Eye Floaters: What Are They, Causes, and Treatment

Everyone has experienced something that floats across their field of vision, at some point in their lives, even though in reality the object doesn’t exist. Shapes appear when staring at a blank wall or the sky. Even attempting to shake your head to clear your vision, the floaters don’t disappear.  When you move your eyes, the shapes move too.

Floaters are a common part of natural aging. At first, they can be quite annoying and they might disappear. For many, treatment is not necessary as the floaters come and go. However, if the floaters appear suddenly and do not go away, you should see a doctor as this might be a sign of an  eye problem such as a retinal tear or detachment.

How to Identify a Floater

There’s no one way you might see floaters and your description of floaters might sound completely different than another person.

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The description of eye floaters depends on your creativity. Some people report them as clouds, spiders, or even amoebas. The floaters can take different shapes including:

• Squiggly lines
• Cobweb patterns
• Threads
• Spots of varying colors
• Tiny shadowy shapes

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What Part of the Eye Is Affected?

You might think of floaters as objects sitting on the surface of your eye. But when you wash or rub your eyes to get rid of these particles, nothing changes. This is because the floaters are inside the eye.

To understand how floaters occur, visualize your eye as a sphere. Within this sphere, there’s a clear, gel-like fluid known as vitreous humor and other structures such as the lens or retina which  help you to see. The retina, located at the back of the sphere, changes the light from an object into electrical signals which are transmitted to the brain and interpreted as an image. Before the light reaches the retina, it passes through the vitreous humor.

When parts of the vitreous solidify, due to age-related changes or disease, the result is objects floating through the otherwise clear fluid. As the solidified parts of the vitreous humor move around, they pass in front of the macula thereby casting shadows of different shapes on the retina. The shadows are what you perceive as floaters.

Symptoms of Eye Floaters

Floaters are more evident when you are looking at bright backgrounds, such as a white screen, blue sky, or blank paper. Typically, eye floaters do not bring any discomfort or pain.

The shapes and sizes of floaters vary. Relatively large floaters might cause temporary dark spots in your field of vision necessitating surgery for their removal.

Floaters move with eye movements and when you steady your vision, they can drift past. Floaters can occur in either or both eyes.

Causes of Floaters

Eye floaters happen because of many reasons, but age-related changes are the primary cause. As you age, the vitreous humor begins to shrink, a process known as vitreous syneresis. The microscopic fibers within the vitreous then clump together to form small solid particles that initially float within the gel-like fluid. With time, the floaters may settle at the bottom of your eye and you will not notice them anymore.

Besides being part of normal aging, floaters can result from:

• Eye infection or inflammation such as uveitis
• Eye injury
• Retinal tearing or detachment
• Vitreous detachment where the vitreous separates from the retina
• Bleeding in the eye

Individuals with diabetes can develop an eye complication called diabetic retinopathy, which is  bleeding from the retina into the vitreous. The streaks of blood appear as floaters.

Are You at Risk of Eye Floaters?

Since floaters occur mainly due to age-related changes, age is a risk factor for everyone. However, the chances of developing eye floaters are higher if you have:

• Myopia or nearsightedness- difficulty seeing near objects
• Diabetes
• History of eye inflammation in the past
• Had cataract surgery

If you have a family history of retinal detachment or tears, you might be at a higher risk of developing eye floaters in the future.

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When to See a Doctor

Occasional floaters occurring after the age of 50 are nothing to worry about as they are part of normal aging. But it is important to visit your eye care professional when you notice any of the following signs and symptoms accompanying the floaters:

• Sudden and frequent appearance of floaters
• Blurring or loss of vision
• Increasing frequency of light flashes
• Pain in the affected eye
• Diminished or a shadow in your peripheral vision

These signs usually indicate a more serious eye problem such as posterior retinal detachment or a retinal tear that requires immediate treatment.

How Do Doctors Diagnose Eye Floaters?

Your ophthalmologist will perform a dilated eye exam to check for the floaters. This procedure involves using eye drops to widen the pupil and provide a larger window to view the floaters in the vitreous.

The procedure is painless although you may feel some discomfort when the doctor presses your eyelids to check for retinal problems.

Treatment for Floaters

Particles floating in your field of vision can be quite annoying and frustrating. However, the floaters are usually harmless and will disappear with time. Leaving them alone is the safest option, especially when they are age-related and no other signs of eye emergency exist.

When the floaters impair your vision so that you cannot see clearly because of their size or number, your doctor may recommend surgery, a vitrectomy, to take them out.

When the floaters impair your vision so that you cannot see clearly because of their size or number, your doctor may recommend surgery, a vitrectomy, to take them out. A vitrectomy is when you drain the vitreous humor from your eye and replace it with an artificial gel-like fluid.

The surgery poses a significant risk to your vision as you can develop retinal detachment, cataracts or retinal tears after the procedure. You should discuss the pros and cons with your doctor before choosing surgery.

Laser is another option for dealing with floaters. It breaks the floaters into smaller pieces, making them less noticeable. Some report vision improvement while others do not experience any change after laser treatment. Damage to the retina is a potential complication of laser therapy.

If your eye floaters are because of an underlying condition such as retinal detachment, treatments can vary.

Prevention

Eye floaters occur because of aging. Between 50-70 years old, the vitreous begins to shrink by syneresis, and floaters form. So, age-related floaters cannot be prevented because they are part of a natural process.

Flashing Lights (Auras) vs. Floaters

Both eye floaters and flashing lights result from the shrinking of the vitreous humor in the eye, which is common with aging. Floaters can be either specks of dark spots or shapes within the visual field or flashes,  which can appear as streaks or bursts of light resembling fireworks. Like floaters, flashes do not require treatment in most instances.

However, increased frequency of both eye floaters and flashes can be a sign of a serious eye problem that requires immediate treatment. Conditions such as retinal tear and retinal detachment usually develop with sudden onset and frequent flashing lights or floaters.

Besides aging, migraine is a risk factor for developing flashing lights while previous cataract surgery, diabetes, and previous eye inflammation increase your risk of developing floaters.

How to Prepare for the Appointment

When floaters concern you, it is important to see your eye doctor be it an ophthalmologist or optometrist. Before the appointment, you should write down your symptoms, taking note of any changes in frequency or sizes of the floaters. Also, make a list of medications, vitamins, and supplements you are currently using.

To get all your concerns addressed, you should prepare a list of questions and ask them during the visit. Here are sample questions:

• Why did I develop floaters?
• Will the floaters ever go away?
• How can I get rid of the floaters and what are the possible complications?
• Do I need a follow-up appointment even if my floaters are age-related?
• Are eye floaters hereditary?
• When are eye floaters an emergency?

FAQs

When should I worry about eye floaters?

Typically, floaters are harmless and you should not worry about them as long as they do not interfere with your vision. But when eye floaters occur alongside other symptoms such as blurring of vision, pain, or flashlights, you need to visit an eye specialist immediately. Sudden appearance of floaters and flashes is also a serious sign.

Are eye floaters serious?

Occasional floaters associated with age are nothing to worry about. However, eye floaters appearing suddenly or more frequently, regardless of your of age may be an indicator of a serious eye condition.

When you develop floaters, you should tell your eye doctor to make sure no other vision issues exist, especially if they impair your vision.

Are eye floaters normal?

In most cases, eye floaters occur as part of age-related changes that do not require any treatment. While they might be annoying at first, the floaters will disappear with time.

How long do floaters last?

Floaters may disappear in time. But some parts of the solidified vitreous remain in the eye permanently. They only settle at the bottom of the eye where they are not part of the field of vision.

References

1. What are floaters? (September 2020). National Eye Institute.

2.  Vitreous Floaters. (July 2021). NCBI.

3. What Are Floaters and Flashes? ( September 2021). American Academy of Ophthalmology.

4. Long-term Safety of Vitrectomy for Patients with Floaters.(June 2013).  ARVO Journals.

5. To Treat or Not to Treat: Management Options for Symptomatic Vitreous Floaters. (April 2020). Pub Med.

6. What you can do about floaters and flashes in the eye. (April 2020).  Harvard Health.

7. Sudden appearance of floaters and flashes can signal serious eye issues. (January 2016). UCLA Health.