Have you ever seen small spots, filaments or cobwebs floating in front of your eyes, especially when looking at a bright background such as the sky or a white wall? These visual phenomena are called floaters. Although they are generally benign, they can sometimes be a sign of a more serious problem.
What are floaters?
Floaters are tiny clumps of gel or cells that form inside the vitreous humour, the gel-like substance that fills the inside of the eye. They cast a shadow on the retina, giving the impression that something is floating in your field of vision. They often move when you move your eyes, and seem to run away when you try to focus on them.
Causes of floaters
Most floaters are related to the natural ageing process of the eye. Here are the most common causes:
- Vitreous degeneration: With age, the vitreous can lose its gelatinous consistency and become partially liquefied. Collagen fibres can then group together and become visible in the form of floating bodies.
- Posterior vitreous detachment (PVD): The vitreous may detach from the retina, often resulting in the sudden appearance of new floaters. This phenomenon is common after the age of 50.
- Myopia: People who are very short-sighted are at greater risk of developing floaters earlier in life.
- Intraocular inflammation (uveitis): Inflammation of the eye can lead to the formation of visible debris in the vitreous.
- Eye trauma or surgery: Shock or surgery can disrupt the vitreous and cause myodesopsia.
- Intraocular haemorrhage: Blood in the vitreous, caused by a retinal tear or diabetic retinopathy, can produce shadows perceived as floating bodies.
When should you consult an optometrist?
The presence of a few isolated floating bodies is normal and common. However, certain signs should alert you:
- The sudden appearance of numerous new floating bodies.
- The presence of flashes of light in your vision.
- Partial loss of vision or sensation of a dark ‘curtain’ on the side of the eye.
- A sudden drop in vision.
These symptoms may indicate a tear or detachment of the retina, a medical emergency requiring rapid intervention.
How are floating bodies treated?
In the majority of cases, no treatment is necessary. Here are the main options, depending on the severity of the symptoms:
Monitoring
Floaters often fade over time. The brain learns to ignore them, or they may move outside the central visual field.
Adaptation
Certain tricks can help you tolerate their presence better:
- Wear sunglasses outdoors to reduce their visibility.
- Avoid staring at uniform surfaces for too long.
Vitrectomy
This is surgery to remove the vitreous and replace it with a saline solution. Although very effective in eliminating floating bodies, it carries risks (infection, cataract, retinal detachment) and is only considered as a last resort when symptoms are very disabling.
Floaters are generally harmless, but can be a nuisance, especially if they appear suddenly or in large quantities. An assessment by an optometrist is essential to rule out any retinal complications. In the majority of cases, rest assured: they are a normal part of eye ageing... and you can learn to live with them!
