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Eye floatersBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/eye-floaters/DS01036
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Eye floaters are spots in your vision. Eye floaters may look like black or gray specks, strings or cobwebs that drift about when you move your eyes.
Most eye floaters are caused by age-related changes that occur as the jelly-like substance (vitreous) inside your eyes becomes more liquid. When this happens, microscopic fibers within the vitreous tend to clump together and can cast tiny shadows on your retina, which you may see as eye floaters.
If you notice a sudden increase in the number of eye floaters, contact an eye specialist immediately — especially if you also see flashes of light or lose your peripheral vision. These can be symptoms of an emergency that requires prompt attention.
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Symptoms of eye floaters may include:
- Spots in your vision that may look like dark specks or knobby, 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 visual field
- Spots that are most noticeable when you look at a plain bright background, such as a blue sky or a white wall
- Spots that eventually settle down and drift out of the line of vision
When to see a doctor
Contact an eye specialist promptly if you notice:
- Many more eye floaters than usual
- A sudden onset of new floaters
- Flashes of light
- Darkness on the sides of your vision (peripheral vision loss)
These painless symptoms could be caused by a retinal tear, with or without a retinal detachment — a sight-threatening condition that requires immediate attention.
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Eye floaters may be caused by:
- Age-related eye changes. Eye floaters most commonly occur as a result of age-related changes in the vitreous, the jelly-like substance that fills your eyeballs and helps maintain their round shape. Over time, the vitreous changes in consistency and partially liquefies — a process that causes it to shrink and pull away from the interior surface of the eyeball. As the vitreous shrinks and sags, it clumps up and gets stringy. Bits of this debris block some of the light passing through the eye, casting tiny shadows on your retina.
- Inflammation in the back of the eye. Posterior uveitis is inflammation in the layers of the uvea in the back of the eye. Posterior uveitis, which can cause eye floaters, may be caused by infection or inflammatory diseases, among other causes.
- Bleeding in the eye. Vitreous hemorrhage is bleeding into the eye's jelly-like vitreous. Bleeding in the eye can have many causes, including injury and blood vessel problems.
- Torn retina. Retinal tears can occur when a sagging vitreous tugs on the retina with enough force to tear it. A retinal tear may cause new floaters to appear in your vision. Without treatment, retinal tear may lead to retinal detachment — an accumulation of fluid behind the retina that causes it to separate from the back of your eye. Untreated retinal detachment can cause permanent vision loss.
Factors that may increase your risk of floaters include:
- Age over 50
- Eye trauma
- Complications from cataract surgery
- Diabetic retinopathy
- Inflammation in the eye
Preparing for your appointment
If you're concerned about your eye floaters, make an appointment with a doctor who specializes in eye disorders (an optometrist or an ophthalmologist). If you have complications that require treatment, you'll need to see an ophthalmologist. Here's some information to help you get ready for your appointment and what to expect from your doctor.
What you can do
- Write down any symptoms you're experiencing. Try to make note of any situations that increase the number of eye floaters you see or times when you see fewer eye floaters.
- Make a list of all medications, including all vitamins or supplements, that you're taking.
- Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. For eye floaters, some basic questions to ask your doctor include:
- Why do I see these eye floaters?
- Will they always be there?
- What can I do to prevent more from occurring?
- Are there any treatments available?
- What types of side effects can I expect from treatment?
- Are there brochures or other printed material that I can take with me? What websites do you recommend?
- Do I need to come back for a follow-up appointment, and if so, when?
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- When did you first begin experiencing symptoms?
- Have your symptoms been continuous or occasional?
- Have you recently noticed many new floaters?
- Have you seen flashes of light?
- Does anything seem to improve or worsen your symptoms?
- Have you ever had eye surgery?
- Do you have any medical conditions, such as diabetes or high blood pressure?
Tests and diagnosis
Your doctor will conduct a complete eye exam to make sure your floaters aren't a sign of something more serious. Part of the exam will include looking into your eyes after your doctor has placed pupil-dilating drops into your eyes.
Treatments and drugs
Most eye floaters don't require treatment
In most cases, eye floaters don't require treatment. Learning to cope with your floaters may take time. Living with eye floaters may be frustrating. With time, you may find you can ignore the floaters more easily and that you notice the floaters less often.
Treatments for floaters that impair your vision
In rare cases, your eye floaters may impair your vision. Rarely, floaters may be so large or so numerous that it's difficult to go about your daily tasks. In these situations, you and your eye doctor may consider treatment for your eye floaters.
Options may include:
- Using a laser to dissolve floaters. During laser therapy, an ophthalmologist aims a special laser at the floaters in the vitreous. The laser may break up the floaters and make them less noticeable. Some people who undergo laser therapy for their floaters report improved vision, while others notice little or no difference. Risks of laser therapy include damage to your retina that can occur if the laser is pointed incorrectly. Laser surgery to treat floaters is considered experimental and isn't widely used.
- Using surgery to remove the vitreous. During a vitrectomy procedure, an ophthalmologist makes a small incision in your eye and removes the gel-like vitreous. A solution is placed in the eye to help it maintain its shape. Eventually, your body makes and fills your eye with fluid that will replace the solution. Vitrectomy may not remove all the floaters in your vision, and new floaters can develop after surgery. Risks of vitrectomy include bleeding and retinal tears.
- Charles S, et al. Vitreous. In: Riodan-Eva P, et al. Vaughan & Asbury's General Ophthalmology. 17th ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=19. Accessed Dec. 21, 2011.
- Differential diagnosis of ocular symptoms. In: Ehlers JP, et al. The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease. 5th ed. Philadelphia, Pa.: Wolters Kluwer Health Lippincott Williams & Wilkins; 2008. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=booktext&D=books&AN=01337416/5th_Edition/3&XPATH=/OVIDBOOK%5b1%5d/METADATA%5b1%5d/TBY%5b1%5d/EDITORS%5b1%5d. Accessed Dec. 21, 2011.
- Sendrowski DP, et al. Current treatment for vitreous floaters. Optometry. 2010;81:157.
- Facts about floaters. National Eye Institute. http://www.nei.nih.gov/health/floaters/floaters.asp. Accessed Dec. 21, 2011.
- Retinal detachment: Torn or detached retina treatment. EyeSmart. http://www.geteyesmart.org/eyesmart/diseases/detached-torn-retina-treatment.cfm. Accessed Dec. 27, 2011.