Have you ever noticed stringy objects appear in you field of vision, perhaps when looking at a blue sky? Most people can see floaters – but what are they, where do they come from and are they anything to worry about? Many people know very little about this incredibly common phenomenon.  One of our leading ophthalmologists Mr Felipe Dhawahir-Scala explains all.

What are Floaters?

Eye floaters are perceptible deposits within the jelly-like substance in the eye. They can have various different shapes and sizes, but they are commonly string-like or appear as black or grey specs and are most apparent against a clear background. Floaters will follow the movement of the eye. The term used to describe the perception of floaters is known as myodesopia.

What Causes Them?

The vast majority of floaters are a consequence of ageing. The jelly-like substance in the eye is known as vitreous fluid and overtime it develops imperfections which form clumps and drift in the fluid inside the eyeball. They cast a shadow over the retina and thereby become visible. They are not optical illusions, rather the source of the phenomena is from within the eye. This also has a specific term – entoptic phenomena.

Most floaters are caused by the process of vitreous syneresis, whereby collagen in the vitreous fluid breaks down into fibrils that form the floaters. Other less common conditions, such as retinal detachment, leaky blood vessels, inflammation of the eye can all cause floaters.

Who Gets Floaters?

Everyone is susceptible to floaters and they are extremely common; however, there are certain risk factors involved. Age is the biggest single contributing factor and the majority of people over 50 have floaters. The process of vitreous syneresis produces more floaters as people get older.

Additional risk factors include near-sightedness, eye trauma, retinal detachment, complications from cataract surgery, diabetic retinopathy and eye inflammation.

Are they Dangerous?

Normally, floaters are harmless and no cause for concern; however, in certain circumstances they can be an indication of something more serious. The sudden appearance of many new floaters, or flashes of light with or without loss of peripheral vision should always be assessed by an ophthalmologist or an optometrist.

Overtime, the vitreous fluid in the eye liquefies and begins to shrink, causing it to detach from the back of the eye. Occasionally, it might pull the retina (which is found at the back of the eye and detects light) with it. This is known as retinal detachment and is a serious condition, of which the sudden appearance of new floaters could be an indication.

Can Floaters be Treated?

Floaters do not normally require treatment, but in some circumstances they can seriously impair vision or become an annoying visual disturbance. For such cases, there are treatments available.

The preferred treatment for floaters is known as a vitrectomy. The jelly-like substance is surgically removed which eliminates all debris and floaters. Mr Dhawahir-Scala is an expert in this field and uses the latest surgical technologies, such as the use of 27G Vitrectomy, in which he is a worldwide leading expert.

Laser vitreolysis is used by a minority of non-retinal surgeons. This procedure tends to have very limited and often poor outcomes.

If you think you might have floaters and would like to find out more, make an appointment with an ophthalmologist.