Eye Floaters

 

Eye floaters are spots in your vision. They may look to you like black or gray specks, strings, or cobwebs that drift about when you move your eyes and appear to dart away when you try to look at them directly.

Most eye floaters are caused by age-related changes that occur as the jelly-like substance (vitreous) inside your eyes becomes more liquid. Microscopic fibers within the vitreous tend to clump and can cast tiny shadows on your retina. The shadows you see are called floaters.

If you notice a sudden increase in eye floaters, contact an eye specialist immediately — especially if you also see light flashes or lose your peripheral vision. These can be symptoms of an emergency that requires prompt attention.

Symptoms

Symptoms of eye floaters may include:

  • Small shapes in your vision that appear as dark specks or knobby, transparent strings of floating material

  • Spots that move when you move your eyes, so when you try to look at them, they move quickly out of your visual field

  • Spots that are most noticeable when you look at a plain bright background, such as a blue sky or a white wall

  • Small shapes or strings that eventually settle down and drift out of the line of vision

Causes

Eye floaters may be caused by the normal aging process or as a result from other diseases or conditions:

  • Age-related eye changes. As you age, the vitreous, or jelly-like substance filling your eyeballs and helping them to maintain their round shape, changes. Over time, the vitreous partially liquefies — a process that causes it to pull away from the eyeball's interior surface. As the vitreous shrinks and sags, it clumps and gets stringy. This debris blocks some of the light passing through the eye, casting tiny shadows on your retina that are seen as floaters.

  • Inflammation in the back of the eye. Posterior uveitis is inflammation in the layers of the uvea in the back of the eye. This condition can cause the release of inflammatory debris into the vitreous that are seen as floaters. Posterior uveitis may be caused by infection, inflammatory diseases or other causes.

  • Bleeding in the eye. Bleeding into the vitreous can have many causes, including diabetes, hypertension, blocked blood vessels and injury. Blood cells are seen as floaters.

  • Torn retina. Retinal tears can occur when a sagging vitreous tugs on the retina with enough force to tear it. Without treatment, a retinal tear may lead to retinal detachment — an accumulation of fluid behind the retina that causes it to separate from the back of your eye. Untreated retinal detachment can cause permanent vision loss.

  • Eye surgeries and eye medications. Certain medications that are injected into the vitreous can cause air bubbles to form. These bubbles are seen as shadows until your eye absorbs them. Certain vitreoretinal surgeries add silicone oil bubbles into the vitreous that can also be seen as floaters.

Risk factors

Factors that can increase your risk of floaters include:

  • Age over 50

  • Nearsightedness

  • Eye trauma

  • Complications from cataract surgery

  • Diabetic retinopathy

  • Eye inflammation

Diagnosis

Mr. David will conduct a complete eye exam including eye dilation to better see the back of your eyes and the vitreous to determine the cause of the floaters.

Treatment

Any underlying cause of the floaters, such as bleeding from diabetes or inflammation, will be treated. However, most eye floaters don't require treatment. Eye floaters can be frustrating, and adjusting to them can take time. Once you know the floaters will not cause any more problems, you may eventually be able to ignore them or notice them less often.

If your eye floaters impair your vision, which happens rarely, you and your eye doctor may consider treatment. Options may include:

  • Surgery to remove the vitreous. An ophthalmologist removes the vitreous through a small incision (vitrectomy) and replaces it with a solution to help your eye maintain its shape. Surgery may not remove all the floaters, and new floaters can develop after surgery. Risks of a vitrectomy include bleeding and retinal tears.

  • Using a laser to disrupt the floaters. An ophthalmologist aims a special laser at the floaters in the vitreous, which may break them up and make them less noticeable. Some people who have this treatment report improved vision; others notice little or no difference. Risks of laser therapy include damage to your retina if the laser is aimed incorrectly. Laser surgery to treat floaters is used infrequently.

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