Flashes and floaters

• Floaters may be caused by
  • vitreous debris from
    • infection
    • inflammation
    • haemorrhage
  • age-related degeneration of the vitreous
    • forming condensations of collagen fibres
  • Patients may describe floaters as ‘flies’, ‘cobwebs’ or ‘worms’ that are more pronounced against light backgrounds
  • hemorrhage of retinal vessels
    • into the vitreous is described as minute black or red spots
    • most common cause: proliferative diabetic retinopathy
• Flashes
  • are visual phenomena known as photopsias
  • “perception of light in the absence of external light stimuli”
  • described
    • momentary arc of white light
    • similar to a bolt of lightning or a camera flash.

Ophthalmic Flashes	Ophthalmic Floaters	Ophthalmic Both Flashes and FLoaters	Non-opthalmic flashes
Posterior vitreous detachment	Posterior vitreous detachment	Posterior vitreous detachment	Migraine – scintillating scotomas, coloured lights, bilateral, evolves over 5 to 30 minutes before resolving with onset of a headache, normal visual acuity
Retinal detachment	Retinal detachment	Retinal detachment	Postural hypotension – bilateral temporary dimming of vision and light-headedness
Retinal tear/hole	Retinal tear/hole	Retinal tear/hole	Occipital tumours
Optic neuropathy/neuritis – photopsia on eye movement, retrobulbar pain	Vitreous haemorrhage	Posterior Uveitis	Vertebrobasilar insufficiency/ TIA
Retinitis	Vitritis		Hallucinations
Rapid Eye movement in Darkenss	Vitreous syneresis		GCA
	Corneal Opacity/FB/Tear film debris