3 doctors weighed in:

I can see halo-like flashes of light. Is this normal? Should I be worried?

3 doctors weighed in
Dr. Ari Weitzner
Ophthalmology
1 doctor agrees

In brief: Maybe

Could be a retinal tear. Or a migraine.
See ophthalmologist asap.

In brief: Maybe

Could be a retinal tear. Or a migraine.
See ophthalmologist asap.
Dr. Ari Weitzner
Dr. Ari Weitzner
Thank
Dr. Daniel Goldberg
Ophthalmology

In brief: Get checked out

Light flashes should generally be checked out immediately, especially if they are new in onset.
Sometimes light flashes are a symptom of migraine and this is generally benign, but sometimes light flashes mean something more serious such as a retinal tear or detachment. The eye contains a gelatinous substance called the vitreous humor, which occupies the eyeball’s inner cavity. It extends from the front of the eye, behind the lens, to the back of the eye and makes contact with the entire internal eyewall surface. In the back of the eye, the vitreous is adherent to the retina. The adherence is tenuous and the vitreous may separate from the retina at any time but usually does so as people age and the vitreous liquefies. The vitreous is composed of 99% water and 1% mucopolysccharides (hyaluronic acid) and collagen. When we are young, it is homogeneous, like a bowl of jello but as we age, pockets of water separate out and dissociate the back surface of the gel from the retina. This is called a “posterior vitreous detachment” (pvd). The solid constituents (collagen fibers) in the gel then contract centrally. Once a PVD occurs, patients will complain of “floaters” because the collagen fibers condensed in the vitreous float freely in the water and cast shadows on the retina. In most patients, the vitreous separation occurs uneventfully, without pulling the retina with it. As the gel contracts, however, and separates from the retina, to which it is lightly adherent, it may tug on the retina in some patients. The retina’s job is to transmit light impulses to the visual cortex of the brain and the usual stimulus to generate these nerve impulses is a photon of light, but any stimulus to the retina, including the mechanical stimulus of tugging on the nerve fibers that make up the retina, will have the same effect. So if the vitreous pulls at the retina as it attempts to separate, the brain will detect “flashes”. These flashes may appear as lightning bolts, colored strobes and halos. This can occur even in the dark where there are no photons of light to stimulate the retina (the mechanical stimulus is substituting for the photon in this case). Once the vitreous separates from the retina it does not reattach and, in general, the flashes should disappear. The danger however, occurs in a few unfortunate folks in whom the vitreous does not want to let go of the retina. Although the vitreous is generally mildly adherent to the retina, some people have specific conditions (ie: lattice degeneration, high myopia) which render the vitreoretinal adhesion tighter, or the retinal thickness thinner. Under these circumstances, as the vitreous moves away, it may bring the retina away from the back wall with it. This is called a retinal detachment and this will lead to severe vision loss and must be surgically repaired as soon as possible. Retinal detachments occur when the contracting vitreous tears the retina away and makes a hole in the retina. Fluid then travels through this hole and detaches the retina. If caught early, the hole may only need laser in the office. If a full retinal detachment occurs, it likely requires surgery. Most people who develop a retinal tear will bleed into the eye and the blood is opaque so it casts dark, globular, streaky shadows and floaters. So if you have new flashes, especially if there are new, dark, dense floaters associated with them have your eyes checked by an ophthalmologist to make sure you don’t have retinal tears and that your retina is attached.

In brief: Get checked out

Light flashes should generally be checked out immediately, especially if they are new in onset.
Sometimes light flashes are a symptom of migraine and this is generally benign, but sometimes light flashes mean something more serious such as a retinal tear or detachment. The eye contains a gelatinous substance called the vitreous humor, which occupies the eyeball’s inner cavity. It extends from the front of the eye, behind the lens, to the back of the eye and makes contact with the entire internal eyewall surface. In the back of the eye, the vitreous is adherent to the retina. The adherence is tenuous and the vitreous may separate from the retina at any time but usually does so as people age and the vitreous liquefies. The vitreous is composed of 99% water and 1% mucopolysccharides (hyaluronic acid) and collagen. When we are young, it is homogeneous, like a bowl of jello but as we age, pockets of water separate out and dissociate the back surface of the gel from the retina. This is called a “posterior vitreous detachment” (pvd). The solid constituents (collagen fibers) in the gel then contract centrally. Once a PVD occurs, patients will complain of “floaters” because the collagen fibers condensed in the vitreous float freely in the water and cast shadows on the retina. In most patients, the vitreous separation occurs uneventfully, without pulling the retina with it. As the gel contracts, however, and separates from the retina, to which it is lightly adherent, it may tug on the retina in some patients. The retina’s job is to transmit light impulses to the visual cortex of the brain and the usual stimulus to generate these nerve impulses is a photon of light, but any stimulus to the retina, including the mechanical stimulus of tugging on the nerve fibers that make up the retina, will have the same effect. So if the vitreous pulls at the retina as it attempts to separate, the brain will detect “flashes”. These flashes may appear as lightning bolts, colored strobes and halos. This can occur even in the dark where there are no photons of light to stimulate the retina (the mechanical stimulus is substituting for the photon in this case). Once the vitreous separates from the retina it does not reattach and, in general, the flashes should disappear. The danger however, occurs in a few unfortunate folks in whom the vitreous does not want to let go of the retina. Although the vitreous is generally mildly adherent to the retina, some people have specific conditions (ie: lattice degeneration, high myopia) which render the vitreoretinal adhesion tighter, or the retinal thickness thinner. Under these circumstances, as the vitreous moves away, it may bring the retina away from the back wall with it. This is called a retinal detachment and this will lead to severe vision loss and must be surgically repaired as soon as possible. Retinal detachments occur when the contracting vitreous tears the retina away and makes a hole in the retina. Fluid then travels through this hole and detaches the retina. If caught early, the hole may only need laser in the office. If a full retinal detachment occurs, it likely requires surgery. Most people who develop a retinal tear will bleed into the eye and the blood is opaque so it casts dark, globular, streaky shadows and floaters. So if you have new flashes, especially if there are new, dark, dense floaters associated with them have your eyes checked by an ophthalmologist to make sure you don’t have retinal tears and that your retina is attached.
Dr. Daniel Goldberg
Dr. Daniel Goldberg
Thank
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