What Are Floaters? | Causes and Treatment

6/12/14

Floaters can be anything seen in your vision that moves “to and fro” with your eye movement. The movement is not stationary compared to a blind spot which is fixed or stationary in your field of vision.

Example of floaters
Example of floaters
The key is that the position changes with eye movement. Size, shape, color, etc. don’t matter. Anything that moves in your vision is called a floater.

Remember, if you experience new floaters; please see an eye doctor for an examination.

Here are some common causes of floaters:

  • Posterior Vitreous Detachment (PVD)
  • Retinal Tears
  • Blood (Vitreous Hemorrhage) can be caused by;
  • Advanced Diabetic Retinopathy
  • Retinal Tears
  • Retinal Vascular Occlusions
  • Inflammation or Infection
  • Asteroid Hyalosis

Posterior Vitreous Detachment
A posterior vitreous detachment (PVD) is a common cause of floaters. A PVD occurs when the vitreous separates from the retinal surface. This is a normal event and will eventually occur in everyone. Retinal tears are more likely to occur right after a PVD has started.

The vitreous is usually a clear watery gel. As we age, enough of the proteins in the vitreous liquefy and degenerate. Eventually, there is a physical separation of the vitreous from the retina due to this liquefaction.

“Floaters” can develop due to opacities/haziness due to the aging gel which is no longer absolutely clear due to changes in the optical properties of the gel or the interface between the vitreous and water inside the eye.

Tears in the Retina
Retinal tears can cause floaters by either causing a small vitreous hemorrhage, or by dislodging cells into the vitreous which are normally located underneath the retina.

Vitreous Hemorrhage
Blood in the vitreous can also cause floaters. A so-called vitreous hemorrhage may result from either a retinal tear or advanced diabetic retinopathy. Occasionally, retinal vascular occlusions can also lead to bleeding in the vitreous.

Blood in the eye often absorbs, but only your doctor can determine the exact nature of the floaters and if they are associated with a retinal tear. It’s impossible for you to tell the cause of floaters without a proper dilated eye exam.

Inflammation
Certain types of inflammation or infection can cause significant floaters. Actually, these are white cells which migrate to the retina and vitreous and can be seen a floaters.

Asteroid Hyalosis
This is a common entity where lots of fine white opacities are suspended in the vitreous. In most cases, these are not noticed by the patient. Sometimes, however, the so-called asteroid bodies are so dense they prevent good examination of the retina. Other times, especially after a PVD, the asteroid bodies are noticed and patients may complain of floaters.

New Floaters: Evaluation
All new floaters must be examined by your eye doctor within 24-72 hours after occurring. Even if the floaters disappear in that time frame, you should be examined to look for a possible tear in the retina.

Again, you, the patient, can NOT tell the cause of the floaters or if you’ve sustained a retinal tears. Retinal tears can cause a retinal detachment – a potentially blinding problem.

Treatment of Floaters
There are no medicines or eye drops to treat floaters. Most doctors advise simply putting up with the floaters.

For patients who have chronic problems with floaters, I recommend a vitrectomy. A vitrectomy is an eye operation, performed by a retinal specialist. The operation is comparable to a cataract operation in terms of safety and possible complications.

There are a handful of doctors who perform Yag laser to break up floaters.

Randall E. Wong MDRandall V. Wong, MD
Retina Specialist
Fairfax, Virginia