What are eye floaters?

Eye floaters are spots that wonder in your field of vision. They usually look like greyish specks or strands or webs wandering in front of your eyes. The more you try to concentrate on them, the faster they move away. 

How do eye floaters appear? What causes eye floaters?

The eye globe has a cornea and lens in its front section, these structures focus the reflected light on the retina. The retina is the light-sensitive tissue of the eye that acts like the film of the camera, it receives the image, prints it and sends it through the optic nerve to the brain to process it. Before the light reaches the retina, it passes through the cornea, the lens and the vitreous body which is a jelly-like structure that occupies the back part of the eye globe.

The vitreous body helps keep the shape of the eye and is normally clear and transparent. 

Any physiological problem like aging or pathological ones like retinal tear may cause the this jelly-like structure to go a little more liquidly, creating pockets (known as vitreous syneresis) inside the vitreous body when your eye moves or concentrates on a bright background, the liquid inside the pockets starts to move, casting a shadow on the retina! These shadows are perceived as eye floaters! 

Also, in the aging process, the collagen fibers that constitute the vitreous body may shrink just like the collagen fibers of our skin shrink with age. This shrinkage causes the fibers to become coarser and more thickened leading to visible shadows on the retina, that we describe as eye floaters. Of course, these changes along with their degree and frequency vary from person to person and depend on many other factors.  

What are the symptoms of eye floaters?

Symptoms of eye floaters include the appearance of:

• Greyish, dark or transparent shadows or specks or strands floating in your field of vision.
• Quick spots that move as fast as you move your eyes appearing and disappearing in your visual field.
• Whitish strings that are most visible when you concentrate on bright backgrounds like white walls or a clear sky.
• Fast insect-like shapes that keep flying in front of your eyes.

Usually, these symptoms mean nothing and are absolutely harmless, but in some cases visiting a doctor is essential especially if you notice any of the following:

• Increased frequency of appearance of the eye floaters than usual.
• Increased number of floaters appearing in the same visual field than the last time.
• Sudden onset of new eye floaters.
• If you see flashes of light accompanying the eye floaters of the same eye.
• Sudden appearance of dark spots or total darkness in your field of vision especially in the sides (peripheral vision loss).

These alarming symptoms are usually caused by a retinal tear (know more here) and/or retinal detachment which is a vision-loss threat that needs to be treated as an emergency! 

What are eye floaters’ causes and risk factors? 

If you suffer any of the following, then you may experience eye floaters in your life. This doesn’t mean that you should ignore these symptoms, in fact, it means that you should visit your ophthalmologist more often! These risk factors include: 

• If you are above 50 years old.
• If you are nearsighted.
• If you experienced any eye trauma.
• If you had eye surgery especially cataract surgery.
• If you are a diabetic.

What are eye floaters’ causes?

As we mentioned earlier, eye floaters happen mainly due to:

1. The aging process: Age-related changes in our body include our eyes too. It causes presbyopia, cataract, and many other eye problems. But with eye floaters being the least significant, people tend to ignore it. Usually, eye floaters appear in old age due to vitreous body shrinkage that causes the vitreous body to detach away from the retina (not a retinal detachment), this pulling away may cast shadows or block light falling on the retina leading to the appearance of greyish specks in your field of vision. This is a physiological process, related mainly to age and requires no medical attention. But as we mentioned before, if you start seeing flashes of light even when you close your eyes then you have to visit your doctor immediately.
2. Myopia:Young people with myopia (aka nearsightedness) may experience eye floaters too. as usually, their eye globe is larger than normal, vitreous syneresis happens faster in nearsighted people than the normal population. 
3. Posterior uveitis: it is the inflammation of the back layers of the uvea. Any inflammation releases white blood cells and inflammatory debris into the vitreous body, these cells create a shadow that falls on the retina especially in bright light and is perceived as eye floaters. This inflammation could occur due to: infection, inflammatory disease, eye injury or blunt trauma.
4. Eye bleeding: It is a common complication of diabetes, hypertension, atherosclerosis and of course eye surgery. The bleeding causes the red blood cells to wander into the vitreous body casting a stringy shadow on the retina aka eye floaters. 
5. Retinal tear and diabetic retinopathy: The vascular damage associated with uncontrolled diabetes may lead to diabetic retinopathy, this causes the retina to lose some of its ability to interpret the falling light and distorts the sent image to the brain. 

Some doctors are now including stress and psychological distress to be one of the newly discovered causes of eye floaters. This conclusion is still under study. 

Treatment of eye floaters causes

Most eye floaters require no treatment at all especially if it is related to aging or nearsightedness. But if it has an underlying problem, then treating the eye floaters cause is the key treatment. 

For example:

• If you are a diabetic then to prevent and treat many eye problems including eye floaters then keep your blood sugar level under control.
• If you are hypertensive then get your medications and blood pressure in check.
• If you had any eye surgery, follow your doctor’s instructions thoroughly. 

And so on.

But if eye floaters are interfering with your daily routine which is very rare, then your doctor will recommend:

1. Surgery: vitrectomy is a known surgery where your eye surgeon removes the vitreous body and replaces it with a certain solution to maintain your eye shape. This surgery doesn’t prevent the recurrence of eye floaters.
2. Laser: your doctor can use laser beams to aim at the floaters inside the vitreous body and disrupt them to make them less noticeable. It is not considered the best option yet as it is expensive and floaters may recur. 

Magrabi’s advice

Eye floaters are not a serious eye problem unless it is accompanied by flashes of light or peripheral vision loss. Its causes include aging, nearsightedness, retinopathies and more. To avoid its rare complications, it is best to frequently visit your ophthalmologist.