Floaters

What are Floaters?

Floaters are small debris floating in the vitreous (the gel filling inside of the eye).

People often see them as drifting across their vision. They come into a variety of forms as black dots, squiggly lines, tadpoles, rings or cobwebs.

What causes floaters?

Normally, the eye is filled with a gel-like substance called the “vitreous”. This gel is made mainly of water and a meshwork of transparent proteins. As we age, the meshwork breaks downs and the gel may form some debris. These debris can cast a shadow over the retina, which we see as “Floaters”.

There are more noticeable when you look at something bright like a blue sky or white paper.

Also, other eye conditions may cause floaters as eye inflammation.

Are floaters serious?

In most cases, floaters are harmless and represent changes in the jell inside the eye. They usually become much less obvious with time and the brain often gets adapted to them. However, for some people, floaters can be quite annoying and may affect their lifestyle.

On some occasions, sudden onset of floaters can be a sign of more serious condition as posterior vitreous detachment that can be complicated with a retinal tear or more seriously a retinal detachment.

Therefore, if you notice new floaters, it’s important to have your eyes checked by an eye doctor urgently.

Is there any treatment for Floaters?

Floaters do not harm the eye, and in the vast majority of people, they do not cause a significant problem, so you generally do not need any treatment for them. Also, in most cases, they become less noticeable over time as the brain can adjust to them. If they are troublesome, you can try wearing dark glasses, they may help to minimize the shadow of the floaters.

However, in a small group of patients, the floaters are large and can get very troublesome and significantly affect their reading or driving. In these cases, treatment can be offered as laser or surgery.

Laser

The laser is used to breakdown the floaters, a procedure called “vitreolysis”.  It is performed in the outpatient clinic by a laser machine similar to the eye examination machine. It works by disrupting large floaters into smaller pieces so they become less obvious. It can improve the symptoms in about 60 % of people.

It is a safe treatment but rarely can the laser can cause some damage to the lens or the retina.

Surgery

The surgery is called “vitrectomy” which involves removing the gel inside the eye using very small instruments. The surgery is performed with the aid of local anaesthetic (small injection of anaesthetic solution around the eye) as day surgery. The surgery often takes about 30 minutes.  Surgery has an excellent outcome with studies showing symptoms to have settled in over 99% of patients.

Mr Ellabban will discuss with you the details of the surgery, risks and benefits, and advise you about the procedure.

What is posterior vitreous detachment?

As we age, the gel inside our eyes gradually liquify and shrink and may separate from the back of the eye. This process is called posterior vitreous detachment or PVD. This commonly affects people over the age of 60 years and more common as we get older. They may occur at a younger age in people who are short-sighted or have other eye conditions.

When PVD occurs, people may see:

  • Flashing light flickers in the periphery of your vision. This usually occurs when the gel pulls on the light-sensitive tissue of the retina.
  • Black floaters in your vision (debris in the vitreous).

PVD is harmless and no treatment is needed. There is nothing you can do to prevent it as it is a part of the natural ageing process.  The flashing lights gradually settle over the next few weeks. The floaters usually become less noticeable over time or your brain may get adapted to them.

In few cases of PVD, the separated vitreous may pull on the retina leading to a retinal tear or retinal bleed.

  • Retinal tears are often treated with laser to seal the retina. If the retinal tear is left untreated, it can cause retinal detachment.  This is an eye emergency that will require surgery.
  • Retinal bleed will need an emergency though examination of the back of the eye for assessment of the retina.

Therefore, if you notice new floaters, it’s important to have your eyes checked by an eye doctor urgently.

What are the warning symptoms for a retinal detachment?

If you experience any of the following symptoms:

  • A sudden shower of new floaters
  • Increased flashing lights
  • Dark shadow or a ‘curtain’ in your vision

These symptoms can be early signs of retinal tear or detachment. You are advised to seek immediate advice and have your eyes checked by an eye doctor