Flashes and Floaters: When to Arrange an Eye Examination and When to Seek Urgent Help

Flashes and floaters are common visual symptoms. Many people notice them from time to time, and in many cases they are not a sign of a serious problem. However, a sudden change in flashes or floaters can sometimes be linked with a tear or detachment of the retina, which needs urgent assessment.

This is why it is important not simply to ignore new symptoms. If you notice a sudden increase in floaters, flashes of light, a shadow or curtain in your vision, or a sudden drop in sight, you should seek advice promptly.

What are floaters?

Floaters are small shapes that seem to drift across your vision. People often describe them as specks, dots, cobwebs, threads or squiggles. They may be more noticeable when looking at a bright plain background, such as the sky, a computer screen or a white wall.

Floaters usually happen because of changes in the gel inside the eye, called the vitreous. As we get older, this gel naturally becomes more liquid and less uniform, and small clumps or strands can cast shadows on the retina. These shadows are what you see as floaters.

Long-standing floaters that change very little over time are often harmless, even if they are annoying.

What are flashes?

Flashes are brief flickers or streaks of light, often noticed more in dim light or out of the corner of the eye. Some people describe them as similar to lightning or a camera flash.

They can occur when the vitreous gel inside the eye tugs on the retina. Sometimes this is part of a normal age-related change, but occasionally it may be linked with a retinal tear.

Why do flashes and floaters happen?

Flashes and floaters are often associated with natural changes in the eye, especially from middle age onwards. They can also be more common in people who are short-sighted, after an eye injury, or after certain eye procedures.

In many cases the cause is not serious, but because some retinal problems begin with similar symptoms, it is important to know when prompt assessment is needed.

When should flashes and floaters be treated as urgent?

You should seek urgent advice if you notice any of the following:

• a sudden shower of new floaters
• new flashes of light, especially in one eye
• a dark curtain, shadow or veil in your vision
• a sudden drop in vision or an area of missing vision
• symptoms following an eye injury
• flashes or floaters that seem to be getting noticeably worse

These symptoms do not always mean a retinal tear or detachment is present, but they do need to be assessed promptly.

At Actons, we provide Urgent Eyecare advice and can advise whether your symptoms may be suitable for an urgent appointment.

When is a routine eye examination enough?

If you have a small number of floaters that have been present for a long time and have not changed, and you have no flashes, no shadow in the vision and no sudden drop in sight, this is less likely to be urgent. Even so, it is sensible to mention them at your next eye examination.

A routine eye examination is also worthwhile if you are unsure whether what you are noticing is new, or if you have concerns about your vision more generally.

What happens if you need an urgent assessment?

The first step is to discuss the symptoms clearly. We may ask when they started, whether they affect one eye or both, whether there has been any change in vision, and whether there has been any recent injury or other eye problem.

If the symptoms suggest a possible retinal problem, you may need urgent examination and, in some cases, referral to hospital eye services. If a retinal tear is found, treatment may be needed to reduce the risk of retinal detachment. If the retina has already detached, urgent hospital treatment is usually required.

Not everyone with flashes and floaters will need hospital treatment, but it is safer to have new symptoms assessed than to assume they are harmless.

Do flashes and floaters go away?

Floaters often become less noticeable with time, either because they settle or because the brain gradually pays less attention to them. Flashes related to vitreous changes may also lessen over time.

However, even if symptoms settle, sudden new flashes or floaters should not be ignored in the early stages, because this is the point when an important retinal problem may need to be ruled out.

What should you do if you are worried?

If you develop new flashes or floaters, especially if the change is sudden, contact the practice promptly for advice. If we are closed, use NHS 111. If you suddenly cannot see properly from one or both eyes, or have a severe and sudden change in vision, seek emergency help.

It is best not to drive if your vision has suddenly changed or if you are not confident that it is safe to do so.

How Actons can help

We can advise whether your symptoms may need urgent assessment or whether a routine appointment is more appropriate. If you are worried about flashes, floaters or a sudden change in your vision, please contact us and explain what has changed.

This article provides general information and does not replace an individual eye examination or urgent professional advice.