One of the most common complaints we hear from our patients is about floaters in their vision. Although often mistaken for a gnat flying around or a piece of fuzz in the eye, floaters are actually particles within the vitreous, or gel, inside your eye. While these are most commonly a benign condition, floaters may also be a sign of a more serious, sight-threatening condition. Here we’ll take a look at what causes floaters and what you should do about them.
Where do floaters come from?
When we are young, the vitreous inside our eye is a gel-like consistency. Over time, it begins to liquefy. The undissolved particles become what we see as floaters. Sometimes they appear as black or gray strings, specks or cobwebs that move about when you drift your eyes, the most frustrating part? Whenever you try to focus your vision on them, they tend to evade your sight immediately.
When are floaters a concern?
Most adults will see floaters in their vision from time to time, but not all floaters are normal. Floaters can be a symptom of some sight-threatening conditions, so anytime you see a new onset of floaters, you should see your eye doctor immediately. Other symptoms that may be associated with floaters include flashing lights or the appearance of a curtain or veil in your vision. Although these symptoms are all painless, their cause can be very serious.
Causes of Eye Floaters
The most common cause of new floaters is a posterior vitreous detachment. This occurs when the vitreous liquefies and starts to pull away from the retina, the inner lining of your eye. This is a natural, harmless process that happens to most people later in life. However, the symptoms are very similar to a retinal detachment, in which the layer of the eye responsible for vision, separates from its source of blood and nutrients. If not treated immediately, a retinal detachment can lead to permanent vision loss.
Retinal breaks, like a hole or a tear, can also cause symptoms of floaters or flashing lights in your vision. These can progress to a retinal detachment, so the symptoms should not be ignored. If a retinal break is found, there are several treatment options available to prevent vision loss.
Less common causes of eye floaters include bleeding or inflammation within the eye. Typically, there is an underlying retinal disease, such as diabetes or macular degeneration, that would lead to a hemorrhage within the eye. A vitreous hemorrhage increases the risk of a retinal hole or tear so close monitoring is necessary. Certain eye infections can also cause inflammation within the eye, contributing to floaters. This inflammation must be treated appropriately to prevent long-term damage to the delicate structures within the eye.
Most floaters do not require any treatment. They can be annoying and distracting when they are new, but once confirmed they are benign, they are usually just monitored for changes. Generally with time, floaters become less noticeable as our brain learns to tune them out and gravity pulls them down out of the line of sight.
When floaters are persistent or very large, a couple of treatment options may be considered. In the past, the only treatment was a vitrectomy, in which the vitreous is surgically removed from the eye. This procedure can be complicated and should be reserved only when the benefits outweigh the risks. More recently, a laser procedure, called laser vitreolysis, has become an option to break up large floaters. Although this method is safer, there are certain risks involved so your eye doctor will help you determine if you are a good candidate for this procedure.
Be sure to discuss your floaters with your eye doctor. It’s never safe to assume they are harmless. Be prepared for a thorough dilated eye exam to determine the cause of your eye floaters.