Eye Floaters: Symptoms, Causes And Treatment

Eye floaters are deposits or tiny specks that float into the field of vision. It is condensation in the vitreous humour - the material that fills the posterior part of your eyes. It appears like black or grey specks, strings, or cobwebs that drift when you move your eyes and can appear to dart when you try to look at them directly. It can stand out when you look at something bright such as the blue sky or a reflective object ^[1] .

The floaters can be irritating and can cause disturbances, however, it does not interfere with your sight. If the size of the floater is big, it can cause a slight shadow over your vision, when exposed to bright lights. It can appear in one eye or both the eyes. It is not necessary that the eye floaters can interfere with your life as you can learn to live with it and ignore it. With time, you may not even notice its presence in your eyes ^[2] . In most cases, the floaters develop as a sign of age-related changes as the vitreous inside your eyes becomes more liquidy ^[3] .

Eye floaters are common in adults, and almost everyone gets it by the age of 70. It is extremely rare for children under 16 to develop eye floaters ^[4] .

Symptoms Of Eye Floaters

The signs which indicate that you may have it are as follows ^[5] :

• Spots that are noticeable when you look at a plain bright background, such as a blue sky or a reflective object.
• Small shapes in your vision that appear as dark specks or transparent strings of floating material.
• Spots that move when you move your eyes, so when you try to look at them, they move quickly out of your field of vision.
• Strings or small shapes that eventually settle down and drift out of the line of vision.

When To See A Doctor

Go to your ophthalmologist or eye care provider if you notice the following ^[6] :

• Flashes of light in the same eye as the floaters
• Sudden onset of new floaters
• More number of eye floaters than usual
• Darkness on any side or sides of your vision
• Pain in the eye

These can also be an indication of severe conditions such as vitreous detachment, vitreous haemorrhage, retinal detachment and retinal tear.

Causes Of Eye Floaters

It can be developed as a result of the ageing process, or due to certain diseases or conditions ^[7] .

• Age-related eye changes: The most common cause of eye floaters, it is caused as a result of changes in the vitreous, or jelly-like substance filling your eyeballs that helps them to maintain the round shape. With age and time, the vitreous partially liquefies causing it to pull away from the eyeball's interior surface. With the vitreous shrinking, it can get stringy and clumpy. This causes the formation of debris, which in turn blocks the light passing through the eye and causing the development of eye floaters ^[8] .
• Bleeding in the eye: Conditions such as diabetes, hypertension, blocked blood vessels and injury can cause bleeding into the vitreous.
• Inflammation in the back of the eye: The inflammation in the layers of the uvea (in the back your eyes) can cause the release of inflammatory debris into the vitreous. The inflammation or posterior uveitis can be caused as a result of an infection or inflammatory diseases ^[9] .
• Eye surgeries and eye medications: Certain medication can cause the formation of air bubbles, which will be viewed as eye floaters until your eyes absorb them. Some vitreoretinal surgeries may add silicone oil bubbles.
• Torn retina: In the event of a sagging vitreous tugging on the retina, it can result in the tearing of the retina. This needs treatment otherwise can elevate to retinal detachment which will result in permanent vision loss ^[10] .

Risk Factors Of Eye Floaters

The following can increase your risk of floaters ^[11] .

• Eye inflammation
• Age over 50
• Complications from a cataract surgery
• Near-sightedness
• Diabetic retinopathy
• Eye trauma

Diagnosis Of Eye Floaters

In order to understand and analyse the symptoms, the ophthalmologist will ask you questions related to it. After that, the doctor will carry out eye examinations to check the following ^[12] :

• Your central and peripheral vision and
• the front of the eyes with a slit lamp.

Once the above is carried out, the ophthalmologist will place drops in the eyes to dilate the pupils to examine the retina and vitreous with bright lights from an ophthalmoscope, which will be mounted on the head of the doctor ^[13] .

Treatment For Eye Floaters

Most cases of the condition, that is, the benign ones do not require any treatment. Although it can be frustrating, you can get used to it with time. If it is irritating you or getting in your field of vision, move your eyes as this will shift the fluid around. Looking up and them down is helpful to clear your area of vision ^[14] , ^[15] , ^[16] .

In the case of too many eye floaters, your doctor may suggest you get surgery.

• Surgery to remove the vitreous: You can go to an ophthalmologist and discuss the options of surgery. A procedure called vitrectomy will be conducted. It involves removing the vitreous through a small incision. A solution will be used as a replacement for the vitreous so as to maintain the shape of your eyes. A vitrectomy may not remove all the floaters and there are chances that new floaters can develop after the surgery. The surgery poses the risks of retinal tears and bleeding.
• Laser to disrupt the floaters: Using a special laser, the floaters in the vitreous can be broken up which will result in it being less noticeable. In most cases, laser treatment has been known to show positive results. But in some cases, it did not have any changes. The laser therapy poses the risks of damage to your retina.