What are they? Are they treatable?
And when do they really matter?
Shawn Kavoussi M.D.
Certainly we all have noticed small squiggly lines or dots, collectively termed “floaters”, moving across our field of vision; particularly when looking at the sky or a bright computer screen.
Floaters can resemble strands of hair, cobwebs, circles and/or dots. Though
they may appear as if located in front of our eyes, they in fact originate inside of our eyes; and represent a normal structure known as the vitreous.
The vitreous is a clear, gel-like sack that fills the eye's largest cavity behind
the iris and pupil. While mostly comprised of water; small amounts of
collagen and hyaluronic acid help give the vitreous its shape and make the
floaters visible in certain lighting situations, which is normal even at a young
In the absence of trauma, floaters can remain relatively stable for several
decades. But as the years pass and the eye ages into the third, fourth, fifth and sixth decades, the vitreous contracts and liquefies, gradually lifting itself
from the retinal surface at the back wall of the eye, which can render the
floaters gradually more visible.
The time the floaters really matter is when a sudden, spontaneous change or
increase in floaters or black specks in one eye can be seen, representing a
separation of the rear portion of the gelatinous sack from the retinal surface.
The new floaters may be accompanied by intermittent flashing lights in the
same eye, representing ongoing traction of the vitreous gel against the retina
in certain small areas.
Why is this a critical time? Because detached retinas, which can lead to
irreversible vision loss, are caused by torn retinas; and studies show that
approximately 10% of the general population develops a torn retina at or
around the time of this vitreous gel separation.
The sudden onset of new flashes or floaters in one eye is a critical time to see
a retinal specialist for a dilated eye exam.
If detected early enough, a torn retina can be treated with a quick in-office
laser procedure without further consequence. However, if left untreated; a
torn retina progresses to a detached retina, which can result in vision loss and requires urgent surgical repair.
Elective Floater Treatment:
Torn and detached retinas aside, certain patients develop larger-than-average floaters that can become bothersome as they interfere with reading, driving and computer work. The brain can adapt to even large floaters after several months, but both laser and surgical floater removal options are available to treat unmanageable floater symptoms for the right candidates as a last resort.
In summary, most floaters are harmless and represent normal cavities within
the gel-like structure of the eye. But any sudden change or increase in floaters in one eye, especially if accompanied by flashing lights, warrants an urgent retinal exam so that any vision-threatening conditions can be identified and promptly treated.