Our eyes are incredible structures that turn light from the outside world into an image for our brain to make sense of. Sometimes however, what we see can originate in the eye, rather than outside of it! This is the case with eye floaters. The majority of the inside of the eye is hollow, and contained within that hollow space is a component of the eye called vitreous. The vitreous is a jelly-like substance primarily made up of water and a protein called collagen. Over time, and with certain eye conditions, the vitreous breaks down and becomes less firm. As this process occurs, strands of collagen can dislodge, clump, and “float” through the vitreous. These spots and strands are what we refer to as floaters.
Floaters are most often seen in older patients, and patients with high eyeglass prescriptions, however, they can occur at any age and in the absence of other eye conditions. Floaters on their own are generally harmless, and do not have a significant impact on vision for most patients. Although they indicate a breakdown of the vitreous body, they do not have a direct impact on eye health or vision long-term.
In some cases, vitreous degeneration and floaters can be indicative of a more serious problem. The vitreous is firmly attached to the retina, the layer of the eye that uses light to help form an image in the brain. If the vitreous breaks down and pulls on the retina hard enough, a retinal tear can occur. This process is often accompanied by flashes and streaks of light in a person’s vision. If left untreated, a retinal tear can develop into a detachment, which is a vision threatening emergency. If someone is experiencing flashes of light and new floaters, it is recommended to see an eye care provider as soon as possible.
The usual treatment for floaters is simply observation and learning to live with them. However, some people have large floaters that can interfere with their vision and quality of life. In recent years, treatments have been developed to rid patients of these pesky spots and strands. One option is to remove the vitreous all together, this is called a vitrectomy. While ridding the patient of their floaters, a vitrectomy is an invasive surgery with potential complications and is typically reserved for cases where patients are particularly bothered by their floaters. Another treatment gaining popularity is called vitreolysis. This procedure is done by focusing a laser on the problematic floaters and “vaporizing” them within the eye. Vitreolysis is much less invasive than a vitrectomy, but does come with its own set of complications as well.
If stable and only a mild nuisance, it is recommended to monitor your floaters and continue routine care with your eye care provider. Floaters are harmless and should only be a cause for concern if you notice an increase in size or number, or if they are accompanied by flashes of light and/or loss of vision. Most people live decades with their floaters and never have any other issues arise. Using dark sunglasses and avoiding bright plain backgrounds can help make them less noticeable, and some of them may get smaller over time. If you are concerned about your vision or interested in getting rid of your floaters, talk to you doctor, as they may have suggestions or recommendations for your specific situation. For more information on floaters and the proposed treatment strategies, see the links below.
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