permanent vision loss. The good news is that tears caught early can often be treated before they become a detachment. Timing matters.

When to call us the same day

Call us right away or go to the emergency room if you notice:

• A sudden shower of new floaters, or many small dots that weren't there before
• New flashes of light, especially if they keep coming back
• A shadow, curtain or veil over any part of your vision
• Sudden blurry vision or vision loss in one eye
• Floaters or flashes after a hit to the eye or head

Please don't wait to see if it goes away. Only an exam can tell a simple PVD from a tear.

Who is at higher risk for a retinal tear or detachment?

Anyone can have one, but some people should be extra alert to new floaters and flashes:

• People who are very nearsighted (high myopia). A longer eye has a thinner, more stretched retina.
• People who have had eye surgery, including cataract surgery.
• People who have had an eye injury, even years ago.
• People with a family history of retinal detachment.
• People who have already had a tear or detachment in the other eye.

If you're in one of these groups, mention it at every eye exam. It helps us know how closely to look.

How does a dilated eye exam find a tear?

To check for a tear, we need to see the edges of the retina, not just the center. Dilating drops widen your pupil, like opening a window all the way instead of peeking through the blinds. Then the doctor uses a bright light and special lenses to look all the way around the retina. OCT, a scan that uses light to show the retina's layers in fine detail, helps us see whether anything is tugging on it.

Your vision will be blurry and light-sensitive for a few hours, so bring sunglasses and, if you can, a driver. We may also ask you back for a recheck a few weeks after a new PVD, because a tear can still form later. If your symptoms change before then, call us right away.

How we do it at Bolt Eye Group

When you call one of our offices about new floaters or flashes, tell the front desk exactly what you're seeing, so they know it's urgent. If you can't be seen promptly, go to the emergency room.

At your visit, we'll ask when it started, which eye, and whether you've noticed a shadow. Then we'll do a dilated exam with retinal imaging and use OCT imaging when we need a closer look. If we find a retinal tear or detachment, we refer you to a retina specialist (an eye surgeon who treats these problems) and help you get seen quickly.

Our comprehensive eye exams also include a full look at the retina every year, which is one more reason regular exams matter. The back of the eye can tell us a lot about your overall health too. Read more in our post on what an eye exam can find.

We accept VSP, EyeMed, Davis Vision, Spectera, Medicare and major medical plans, including Blue Cross Blue Shield, Aetna, UnitedHealthcare, Cigna and Humana.

Frequently asked questions

Are floaters ever normal?

Yes. Most people have a few floaters, and they become more common with age and nearsightedness. Floaters that have been around for a long time and haven't changed are usually harmless. A sudden increase is what needs a same-day exam.

Do floaters ever go away?

Many floaters become less noticeable over weeks to months. Some settle out of your line of sight, and your brain also learns to tune them out. Some floaters stay for good, but most people stop noticing them.

What do retinal detachment flashes look like?

People often describe quick streaks or flickers of light, like a camera flash or lightning, usually at the edge of their vision. They're often easier to see in a dark room. Any new flashes should be checked the same day.

Can I wait until my next regular appointment?

Not for new floaters, new flashes or a shadow in your vision. These need to be checked the same day, because a retinal tear can turn into a detachment. Call us right away or go to the emergency room.

Book an exam at your nearest Bolt Eye Group office

If you're seeing new floaters or flashes, call us today. For routine eye care, book an exam at your nearest Bolt Eye Group office in Canton, East Cobb/Marietta, Lawrenceville, Riverdale or Johnson City, TN. See all locations and directions.