• by Dr. Z Aleksic

Focusing on Floaters



Okay, so it’s been a few weeks and you’ve noticed that those little spots in your vision haven’t gone away. You might even start to wonder if these are new spots or whether you have always had them, but simply never noticed them before. What should you do? Does everyone else have these little flecks in their vision? And if so, how on earth do people live with them?!

This is the stage when some patients might start to panic slightly. So, I find myself writing this blog about floaters in order to ease this panic. In this blog I will be answering the four most common questions around floaters:

  1. What are they?

  2. Why do they occur?

  3. Is there a treatment?

  4. When should I call a doctor?

The harsh truth about floaters is that they often do not go away, but many people learn to live with them.

On a whole, eye floaters are harmless, and most people can expect to experience them at some point in their life. That being said, there are some cases where they are a sign of a more serious condition and this is why learning more about floaters and having them checked by an eye doctor is essential.


1. What are they?


Essentially, they are small, semi-transparent, cloudy specks or cobwebs within the eye. They move as the eye moves, drifting about when you look around and appear to dart away when you try to look at them directly. The specks are often seen by my patients against blue skies or white walls; any plain background highlights them.


2. Why do they occur?

Age:

Your eye is filled with a jelly like composition known as the vitreous. When light passes through the eye in the normal process of vision and seeing, it hits clumps where the vitreous has solidified over time, and shadows are cast onto your retina. This causes the perception of floaters.


Near-sightedness:

Floaters are more common as you age, but near-sighted patients could experience them earlier. This is because the eye’s elongated shape increases the likelihood that the vitreous will detach from the retina.

Inflammation:

This condition is known as uveitis, which occurs from infection or an inflammatory condition. The inflammation causes debris in the eye which results in this appearance of floaters in the eye.


Surgery:

Ocular trauma or head trauma could cause floaters to develop. Certain eye procedures, such as cataract surgery, may increase the likelihood of developing a vitreous detachment and floaters.


Injuries:

When an eye injury causes bleeding in the eye, these blood cells also can appear as floaters.


Retinal tear or detachment:

In some cases, as the deteriorating vitreous pulls away from the back of the eye, it can exert a tugging pressure on the retina, causing a tear. Left untreated, a retinal tear can lead to retinal detachment. While the vitreous detaching from the retina is a normal part of aging, the retina itself detaching from the eye is not.


Diabetes:

All people with diabetes are at increased risk of developing several conditions, including eye floaters. Floaters in diabetics could also represent bleeding within the eye, which requires urgent evaluation. Controlling blood sugar levels, blood pressure and cholesterol levels can help to reduce this risk.


This is why, if you are diabetic, regular screening is essential. Get screened now:

https://www.oxia.org


Or read more about the importance of Diabetes Screening:

https://www.eyesurgery.co.za/post/dealing-with-diabetes-and-the-eye

3. Is there a treatment?


Floaters can be really troubling for patients and can get in the way of your vision. They can be frustrating and they can be right in the centre of vision in some cases. Surgical vitrectomy can be performed, but this is a very serious surgery to do just for floaters. A second option would be to have an ophthalmologist break up the larger floaters with a YAG laser. This option also carries a lot of risk so you would need to speak with your ophthalmologist about these treatments.


At home, you can help to prevent or manage floaters. It sounds obvious, but staying hydrated can really help you to prevent floaters. This is because the vitreous is made of water, so, naturally, dehydration would increase the appearance of floaters and hydration would decrease the appearance of them.


4. When should I call a doctor?


There are times when floaters signify a bigger issue:

  1. Here is the bottom line: floaters and flashes are always symptoms that signal the need for an appointment. This is why the appearance of floaters should always be checked by an ophthalmologist before you proceed normally.

  2. Many floaters at once could signify a retinal tear; appearing like pepper all over your vision. Alternatively, a big lightning bolt that you see, but nobody else saw, signifies a retinal tear or break. This calls for urgent attention from your eye doctor, so do not hesitate to call immediately. This also applies for any loss of peripheral vision; like a curtain coming down or up in your vision. These require urgent attention as they may signal a retinal detachment. Caught early, a retinal detachment can be fixed quickly, but if not it can be difficult to treat.


If you think you are experiencing these floaters, the chances are that they are nothing to worry about. However, it is best to give us a call and let us check them anyway.


*Due to the COVID-19 crisis, we are reducing working hours at our practice and our phone lines will only be open Monday to Friday from 08:30 AM to 16:30 PM. Until further notice, no after hour or emergency services can be provided - please visit your nearest emergency room.