Patients presenting to primary care with new-onset floaters or flashes may be at increased risk of retinal tear or detachment. Risk was highest in patients with numerous new floaters, particularly when accompanied by flashes, according to a new study.

Floaters and flashes are common in the over-50s, and are usually the result of age-related posterior vitreous detachment, although sudden new floaters may indicate retinal tear or retinal detachment. 

Previous studies have shown both floaters and flashes to be associated with retinal tears or retinal detachment, with elevated risks for those with both, and in individuals reporting 10 or more floaters (Gishti et al, 2019). However, most of the evidence to date has come from patients attending ophthalmology services.

Researchers at Radboud University Medical Center in Nijmegen, the Netherlands, analysed the health records of more than 1,000 adults who reported floaters or flashes, or both, during visits to family medical practices between 2012 and 2021.

The research team found that the risk of retinal detachment following episodes of floaters was 6.1%. It was 4.7% after flashes and 8.4% after episodes of both (van Zon et al, 2026).

The risk of retinal detachment following presentations with new-onset or recently changed floaters was 8.5%. When patients reported more than 10 floaters, or a cloud, haze or curtain of them, this increased to 19.8%. One in 10 episodes (9.8%) resulted in a diagnosis of migraine.

The authors, whose study was published in the Annals of Family Medicine, concluded that floaters, especially recent-onset cases and multiple floaters, should be considered more important warning signs for retinal detachment than flashes.