Floaters and Flashes: What They Mean and When to See a Doctor

Ever looked up at a clear blue sky and seen little dots or squiggles darting around? Or caught sudden streaks of light out of the corner of your eye, like a camera flash, even when you’re not near a bright source? You’re not alone. These are called floaters and flashes, and they’re far more common than most people realize. For many, they’re just a mild annoyance. But for others, they’re a warning sign - one that needs urgent attention.

What Are Floaters and Flashes?

Floaters are tiny shadows that drift across your vision. They look like specks, threads, cobwebs, or small bugs that move when you move your eyes. They’re most noticeable against bright backgrounds - like a white wall, a computer screen, or a clear sky. Flashes, on the other hand, are brief bursts of light, often seen at the edge of your vision. They can feel like a camera bulb going off, or a lightning streak in your peripheral sight.

These aren’t problems with your eyesight itself. They’re caused by changes inside your eyeball, specifically in the vitreous humor - the clear, gel-like substance that fills the space between your lens and retina. It’s made mostly of water, but also contains collagen fibers that form a delicate scaffold. As you age, that scaffold breaks down. The gel starts to shrink, liquefy, and pull away from the retina. This is called posterior vitreous detachment, or PVD.

PVD is normal. It happens to about 75% of people over 65 and nearly two-thirds of those over 70. But while it’s common, it’s not always harmless. The real danger comes when the pulling vitreous tugs too hard on the retina - and tears it.

Why Does This Happen as We Age?

Your vitreous starts changing around age 40, but most people don’t notice anything until their 50s or 60s. The collagen fibers clump together, forming tiny bits of debris. These clumps cast shadows on the retina - that’s what you see as floaters. As the vitreous pulls away from the back of the eye, it can tug on the retina. That tug stimulates the retina’s light-sensitive cells, and your brain interprets it as a flash of light.

This process isn’t sudden. It usually happens gradually over weeks or months. But sometimes, it happens fast - especially if you’re nearsighted. People with myopia often develop PVD 10 to 15 years earlier than others because their eyes are longer, creating more tension between the vitreous and retina.

You might only notice these symptoms in one eye at a time. That’s because each eye ages differently. One eye might have a big floater while the other is still fine. It’s not unusual to feel like your vision is changing unevenly.

When Are Floaters and Flashes Dangerous?

Most of the time, floaters and flashes are harmless. They don’t damage your vision. In fact, many people learn to ignore them. The brain eventually adapts and stops paying attention. Within six months, the floaters often settle out of your central vision, and the flashes fade.

But there’s a red flag: sudden changes. If you go from having no floaters to seeing a sudden shower of new ones - especially if they come with flashes - that’s not normal aging. It could mean the vitreous is pulling so hard on the retina that it’s tearing.

A retinal tear is serious. Left untreated, fluid can leak behind the retina and cause it to detach. A detached retina is a medical emergency. Without prompt treatment, it can lead to permanent vision loss.

Here’s what to watch for:

• Sudden increase in floaters - not one or two, but dozens or more
• Flashes that keep happening, especially in clusters
• A dark curtain or shadow moving across your vision
• Sudden loss of side vision
• Blurred or distorted vision that doesn’t go away

If you experience any of these, don’t wait. Call your eye doctor the same day.

Who’s at Higher Risk?

Not everyone who gets floaters and flashes needs to panic. But some people are at higher risk for complications:

• People over 65 - the risk of PVD climbs sharply with age
• Nearsighted individuals - their longer eyes create more tension
• People who’ve had eye surgery - like cataract removal
• Those with a history of retinal tears or detachments
• People with diabetes or inflammatory eye conditions - these can cause bleeding inside the vitreous, which looks like floaters

If you’re under 50 and suddenly get floaters and flashes, it’s more likely to be something other than normal aging. It could be trauma, inflammation, or even a rare condition like retinal vasculitis. Don’t assume it’s just “old age.” Get it checked.

What Happens During an Eye Exam?

If you go to the doctor with these symptoms, they won’t just glance at your eyes. They’ll dilate your pupils with drops. That lets them see the back of your eye clearly - the retina, the vitreous, and any signs of damage.

They’ll look for:

• Retinal tears - small holes or rips in the retina
• Detached retina - where the retina has pulled away from its normal position
• Vitreous hemorrhage - bleeding inside the eye, which can look like a cloud of dark spots
• Signs of inflammation or infection

This exam takes about 20 to 30 minutes. The dilation might make your vision blurry for a few hours, so bring someone to drive you home.

The good news? If a tear is found early, it can often be fixed with a simple laser procedure in the office. It’s quick, painless, and prevents detachment in most cases.

What If It’s Just PVD?

If your doctor confirms it’s just posterior vitreous detachment with no tears or detachments, you’re in the clear. No treatment is needed. You don’t need surgery, eye drops, or special vitamins.

The floaters will likely become less noticeable over time. Your brain gets used to them. Some people say they disappear entirely after six months. Others still see them, but they’re no longer bothersome.

You might be tempted to shake your head or rub your eyes to make them go away. Don’t. That won’t help - and it could even cause more damage if you’re at risk for a tear.

What About Laser Treatment for Floaters?

You might have heard about laser surgery to “zap” floaters. It’s called vitreolysis. A YAG laser is used to break up the clumps of collagen.

But here’s the catch: it’s not widely recommended. The American Society of Retina Specialists says there’s not enough solid evidence to prove it’s safe and effective for most people. Insurance in the U.S. usually doesn’t cover it. And there’s a risk - the laser could accidentally hit the retina, causing more damage.

For the vast majority of people, observation is the best approach. Wait it out. Let your brain adapt. It’s safer and more reliable than unproven treatments.

Can You Prevent Floaters and Flashes?

Unfortunately, no. PVD is part of aging. You can’t stop it. But you can reduce your risk of complications.

• Control your blood sugar if you have diabetes - high glucose levels can damage blood vessels in the eye and cause bleeding
• Manage high blood pressure - it affects blood flow to the retina
• Wear protective eyewear during sports or risky activities - trauma can trigger PVD or retinal tears
• Get regular eye exams - especially after age 50

There’s no magic diet, supplement, or eye exercise that prevents floaters. But keeping your overall health in check helps protect your eyes.

What Should You Do Right Now?

If you’ve had floaters and flashes for months or years and they haven’t changed - you’re probably fine. Keep an eye on them, but no need to rush to the doctor.

But if you’ve noticed a sudden change - new floaters, new flashes, or any vision loss - act fast. Don’t wait a day. Don’t hope it goes away. Call your eye doctor immediately.

Most people who get timely care for retinal tears avoid vision loss. The window to fix it is small - often just hours or a couple of days. Delaying could mean the difference between keeping your sight and losing it.

Final Thoughts

Floaters and flashes aren’t something to ignore - but they’re also not something to panic about. Most are harmless. But a small percentage signal something serious. The key is knowing the difference.

Pay attention to timing. Pay attention to change. And if something feels off - get it checked. Your eyes can’t tell you when something’s wrong. Only you can notice the shift. And that’s enough reason to act.