Floaters Q & A

What are floaters?

Seen as small dots, circles, lines, or web-like strings in your visual field, floaters are microscopic clumps of cells inside the vitreous gel, which is the clear fluid that fills the inside of your eye. Although they appear to be in front of your eye, they actually float inside and cast shadows on the light-sensitive tissue at the back of your eye, the retina, as they drift by when you move your eyes.

What causes floaters?

Floaters are often related to degenerative changes linked to the aging process. As you age, the vitreous gel within your eyes may start to liquify and shrink away from the back wall of the eye. When that occurs, these tiny strands or clumps of cells within the vitreous gel may become more noticeable.

Other causes of floaters include:

• Inflammation that causes the release of debris into the vitreous gel that may be due to an infection or autoimmune disorder
• Bleeding in the eye that’s caused by changes associated with diabetic retinopathy, high blood pressure (hypertension), blocked blood vessels, or injury
• Retinal detachment that occurs when sagging vitreous gel tugs on and tears the retina or causes fluid accumulation behind the retina that pushes it away from the back of your eye
• Severe myopia (nearsightedness)

When should I be concerned about floaters?

As we get older, the vitreous, which is tightly adherent to the back wall of the retina, can begin to peel away from the retina. This is known as a PVD (posterior vitreous detachment).

PVD’s are common. As the vitreous peels away from the retina it can apply tension against the retina and cause lightening type flashes in your vision. This is usually of no consequence. But sometimes, when the vitreous peels away from the retina it can tug too hard on the retina and create a small tear. The tear can bleed and blood cells can float into the vitreous that look like more prominent floaters or smoke. This occurrence has the potential for the retinal tear to worsen into a retinal detachment.

Retinal detachments can result in needing surgery with serious, permanent loss of vision. It is for this reason that whenever you see a new or different floater, it is important to be seen by your ophthalmologist for a dilated examination right away. Only a dilated examination by an eye doctor can determine whether your floaters are just a normal changing of the vitreous or a tear that has occurred in the retina.

Floaters that are a normal changing of the vitreous again are usually something that will eventually subside. In some cases, if the floaters are bothersome enough that they are causing a constant, long-term disturbance in vision, a procedure to remove the vitreous called a vitrectomy can be performed.

Laser of the vitreous floater is also an option. If floaters are found to be due to a tear that has occurred in the retina, then a laser treatment is used to heat seal and barricade around the tear to prevent retinal detachment.

Contact Dr. Lazar immediately if you notice:

• More eye floaters than usual or a sudden appearance of new floaters
• Flashes of light in the same eye as the floaters
• Darkness or a curtain-like shadow affecting your side vision (peripheral vision loss)

These symptoms may indicate a retinal tear, with or without a detachment, and require immediate medical attention to help prevent permanent vision loss. Call the office or book an appointment online.