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 and a normal sign of aging. However, if they increase or appear with light flashes or any vision loss, call your healthcare provider since it could indicate something more serious.

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

Bleeding in the Eye

Bleeding in the eye can happen for a number of reasons. Abnormal blood vessels can bleed spontaneously, and sometimes normal blood vessels can rupture because of stress or trauma. 

Bleeding in the eye can cause you to see floaters that look like specs in the eye or cobweb-like shapes. Some people also see a haze or have vision that is red tinted. 

Floaters caused by blood in the eye will often resolve over time, but it can be a slow process. These floaters are more likely to go away if they are smaller and/or caused by a condition that doesn't cause recurrent bleeding in the eye. Larger areas of bleeding can cause long-term problems and may need to be removed surgically.

Eye Infections

Some viruses and bacteria can cause inflammation of the retina, which can lead to floaters and other symptoms such pain and redness in the eye and/or whole body symptoms such as fever and chills. Some causes of this condition include:

• Herpes simplex virus
• Herpes zoster virus
• Cat scratch disease
• Lyme disease
• Tuberculosis
  

Eye infections caused by bacteria or viruses typically resolve after treatment of the underlying cause. Since some of these conditions can lead to more serious complications, it is important to see your healthcare provider for a diagnosis.

Eye Injuries

Your eye may become injured after a blow such as a punch or a ball that hits your eye during a sporting event. Failure to use safety eyewear during construction or industrial work could also cause an object or a chemical to penetrate your eye and cause injury.

An eye injury can cause floaters and other symptoms such as:

• Pain
• Vision problems
• Bulging eye
• Unusual pupil size
• Bleeding in the eye
• Trouble moving the eye

Eye injuries are treated according to the severity of the injury. Many blows can be treated with rest and cold compress, but more serious injuries like punctures or chemical burns require emergency treatment.

Retinal Detachment

Retinal detachment is an emergency condition where part of the retina becomes detatched from the layer of blood cells that support it. It can cause sudden floaters and/or reduced vision. You may also experience flashes of light.

Retinal detachment requires immediate medical attention. Delaying treatment can cause permanent vision loss. 

Uveitis

Uveitis is an inflammation of the uvea. The uvea is the part of the eye that supplies blood to the retina. When this part of the eye becomes inflamed, it can cause symptoms like floaters, blurry vision, redness, light sensitivity, and pain. These symptoms often develop suddenly.

Uveitis can be treated with steroid medication to help reduce inflammation.

Vitreous Detachment

Vitreous detachment or retinal tear occurs when the vitreous pulls away from the retina. The vitreous is the gel-like fluid in the center of your eye. Besides floaters, vitreous detachment can cause symptoms like flashes of light in your side vision. 

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. This is why it is important to see your eye care provider if you notice any of these symptoms.

If the detachment doesn't lead to a more serious condition, it probably won't need to be treated. 

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 healthcare provider will monitor floaters.

In rare cases, your eye care provider 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. 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.