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Floaters

What are Floaters?

Eye floaters (also known as Posterior vitreous detachments, PVD) are little “cobwebs” or specks that float about in your field of vision. They can take on many different forms including dark spots, bugs, strands, or squiggly lines that drift with or without eye moving. 

Initially floaters are alarming (due to their presentation and appearance) but over time most floaters will settle down and become evident when looking at something bright, such as white paper or a blue sky. 

What are floaters?

What causes Floaters?

The back of the eye is filled with Vitreous, a gel-like substance (made of protein and water).  Vitreous is important due to the fact it maintains the shape of the eye and acts as the shock absorber, providing protection to the retina.  Overtime and as we age vitreous slowly shrinks.

As the vitreous shrinks, it becomes somewhat stringy, and the strands can cast tiny shadows on the retina. These are floaters.

Protein clumping and vitreous gel shrinkage

Who is at risk for Floaters?

Floaters develop as we age.  Usually the process begins after the age of 50 but in some people, can develop in their 30’s and 40’s.  Floaters are more common and more likely to develop at a younger age in those who are very nearsighted (myopic), have Diabetes Mellitus, had a history of trauma or who have had a cataract operation.

Who is at risk for floaters?

How are Floaters treated?

Treatment is not recommended.  On rare occasions, floaters can be so dense and numerous that they significantly affect your vision. In these cases, a pars plana vitrectomy, a surgical procedure that removes floaters from the vitreous, may be needed.

A Vitrectomy removes the vitreous gel, along with its floating debris, from the eye. The vitreous is replaced with a salt solution. Because the vitreous is mostly water, you will not notice any change between the salt solution and the original vitreous.

Although this operation is quick to perform, generally taking less than 20 minutes, it does carry a risk of complications including retinal detachments, retinal tears, and early cataract development or progression.  Although that risk is very low.

Recently, a laser procedure called laser vitreolysis can be performed, where a laser beam is projected into the eye through the pupil and is focused on large floaters, breaking them apart.  This is option if your floaters are more anterior.  This is not a definitive treatment because it does not remove them but simply lasers the floaters to a smaller size but in doing so increases the number of floaters.  As such it is not as definitive of an option as Pars Plana Vitrectomy is.

Can Floaters be dangerous?

When new floaters appear, it is important to seek care by an eye care specialist to assure no signs of retinal tears or retinal detachments are evident.

Sometimes as a section of the vitreous pulls away from the retina, it tugs on the retina causing a retinal tear or break leading to a retinal detachment.  A retinal detachment is a serious condition and should always be considered an emergency. If left untreated, it can lead to permanent visual impairment within two or three days or even blindness in the eye.

Those who experience a sudden increase in floaters, flashes of light in peripheral vision, or a loss of peripheral vision, like a curtain covering part of their vision should seek care by an eye care specialist as soon as possible.