Most of us have, or will have, eye floaters. Some people notice small gray or black spots, shadows, specks, “cobwebs”, or even small transparent like material that floats across the visual field periodically when looking at a bright, solid background. They are one of the most common conditions seen by eye doctors during comprehensive eye exams. So what are they, exactly? And if they’re so common, when do they become dangerous?
There is a vitreous gel — a clear jelly-like organ made of water, collagen, and hyaluronic acid — occupying close to 80% of the volume inside our eye. Its main purpose is to act as a mechanical buffer to our retina. To support, protect and supply our retina with nutrients. Eye floaters are created when that vitreous gel becomes liquefied in small pockets. This causes the vitreous gel to coalesce together. As light passes over the liquified area, a shadow is created on the retina. To us, it looks like a small gray or black spot that moves in our vision, otherwise known as “floaters”.
Floaters can vary from person to person. As time goes by, most floaters can decrease in size and contrast or shift position within the eye to help reduce the shadow-like effect. The human brain also has the ability to adapt to or become used to the floaters. This process is known as neuroadaptation.
It is inevitable that patients will likely notice floaters at some point in their life. On its own, floaters are not a serious condition. The liquefaction of our vitreous that causes floaters is a natural process over time.
Much like moles and freckles, floaters are typically benign and usually do not warrant any treatment. However, if they reduce your ability to see adequately, you notice vision loss, or activities in your daily life are affected, further treatment may be recommended.
Even though floaters are benign, they could also be a sign of a retinal problem, such as retinal detachment. Those with diabetic retinopathy, eye inflammation or complications from cataract surgery, past eye trauma, nearsightedness, or are over the age of fifty can be more prone to abnormal eye floaters.
Typical warning signs include: if floaters are new and numerous, are associated with flashing lights, loss of peripheral vision, and visual decline. In this case, a dilated eye examination is recommended to ensure the retina is healthy.
Although not a first-line treatment due to the risks of retinal eye surgery, removal of the vitreous gel (vitrectomy) can be done to eliminate floaters.
A more recent therapy is laser vitreolysis. This procedure uses a laser to break apart large floaters but does not typically eliminate all floaters.
In most cases, routine observation is the best treatment. If you’re concerned, make sure to bring it up with your eye care specialist at your next appointment.