Spots and flashes
Very often, spots that people see moving in or in front of their eye or eyes are the result of cloudiness in the vitreous. A sudden appearance of spots may be accompanied by flashes of light. This usually indicates a fairly sudden shrinkage of the vitreous.
Vitreous humour
The vitreous is a jelly that fills the back part of the eye, the space between the lens and the retina. Normal vitreous allows light rays to pass through unhindered. However, if condensations or opacities occur in the vitreous, they can cast a shadow on the retina. This can appear as spots in all kinds of shapes: dots, circles, threads, strings, spider webs. The cause of vitreous opacities is usually aging. Nearsighted people are more prone to this. Although the spots can be annoying, vitreous opacities are a harmless condition.
The combination of spots and flashes of light usually indicates a fairly sudden shrinkage of the vitreous. This is also called vitreous detachment, because the shrinking vitreous jelly pulls itself away from the retina where it was previously lying against. Vitreous detachment is also a process that is part of normal aging. This is usually harmless, but sometimes it can be the start of a retinal problem.
Risks of vitreous detachment
When the vitreous shrinks and pulls away from the retina, in a small number of cases a tear can occur in the retina. In a small number of cases, such a tear in the retina can be the start of a retinal detachment, a serious condition of the eye that threatens vision. When a tear in the retina occurs, bleeding in the vitreous can sometimes occur. Although the risk of retinal problems is generally not very high with a vitreous detachment, the advice is that people with suddenly developing (or worsening) complaints of spots and flashes have an ophthalmological examination within 24 hours. Please contact your GP or ophthalmologist for this.
Treatment
Small retinal spots or tears are treated by us with a laser. Follow-up visits follow for approximately 3-4 months.
In the case of (medium) large deviations, surgery must be performed in a specialized center. You will then be referred there by us.
Other common problems
Migraine
Sometimes people see light phenomena that appear as stars or jagged lines and expand slowly, in both eyes, and last for 10 to 30 minutes. This is often a form of migraine. For causes and treatment of migraines, it is best to contact your doctor.
Treatment
For causes and treatment of migraine, it is best to contact your family doctor. The ophthalmologist can investigate whether there are vision problems or retinal problems that could explain the light phenomena. For this, for example, a vision and fundus examination and a macula scan and/or visual field examination are performed.
If no abnormalities are found that are the cause of the experienced problem, it is best to consult a family doctor or neurologist. The ophthalmologist will discuss this with you.
Inflammation
Moving spots can also be seen with inflammation within the eye (inflammation of the eye, iridocyclitis or uveitis). This condition often also causes other eye complaints and symptoms, such as redness, increased sensitivity to light, poorer vision and pain.
Treatment
Almost always an inflammation responds well to the prescribed drop therapy that often lasts several weeks to a few months.
If this is not the case, or if it concerns a recurrence or an inflammation of both eyes at the same time, whether or not both in front and back of the eye, then a referral is made to a specialized center with additional research facilities (internist, X-ray, CT, laboratory, etc.). In those cases, another underlying inflammatory condition is often found that needs to be treated.
Bleeding
Suddenly appearing and increasing point-shaped spots and/or strings and blurring vision may be a manifestation of blood in the vitreous. Such a vitreous hemorrhage can sometimes occur with more serious damage to the retina due to diabetes mellitus, or with a retinal tear.
The danger of such a (regular) hemorrhage in diabetes is, for example, that scars form in the eye that pull the retina loose when it shrinks. A permanent increase in eye pressure can also occur. Both can lead to serious damage or permanent blindness.
Treatment
Depending on the moment of occurrence and the nature of the hemorrhage, the origin of the hemorrhage can be lasered and stopped. Sometimes repeated injections in the eye may also be necessary to calm the eye down again.
