Eye floaters are a common occurrence many people experience at some point in their lives. While they can be a bit alarming, they are usually harmless and do not necessarily indicate a serious eye condition. In this publication, we will explore what floaters are, why they happen, and when you should seek medical attention. Our goal is to provide a comprehensive and easy-to-understand guide for patients like you.
Understanding Eye Floaters
What Are Eye Floaters?
Eye floaters are tiny specks, dark dots, squiggly lines, or cobweb-like strands that seem to "float" across your field of vision. Sometimes, they may also seem like dust particles. Floaters get their name from their tendency to drift and evade your focus when you attempt to fix your gaze on them.
They become more conspicuous when you look at a simple, well-lit backdrop. For instance, a clear blue sky or a bright white wall.
What Causes Eye Floaters?
Causes of eye floaters are specks of protein (collagen) or other materials forming in the clear, gel-like substance inside your eyeball (the vitreous humor). Along with the aging process, this gel can become more liquid, and these particles may cast shadows on the retina, leading to the perception of floaters.
Apart from aging, nearsightedness and migraines may contribute to seeing floaters in eyes. Some of the rare but serious conditions causing floaters are hemorrhages, retinal tears, diabetic retinopathy, cataracts, eye infections, surgery complications, and more. We will talk about them in more detail later in this article.
Are Floaters in Eye Normal?
Eye floaters are extremely common, more than you would think. Most people will experience them to some extent during their lifetime. Eyesight floaters become more prevalent as we get older, typically appearing in individuals over the age of 50.
In many cases, floaters in eyes are just a normal part of the aging process. They are generally harmless and don't require treatment. Yet, there are situations when you should consult an eye specialist, even if you've had floaters for a long time.
When to Seek Medical Attention?
It's time to seek medical help for your floaters when you:
Suddenly see a significant increase in the number of eye floaters
Notice flashes of light along with the floaters
Your vision is significantly compromised by the specs in your field of view
A sudden onset of numerous new floaters in eyes or a change in their appearance may be a sign of a more serious issue. Those may be retinal detachment or bleeding in the eye. This requires urgent eyedoctor's attention.
Flashes of light, especially when they accompany floaters, can potentially be a sign of retinal traction, tear or detachment. These conditions can lead to vision loss and require prompt medical evaluation by an eye care professional.
Last but not least, if floaters are interfering with your daily activities or significantly impacting your vision, you should go for a medical assessment.
Can Ophthalmologists See Floaters in Patients' Eyes?
Ophthalmologists can indeed see floaters in patients' eyes during eye exams. Eyesight floaters are typically visible to eye care professionals when they use specialized instruments to inspect the interior of the eye.
Eye doctors detect floaters in a dilated eye examination. They instill eye drops that dilate the pupils, allowing more light to enter the eye and providing a larger view of the inside of the eye. Then they use a slit lamp (a binocular microscope with an intense light source) to examine the eye's anterior and posterior segments.
Indirect ophthalmoscopy is also a technique that allows eye doctors to observe eye floaters as they cast shadows on the retina with a special handheld lens and a bright light. In some cases, ophthalmologists may use OCT. That's a non-invasive imaging technique, to obtain high-resolution cross-sectional images of the retina and vitreous.
Eye Conditions with Floaters
Eye floaters occur in various eye conditions, and while they are often harmless, they can sometimes be a symptom of deeper issues.
Here are some eye conditions in which floaters may appear:
Posterior Vitreous Detachment (PVD). PVD is a common age-related condition where the gel-like vitreous inside the eye shrinks and pulls away from the retina. This process results in floaters as the vitreous tugs on the retina.
Retinal Tears and Detachment. Floaters can also be a symptom of a torn retina. If the retina tears or detaches, it can cause bleeding in the eye, presenting as eye floaters along with flashes of light.
Vitreous Hemorrhage. When blood vessels in the retina leak, blood mixes with the vitreous humor. This can trigger the sudden onset of floaters in the field of vision.
Diabetic Retinopathy. People with diabetes are at risk of developing diabetic retinopathy. A condition in which abnormal blood vessels in the retina can bleed into the vitreous, causing eyesight floaters.
Uveitis. Uveitis is inflammation of the middle layer of the eye, the uvea. The release of inflammatory cells into the vitreous can result in spots or specs floating around in your vision.
Cataracts. While cataracts primarily cause clouding of the eye's lens, severe cataracts may lead to secondary symptoms, including floaters in eyes.
Infections and Inflammation. Eye infections and inflammatory diseases contribute to the onset of floating specs as well.
Surgery complications and medications. Certain medications and interventions have the potential to result in harm to the retina. This harm may manifest as retinal tears with the presence of air bubbles in the vitreous humor, giving rise to the visibility of eye floaters.
NOT all floaters are indicative of these conditions! Eye floaters mainly occur as a normal part of the aging process.
RELATED: Early Signs of Eye Problems
Eye Floaters Treatment
Eye floaters treatment depends on the cause and severity of the symptoms. In many cases, no treatment is necessary, as floaters are typically harmless.
The decision to pursue treatment should be made in consultation with an eye care professional. Furthermore, individuals should be aware treatment options may carry risks and limitations.
In certain cases, ophthalmologists may prescribe medication to alleviate eye floaters. But this is NOT a common approach, and the effectiveness is debated. Instead, if floaters are a result of a medical condition, such as diabetes or inflammation, addressing the root cause is likely to reduce or eliminate them.
Laser Floater Treatment (LFT) or laser vitreolysis uses laser technology to target and break down floaters in the vitreous. LFT is less invasive than vitrectomy and is suitable for some cases of bothersome floaters. It may require multiple sessions for better results. Despite the reduced risks, there are some concerns with inducing traction on the retina through the movement of the vitreous during the laser therapy and potentially causing small retinal breaks. Vitrectomy is a surgical procedure that involves the removal of the vitreous humor and its replacement with a clear saline solution. This is only an option for severe cases of floaters, where they significantly impair vision or quality of life. The procedure carries significant intraoperative and postoperative risks and is usually a last resort.
Regular eye check-ups are the best way to monitor your eye health and catch issues early.
For more information about eye health, read our blog for patients!
Checked by Atanas Bogoev, MD.