Eye Floaters: Causes, Symptoms, and Treatment

Eye floaters are small shapes that people see floating in their field of vision. They can appear as spots, threads, squiggly lines, or even small cobwebs. These shapes are usually most noticeable when looking at a plain bright background, like a clear blue sky or a white wall.

Causes

Eye floaters are caused by changes in the vitreous, the gel-like substance inside your eyes. As we age, the vitreous tends to liquefy and shrink, which can lead to clumping of the collagen fibers inside the vitreous. These clumps cast shadows on the retina, which are perceived as floaters. Other causes include:

• Posterior Vitreous Detachment (PVD): A common condition where the vitreous gel separates from the retina.
• Retinal Tears and Detachments: When the vitreous tugs on the retina, it can cause a tear. If left untreated, this can lead to retinal detachment.
• Inflammation (Uveitis): Inflammation in the eye can cause the release of inflammatory debris into the vitreous, which appear as floaters.
• Hemorrhages: Bleeding within the eye, often due to conditions like diabetic retinopathy or trauma, can result in floaters.
• Eye Injuries: Trauma to the eye can cause floaters.
• Eye Surgeries: Certain eye surgeries can lead to the development of floaters.

Symptoms

• Spots 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.
• Spots that eventually settle down and drift out of the line of vision.

When to See a Doctor

While eye floaters are usually harmless, they can sometimes indicate a serious condition. Seek medical attention if:

• There is a sudden increase in the number of floaters.
• You see flashes of light.
• You experience a loss of side vision.
• There is a sudden onset of floaters after eye surgery or eye trauma.

Diagnosis

An eye examination by an ophthalmologist or optometrist can help diagnose the cause of eye floaters. This examination might include:

• Visual Acuity Test: Measures how well you see at various distances.
• Dilated Eye Exam: Drops are placed in your eyes to widen (dilate) the pupils, allowing your doctor to examine the retina and vitreous in greater detail.
• Ultrasound: If the retina isn't visible clearly due to bleeding or other issues, an ultrasound can help provide a detailed view of the inside of the eye.

Treatment

Most eye floaters do not require treatment and may become less noticeable over time. However, if floaters impair your vision significantly or are caused by a more serious condition, treatment may be necessary. Options include:

• Observation: Most floaters are benign and will fade over time.
• Laser Treatment (Laser Vitreolysis): A laser is used to break up floaters, making them less noticeable. This procedure is not widely performed and its long-term safety and effectiveness are still being studied.
• Surgery (Vitrectomy): In this procedure, the vitreous gel along with its floating debris is removed and replaced with a saline solution. This is usually reserved for severe cases due to potential risks such as retinal detachment and cataracts.

Prevention

There is no guaranteed way to prevent eye floaters, but maintaining overall eye health can help. Regular eye check-ups, managing chronic conditions like diabetes, and protecting your eyes from injury can reduce the risk of developing serious issues related to floaters.

If you notice any changes in your vision or experience a sudden increase in floaters, it is important to seek professional medical advice to rule out any serious conditions.