Eye floaters are small specks, strings, or cobwebs that appear to drift across a person’s field of vision. Eye doctors can see floaters during an eye examination. This ability is important for assessing overall eye health and distinguishing between benign occurrences and those that may signal a more serious underlying condition.
How Eye Doctors Detect Floaters
Eye doctors rely on a comprehensive dilated eye exam to detect and evaluate floaters. This process begins with dilating eye drops, which widen the pupil for a clearer view of the eye’s internal structures, particularly the vitreous humor and retina. Dilation temporarily increases light sensitivity and can make existing floaters more noticeable.
Once the pupils are dilated, specialized instruments are used to examine the back of the eye. An ophthalmoscope, which can be direct or indirect, allows the doctor to view the retina and optic nerve. A slit lamp microscope, combined with high-powered lenses, is used to gain a magnified, stereoscopic view of the vitreous humor and retina. These tools help identify changes in the vitreous, such as collagen clumps or debris, and check for signs of retinal tears or detachment, which could be the source of floaters.
When Floaters Signal a Serious Condition
While most floaters are benign, their sudden appearance or a change in characteristics can indicate a serious underlying eye condition that requires immediate attention. A sudden increase in floaters, especially when accompanied by flashes of light, is a warning sign. These flashes occur when the vitreous gel pulls on the retina.
Other indicators that floaters may signal a serious problem include a shadow or curtain obscuring part of the vision, or significant vision loss. These symptoms can point to conditions like a retinal tear, where the retina pulls away from its supporting tissue, or a retinal detachment. Retinal detachment is a medical emergency that can lead to permanent vision loss if not treated promptly. A vitreous hemorrhage, which is bleeding into the vitreous gel, can also cause a sudden onset of new floaters and requires professional evaluation.
Understanding the Causes of Floaters
Eye floaters typically occur due to age-related changes in the vitreous humor, the gel-like substance that fills the eye. As people age, the vitreous can liquefy and shrink, causing collagen fibers to clump together. These clumps cast shadows on the retina, perceived as floaters. This process is known as posterior vitreous detachment (PVD), where the vitreous gel separates from the back of the eye.
Beyond age, several other factors can contribute to the development of floaters. Nearsightedness (myopia) is associated with an increased risk of floaters. Eye injury or trauma can also cause changes in the vitreous, leading to floaters. Eye inflammation, such as uveitis, or certain medical conditions like diabetic retinopathy, can also result in floaters.
Managing and Treating Floaters
Most eye floaters are harmless and do not require specific treatment. Patients often adapt to their presence, and floaters may become less noticeable over time as the brain learns to ignore them. Intervention is generally considered only when floaters significantly impair vision or are linked to a serious underlying condition.
Two primary treatment options exist for problematic floaters. Vitrectomy involves surgically removing the vitreous humor and replacing it with a saline solution. This procedure effectively removes floaters but carries risks, including infection, bleeding, retinal tears, or accelerated cataract formation.
Another option is YAG laser vitreolysis, which uses a laser to break up larger floaters into smaller, less noticeable fragments. While less invasive than vitrectomy, laser treatment also has risks, such as increased eye pressure, damage to the retina or lens, or the possibility that floaters may re-clump or new ones may form. The suitability of treatment should be discussed with an ophthalmologist, who can assess the individual case and weigh the benefits against the potential risks.