When Should I Worry About Eye Floaters?

Eye floaters are small shapes that appear in your field of vision. They can look like cobwebs, spots, squiggly lines, or threads. Floaters can be harmless, but certain signs indicate you should have them evaluated.

This article explains the symptoms of eye floaters, how to deal with them, and when you should see a healthcare provider.

What Are Eye Floaters?

Eye floaters are a normal part of eye aging. There’s a jelly-like fluid in your eye called the vitreous. As you reach your 50s and beyond, small fibers from the vitreous stick together. They then cast shadows on the retina, which is in the back of the eye. The shadows that you see are floaters.

Symptoms of Floaters

People experience floaters as black spots that appear in their vision. Not everyone sees floaters in the same way. However, common symptoms of floaters include:

• Black or gray specks or dots
• Cobwebs
• Squiggly lines
• Threads
• Seeing the shapes move around
• Seeing the shapes more frequently when you look at a plain or light-colored background
• Having the shapes go away when you try to look at them directly

In addition, sometimes flashes of light, called photopsia, accompany floaters. These may look like lightning or stars. They also could look like camera flashes.

Flashes occur when the vitreous gel in your eye rubs or pulls on your retina. This symptom is more common with aging. The flashes of light may occur for a few weeks or months.

Contact an ophthalmologist or optometrist right away if you experience sudden flashes of light and you have not had them before, as this can be a sign of a more serious condition called a retinal detachment, where the retina pulls away from the back of the eye.

Causes of Floaters

Most commonly, eye floaters are a part of aging. As such, most eye floaters are harmless. However, a more serious eye condition may cause them, including:

• Bleeding in the eye
• Eye infections
• Eye injuries
• Retinal detachment
• Uveitis (eye inflammation)
• Vitreous detachment or retinal tear (when the vitreous pulls away from the retina)

Most of the time, vitreous detachment is not vision-threatening. However, in 15% of cases, a vitreous detachment can lead to a hole or tear in the retina, causing a retinal detachment.

Sometimes, floaters are confused with vision changes associated with other systemic health problems, including:

• Diabetes
• High blood pressure
• Multiple sclerosis
• Stroke

Complications

Any time your vision is affected, it’s essential to let your eye doctor know. For example, a change in your vision associated with floaters could indicate a retina tear or detachment.

A retina tear or detachment is a more serious problem that can cause eye floaters. A retina tear can rapidly turn into a retina detachment, causing loss of some of your vision. That’s why it’s important to know the signs of a retina tear or detachment and, if you have them, to act quickly.

Some signs of a retina tear or retina detachment include:

• Many new floaters in the eye
• Light flashes in one or both eyes
• A loss of peripheral (side) vision
• What appears to be a gray curtain affecting part of your vision

Treatment for Severe Floaters

Most of the time, you don't need treatment for floaters unless there are other problems like retinal tears, holes, or detachments. Instead, your doctor will monitor floaters.

In rare cases, your eye doctor may recommend treatment for them, such as surgery.

Vitrectomy

Vitrectomy is a surgery to remove the vitreous. During this procedure, the surgeon removes the vitreous through a small incision. They then replace it with a fluid that mimics the vitreous and helps your eye keep its shape. However, a vitrectomy doesn’t always remove all of your floaters.

Laser Vitreolysis

With this procedure, an eye surgeon uses a special laser to break up floaters, so you don’t notice them as much. This surgery is helpful for some people but not others.

Laser vitreolysis remains controversial. That's because while this treatment may offer symptomatic relief for some, it is an invasive approach for a condition that doesn't threaten vision. Therefore, more research is needed to guide when this treatment would be most valuable.

Summary

Eye floaters are visual disturbances that look like spots or wavy lines. They are often not a cause for concern and are usually due to aging. However, sometimes they may result from an existing medical condition or could be a sign of something more serious, such as a detached retina.

Usually, they do not require treatment, but sometimes if they are severe or something serious causes them, you may need surgery. If your vision changes or your floaters become more problematic, contact an ophthalmologist, optometrist, or go to an emergency room.