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Floaters. We all get them, sometimes!

What Are Floaters?

One of the most common complaints in eye care is the “floater.” Most people have seen them, a speck that meanders across the field of view and can be seen as a nuisance to some, but this may be a sign of a serious problem.

Most of the eye’s interior is filled with vitreous, a gel-like substance that helps the eye maintain a round shape. There are millions of fine fibers intertwined within the vitreous that are attached to the surface of the retina, the eye’s light-sensitive tissue. As we age, the vitreous (liquid gel) slowly shrinks, and these fine fibers pull on the retinal surface. Usually the fibers break, allowing the vitreous to separate and shrink from the retina. This is a vitreous detachment. In most cases, a vitreous detachment is not sight-threatening and requires no treatment.

As the vitreous shrinks however, it becomes somewhat stringy, and the strands can cast tiny shadows on the retina. You may notice these floaters, which appear as little “cobwebs” or specks that seem to float in your field of vision. If you try to look at these shadows they appear to quickly dart out of the way. One symptom of a vitreous detachment is a small but sudden increase in the number of new floaters. This increase may be accompanied by flashes of light (lightning streaks) in your peripheral, or side, vision. In most cases, either you will not notice a vitreous detachment, or you will find it merely annoying because of the increase in floaters.

Vitreous Detachment

A vitreous detachment is a common condition that usually affects people over age 50, and is very common after age 80. “People who are nearsighted are also at increased risk. Those who have a vitreous detachment in one eye are likely to have one in the other, although it may not happen until years later,” stated Dr. Lance Dunoff of Fox Chase Family Eye Care in Philadelphia, PA. “Although a vitreous detachment does not threaten sight, once in a while some of the vitreous fibers pull so hard on the retina that they create a macular hole or lead to a retinal detachment.”

Treatment for Vitreous Detachment

Both of these conditions are sight-threatening and should be treated immediately. If left untreated, a macular hole or detached retina can lead to permanent vision loss in the affected eye. Those who experience a sudden increase in floaters or an increase in flashes of light in peripheral vision should have an eye care professional examine their eyes immediately. “The only way to diagnose the cause of the problem is by a comprehensive dilated eye examination,” reported Dr. Dunoff. “If the vitreous detachment has led to a macular hole or detached retina, early treatment can help prevent loss of vision.”

Dr. Dunoff reassures patients who have these symptoms that they are undergoing a normal process, but should have their vision monitored closely over the next several weeks to ensure there are no signs of a retinal detachment.