Floaters are the small specks or clouds you may sometimes see moving in your fields of vision. You can often see them when looking at a plain background, like a blank wall or blue sky. Floaters are actually tiny clumps of gel or cells inside the vitreous, the clear jelly-like fluid that fills the inside of your eye.
While these objects look like they are in front of your eye, they are actually floating inside. What you see are the shadows they cast on the retina, the nerve layer at the back of the eye that senses light and allows you to see.
Floaters can have different shapes: little dots, circles, lines, clouds or cobwebs.
A common cause of floaters is aging. When people reach middle age, the vitreous gel may start to thicken or shrink, forming clumps or strands inside the eye.
Floaters are more common for people who:
- Are nearsighted
- Have undergone cataract operations
- Have had YAG laser surgery of the eye
- Have had inflammation inside the eye
The retina can tear if the shrinking vitreous gel pulls away from the wall of the eye. This sometimes causes a small amount of bleeding in the eye that may appear as new floaters. A torn retina is always a serious problem, since it can lead to a retinal detachment. Seek medical attention as soon as possible if:
- A new floater appears suddenly
- You see sudden flashes of light
- Loss of side (peripheral) vision
Your doctor will discuss your treatment options with you and help you choose the best option for your individual situation.
A YAG laser may be used to break down floaters in select cases. Patients with significant opacities located in the anterior vitreous cavity (behind the lens or lens implant) may benefit from this procedure. However, the floaters are often found more posterior, which becomes a highly controversial subject. It may be difficult to identify the floaters from which the patient’s complaints arise.
If a patient’s floaters do not improve after a couple of months of observation, and they interfere with activities of daily living, we do believe it is appropriate to consider a vitrectomy. This is where the vitreous gel is removed and replaced with clear saline solution.
Performing a vitrectomy for floaters is controversial and some retinal surgeons will not perform this procedure. There are risks associated with any procedure, but if a patient has enough visual disability, the benefits of the procedure generally outweigh the risks. We have found that in carefully selected patients, vitrectomy eliminates the patient’s symptoms and is a highly successful procedure.