We left off with our story with…

…63 year-old gelatin sitting in its clear-plastic-lined glass bowl.

The years have gone by and slowly transformed this once great, jiggling substance into something – a little more complicated.

(You could always accelerate the process by breaking the bowl (blunt trauma) or with the rare surgical complication).

What we would see in this now vintage gel are little pools of liquid suspended and surrounded by what’s left of the intact gelatin.

This creates a major shift (increase) in the overall tension inside the bowl – and perhaps this story.

A lot of us have floaters.

Indeed, some of us develop deep, intense, border-line-passionate relationships with these little strings, loops, spiders, specks, etc. that float around in our visual fields.

While I enjoy a good history, I am most interested in your brand new flashes, floaters, and/or any weird stuff you see in your visual field.

Brand new floaters can mean a bunch of different things – ranging from the blinding to the benign — though not in that particular order.

Floaters and their associated phenomenon...

(spots, lights, waves, lightening flashes, pin points, dots, spider-webby looking, circular string-like things that float around and sometimes appear to be little animals flying around that are not actually there)…

…are NEVER painful…

Which means that when they appear, it is more likely that the average bear will just sit on it.

I know that sounds hard to believe.

Who in their right mind would/could ignore the fly that isn’t really there, but won’t go away – for months!??

And yes, most of us see “stuff” floating around in our vision from time to time. Usually shadows of particles inside the eye or in our tears.

Most of that kind of debris is normal and intermittent. And the visual system is adept at adapting.

Floaters and flashes are all about the vitreous – and/or the retina.

——

So we have the vitreous in a new state of tension.

This tension causes the whole complex to enter a process of slow (or potentially sudden) collapse.

Gradually or again, suddenly, the gelatin detaches from the sides of the bowl.

It can happen all at once or only in small or medium sections.

Most of the time this (gradual or sudden) separation does not take the “plastic lining” with it. In other words, usually the vitreous will separate “cleanly” from the retina.

To have the retina “go along for the ride” requires really bad luck.

(Occasionally, depending on where the vitreous separation occurs, the overall tension will wrinkle the macula very slightly – causing distortion in vision. But that is less common).

In the “clean type” of separation or pure vitreous detachment/separation, many see and report the sudden onset of floaters and/or light flashes.

In the “bad-luck-version”, where the retina rips, tears or detaches, many see and report the sudden onset of floaters and/or light flashes…

There in lies the dilemma.

Same symptoms, yet totally different on the “worry-scale”.

Vitreous detachments or separations are:

Common,

Generally benign,

And they settle down over time.

We just watch things carefully in the short-term because we know that the process occurs over a few months.

Normally floaters will gradually settle into the bottom of the eye ball, and out of the visual access after about 8-12 months.

The bad luck scenarios (Retinal breaks, tears, or detachments) are rare, but much more ominous and sight threatening.

When we find one of these, it will usually gets you an immediate appointment with the retina surgeon.

How do we find them?

We dilate the pupils and examine the retina carefully. Often, I can actually to see what you are seeing!

Retinal breaks, holes, and tears are hard to miss.

And occasionally I find holes and/or small breaks on routine exam – absent any symptoms!

Basically, the faster we identify what it is — the faster we can get you where you need to be.

But speed can mean the difference between a little painless laser treatment and full-blown visit to the OR.

If it happens to you:

Don’t panic

Call the office or email me,

Dr. L

PS. Here’s a short video about the anatomy.