Almost everyone notices floaters at some point. Those small specks, threads, or cobweb-like shapes that drift across your vision when you look at a bright sky or a white wall. For most people, most of the time, they are completely harmless. But there are specific circumstances in which floaters or flashes of light require urgent assessment, within hours, not days.
This article explains the difference between floaters that can wait and symptoms that need immediate attention. If you are unsure after reading this, call Prime Optometrists Auburn on (02) 9761 0005 and describe what you are experiencing.
What Causes Floaters?
The inside of the eye is filled with a gel-like substance called the vitreous humour. In young eyes, the vitreous is clear and firmly attached to the retina at the back of the eye. As we age, the vitreous gradually liquefies and shrinks, a completely normal process. As it does, small clumps of collagen fibres form within it. These clumps cast shadows on the retina, which we perceive as floaters.
This age-related process, called vitreous syneresis, begins in most people from their forties or fifties. Floaters that have been present for years and are not changing are almost always benign.
Posterior Vitreous Detachment (PVD)
At some point in the vitreous shrinkage process, the gel separates from the retina entirely. This is called a posterior vitreous detachment (PVD)and it is very common, occurring in approximately 75% of people over 65.
When a PVD occurs, most people notice a sudden onset of new floaters, often described as a ring, cobweb, or shower of new spots. Flashes of light (photopsia) are also common at the time of separation, caused by the vitreous tugging on the retina as it detaches.
A PVD itself is not dangerous. However, it must be assessed urgently because in approximately 10 to 15% of cases, the vitreous pulls hard enough as it detaches to cause a tear in the retina. A retinal tear, if not treated, can lead to a retinal detachment, which is a serious condition that can cause permanent vision loss.
Warning Signs That Require Immediate Assessment
Seek urgent care on the same day (not next week) if you notice any of these:
- A sudden shower of new floaters, particularly if they appeared all at once or have significantly increased in number over hours or days
- Flashes of light in the peripheral vision, especially if they are new, frequent, or appear in the dark
- A shadow, curtain, or dark area at the edge of your vision that seems to be spreading inward — this is a medical emergency requiring immediate hospital care
- A sudden decrease in vision or a grey area in the centre of your visual field
If you see a curtain or shadow spreading across your vision, go directly to Auburn Hospital emergency department. This may indicate a retinal detachment, which requires urgent surgical treatment and cannot wait.
Floaters That Can Wait
Long-standing floaters that have been present for years without change are generally benign. Small, stable spots or threads that are most visible in bright light and have not increased do not typically require urgent assessment. They are still worth mentioning at your next routine eye examination so they are documented.
Floaters are also more common in people who are:
- Significantly short-sighted (myopic), as the vitreous in a myopic eye tends to liquefy earlier
- Post-cataract surgery
- Diabetic
- Over 50
How We Assess Floaters and Flashes
At Prime Optometrists Auburn, an assessment for new floaters or flashes involves a dilated fundus examination to view the peripheral retina in detail, with OCT imaging where indicated. We can identify retinal tears, areas of retinal thinning, and signs of vitreous traction. If a retinal tear is found, we arrange urgent referral to a retinal specialist, typically within 24 hours.
Dr Zobaida Tahiri is therapeutically endorsed, meaning she can conduct a thorough posterior segment assessment and manage the referral pathway without requiring you to first see a GP.
When to Call Us
If you have noticed new floaters or flashes of light in the past few days, call us on (02) 9761 0005. We will ask you a few quick questions and, if there is any concern, arrange a same-day or next-day appointment. Do not leave new floaters or flashes uninvestigated for weeks.
Book online or call (02) 9761 0005. We are at 43 Auburn Road, Auburn NSW 2144, open six days a week.