Why these signs matter
Your retina is the light-sensitive layer at the back of your eye. When it tears or pulls away, the National Eye Institute lists the sudden symptoms as a lot of new floaters, flashes of light, and a dark shadow or curtain across your vision.[1] The symptoms often come on quickly, and if a detachment isn’t treated right away, more of the retina can detach, which raises the risk of permanent vision loss.[1]
Floaters themselves are usually harmless. They’re small dark spots, threads or squiggles that drift across your vision, and they usually come from normal age-related changes in the gel that fills the eye.[2] The warning is when new ones appear suddenly, especially with flashes, or with a shadow or blurry area at the side or center of your vision.[2]
A scleral lens sits on the front of your eye. Floaters and flashes come from inside it. That’s why a lens can’t explain these warning signs, and why sorting out the lens is never a reason to delay.
Things on the lens that can look like floaters
Plenty of spots that scleral wearers see do come from the lens, and wearers often describe them:
- Debris in the fluid behind the lens. Specks or haze in the reservoir that stay roughly in place.
- A small air bubble. Wearers describe distortion that shifts when they blink and is easier to see looking toward a light. See air bubbles.
- Film or smudges on the front surface. Makeup, lid oil, or night ointment residue. See film and deposits.
- Floaters you always had. Some wearers notice old floaters more once their vision is sharper with the lens.
True floaters move as your eyes move and keep drifting when your eyes stop.[2] Spots that come from the lens usually clear when you take the lens out, rinse it, and refill.
Only troubleshoot this way if you have none of the warning signs above. If you’re unsure whether something is new, treat it as new.
What wearers say
- Many wearers have been through this. Wearers who reported new floaters with flashes were consistently told by others to get seen urgently, not to wait for an appointment that was days away.
- Waiting after an injury is a common mistake. People who had flashes after a knock to the eye and planned to wait were urged to call sooner.
- Floaters often fade from attention. Wearers diagnosed with a posterior vitreous detachment (the gel pulling away from the retina) often said their floaters became less noticeable over time, and that keeping in touch with a retina specialist mattered.
- Getting back into lenses can be possible. Some wearers who had a retinal tear or detachment treated went back to their scleral lenses afterward, once their retina doctor agreed.
Going to the appointment
- Expect dilation. To check for a tear or detachment, your doctor will put drops in to widen your pupils and look at the back of your eye.[1] Afterward your vision may be blurry and light-sensitive for a few hours, so ask someone to drive you.[3] See scleral lenses and dilation.
- Bring your kit. Glasses, your lens case, saline and your plunger, so you can take the lens out and put it back safely if you’re told you may.
- Tell them you wear scleral lenses and how long you’ve worn them that day.
What to ask your eye doctor
- Did you find a tear or detachment, and what follow-up do I need?
- What new symptoms should make me come straight back?
- When can I go back to wearing my scleral lens, and is there anything I should avoid while I heal?
- Does my eye condition, or how nearsighted I am, put me at higher risk?
- After treatment, should my scleral lens fitter check the fit before I go back to full-day wear?
When it’s the lens, not the retina
If you’ve ruled out the warning signs and the problem is haze, specks or blur that come and go with the lens, our blurry after insertion and midday fogging guides cover the common fixes.
Common questions
Can a scleral lens cause a retinal detachment?
We haven't found evidence that it does, and the warning signs need the same urgent care either way. The National Eye Institute lists aging and eye injury as the most common causes, and higher risk with extreme nearsightedness, earlier eye surgery such as cataract surgery, a serious eye injury, or a posterior vitreous detachment. If you've had a hard knock to the eye, including a fumbled insertion or removal, mention it.
I've always had a few floaters. Do I need to go in?
Floaters that come and go and haven't changed are common, and the National Eye Institute says they often don't need treatment. What matters is something new: a lot of new floaters appearing suddenly, flashes of light, or a shadow in your vision. Those need to be checked right away.
Should I take my lens out before I go?
If you can do it safely and quickly, yes, and bring it in its case. But don't delay leaving because of the lens. The doctor will need to dilate your pupils and look at the back of your eye, and you shouldn't drive yourself home afterward.
My eye doctor's office is closed. What do I do?
Call the after-hours line if there is one, or go to an emergency room. The National Eye Institute says to go to your eye doctor or the emergency room right away. Some wearers found it helped to call ahead and ask whether an eye specialist was available.