Eye floaters are common visual disturbances appearing as small spots or cobweb-like shapes drifting across one’s field of vision. They are usually more noticeable when looking at a plain, bright background, such as a clear sky or a white wall. While a minor annoyance, floaters are generally harmless and do not interfere with vision.
Understanding Eye Floaters
Floaters originate from within the eye. They are tiny clumps of cells or protein fibers suspended in the eye’s internal gel. What is perceived as a floater is actually the shadow these structures cast onto the retina, the light-sensitive tissue at the back of the eye. These shapes appear to move when the eye shifts, then slowly drift as the eye comes to rest.
How Floaters Form
The eye is filled with a clear, jelly-like substance called the vitreous humor, which helps maintain the eye’s shape and allows light to pass to the retina. As individuals age, the vitreous humor naturally becomes more liquid, a process known as vitreous syneresis. During this liquefaction, collagen fibers within the vitreous clump together. These clumps cast shadows on the retina, seen as floaters.
The most common cause of a sudden increase in floaters is posterior vitreous detachment (PVD), occurring when the vitreous gel shrinks and pulls away from the retina as a normal part of aging. This separation releases more debris into the vitreous, leading to new floaters. While PVD is generally harmless, it is important to rule out more serious conditions.
Factors Contributing to Floater Development
Beyond natural aging, several conditions can increase floaters. Age is a primary factor, with most people experiencing vitreous changes by age 60. People with severe nearsightedness (myopia) are more prone to floaters and PVD at an earlier age.
Eye trauma can dislodge vitreous material, leading to new floaters. Inflammation inside the eye (uveitis) can cause debris to form in the vitreous, resulting in floaters. Eye surgery, such as cataract surgery, can trigger new floaters, though often temporary. Diabetic retinopathy, a complication of diabetes, can cause bleeding into the vitreous, perceived as floaters.
When Floaters Warrant Concern
While most floaters are benign, certain symptoms signal a more serious condition requiring immediate medical attention. A sudden onset or significant increase in floaters is a warning sign. Flashes of light (photopsia) in one or both eyes, especially alongside new floaters, should prompt immediate evaluation. These flashes occur when the vitreous gel pulls on the retina.
Other concerning symptoms include a dark curtain or shadow obstructing vision, indicating a retinal tear or detachment. Loss of peripheral vision also warrants urgent medical assessment. Any floaters after eye trauma, or sudden, significant vision changes with floaters, should be promptly evaluated by an eye care professional to rule out a medical emergency.
Living With or Treating Floaters
Most floaters do not require specific treatment. The brain often adapts to and ignores these visual disturbances, making them less noticeable. Floaters also settle to the bottom of the eye, moving out of direct line of sight.
In rare, severe cases where floaters significantly impair vision, medical interventions are considered. Vitrectomy is a surgical procedure where the vitreous gel and floaters are removed and replaced with a saline solution. This procedure is reserved for extreme circumstances due to risks, including infection, bleeding, retinal tears or detachment, and cataract formation. Another option is laser vitreolysis, using a laser to break up large floaters into smaller, less noticeable pieces. The effectiveness and safety of laser vitreolysis are debated, and it is not widely available or recommended for all types of floaters.