Many patients experience a sudden onset of flashes and floaters. This could be a sign of a retinal tear or detachment. Most people notice "floaters" throughout their lives as normal particles of their vitreous gel moving around. However, a sudden onset of new floaters and/or flashes of light should be checked by an eye doctor.
Retinal Tear
Retinal Tears can be effectively treated in the office with laser. This is an outpatient procedure that has minimal discomfort and no restrictions afterwards.
Retinal Detachments
If a Retinal Tear is left untreated for more than a few days, a Retinal Detachment occurs. It is analogous to the wallpaper in a room peeling off the wall. You will start seeing a shadow in your peripheral vision that worsens and moves towards the center vision daily if not hourly. There are 3 different methods to repair a Retinal Detachment: 1-Pneumatic Retinopexy 2-Scleral Buckle 3-Pars Plana Vitrectomy
Pneumatic Retinopexy
This is an office procedure done under local anesthetic. It is very effective but it has to be done in the right situation (degree of retinal detachment, location of retinal tear and cooperation of the patient). A small gas bubble is injected into the eye to push the retina back in place. Laser or Cryotherapy (freezing) is used to seal off the retinal tear. This is the least traumatic procedure for a retinal detachment and patients usually recover vision quickly.
Scleral Buckle
This is the oldest technique to repair Retinal Detachments and is sometimes combined with Vitrectomy (below). A silicone band is sutured around the white part of the eye (similar to the equator of the globe). It helps support the retina on the inside and is permanent. It is usually not visible to others after the eye is healed. It can be painful for a couple of weeks because you essentially have a "belt" squeezing the eyeball.
Pars Plana Vitrectomy
This is the most common procedure today to reattach the retina. Through microscopic incisions the vitreous gel is removed (including all those annoying floaters). The entire vitreous cavity is filled with a gas bubble to push the retina back in place. While relatively painless the bubble dissolves over several weeks so vision is quite blurred or nonexistent for at least 2-3 of those weeks. In addition there is a high likelihood of developing a cataract in a year and you cannot fly or go to high altitudes with a gas bubble.