Floaters and Spots

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Eye floaters are small moving spots that appear in your field of vision. They may be especially noticeable when you look at something bright, such as white paper or a blue sky.

Eye floaters can be annoying, but they generally don’t interfere with your sight. Occasionally a particularly large eye floater may cast a subtle shadow over your vision. But this tends to occur only in certain types of light.

Most of the time people learn to live with eye floaters and ignore them. And they often improve over months to years. Only rarely do benign eye floaters become bothersome enough to consider treatment.  But sometimes eye floaters are a sign of a more serious condition. You should seek immediate medical attention if you notice a sudden increase in the number of eye floaters.

Immediate medical attention is especially important if the floaters are accompanied by flashes of light or a loss of side vision. If you have these symptoms, see an eye doctor right away. Without immediate treatment, you can have permanent vision loss. These symptoms may be caused by:

  • Retinal detachment
  • Retinal tear
  • Bleeding within the eye

Symptoms of Eye Floaters

Eye floaters move as the eyes move. They generally appear to dart away when you try to focus on them.

Eye floaters can appear in many different shapes, such as:

  • Black or gray dots
  • Squiggly lines
  • Threadlike strands, which can be knobby and semi-transparent
  • Cobwebs
  • Ring shaped

Once you develop eye floaters they usually do not go away, though they tend to improve over time.

Causes of Eye Floaters

Eye-floaters 2Most eye floaters are caused by small flecks of a protein called collagen. The back compartment of the eye is filled with a gel-like substance called the vitreous humor.  As you age, the vitreous and its millions of fine collagen fibers shrink and become shred-like. Shreds can accumulate in the vitreous. This can cause a change in the amount of light that hits the retina — the light-sensitive tissue in the back of the eye. This change causes the symptoms of eye floaters.

These changes can happen at any age. They most often occur between ages 50 and 75, especially in people who are very nearsighted or have had cataract surgery.

Rarely, eye floaters can result from other eye surgery or:

  • Eye disease
  • Eye injury
  • Diabetic retinopathy
  • Crystal-like deposits that form in the vitreous
  • Ocular tumors such as lymphoma (rarely)

Serious eye disorders associated with eye floaters include:

  • Retinal detachment
  • Retinal tear
  • Vitreous hemorrhage (bleeding)
  • Vitreous and retinal inflammation caused by viral infections, fungal infections, or auto-immune inflammation
  • Ocular tumors

In addition, a unique form of eye floaters is associated with the visual aura of migraine headaches.

When to Seek Medical Attention for Eye Floaters

If you only have a few eye floaters that don’t change over time, it usually does not indicate a serious eye problem.

It’s important to see a doctor if:

  • Eye floaters seem to worsen over time, especially if the changes are sudden in onset.
  • You experience flashes of light or any vision loss accompanied by eye floaters.
  • You develop eye floaters after eye surgery or eye trauma.
  • You have eye pain along with eye floaters.

Treatment of Eye Floaters

Benign eye floaters almost never require medical treatment.

If they are bothersome, you can move them away from your field of vision by moving your eyes. This maneuver shifts the fluid in your eyes. Looking up and down is usually more effective than looking from side to side.

If eye floaters are so dense and numerous that they affect your vision, your eye doctor may consider a surgical procedure called a vitrectomy. During this procedure, the vitreous and its floating debris are removed and replaced with a salt solution.

Vitrectomy may have complications, such as:

  • Retinal detachment
  • Retinal tears
  • Cataracts

The risks of such complications are quite high. Most surgeons will not perform vitrectomy unless eye floaters are seriously affecting the patient’s vision.

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