Floaters are one of the most commonly diagnosed problems in the office of a general ophthalmologist, and is probably the most UNDERdiagnosed problem in the general population. Usually, patients will call, in a panic, due to the appearance of new dots, lines, or webs in their vision. It is very common for them to think that they have been seeing a bug or fruit-fly in their field of vision! And sometimes, they have already been on the internet and learned that their symtpoms can be associated with a retinal detachment. Luckily, most patients are merely suffering from a Posterior Vitreous Detachment (PVD). We treat this symptom as an urgent problem, and patients are usually seen the same day, or within 48 hours at the latest!
What are floaters?
Floaters are fragments or strands that are normally present in the vitreous gel, a gel that fills the back two thirds of the eye. This gel is normally attached to the retina in the back of the eye. Since the gel is attached very tightly, it moves with the eye, and the fragments are not visible.
Why do the floaters suddenly become visible?
Over time, the vitreous gel turns more liquid, and moves in the eye more freely. At times, the gel breaks free from the retinal attachments. At this point, when the eye moves, the gel lags behind, and the shadows of the fragments become visible. Another reason that floaters may become visible is if the vitreous detachment causes bleeding in the eye.
Why are floaters an urgent problem?
Floaters can be a sign of much worse problems, not just of a vitreous detachment. There is special concern if the floaters are associated with bleeding inside the eye. This is because a majority of patients with blood in the vitreous gel have a retinal tear. Retinal tears can lead to retinal detachments, which are a problem that can lead to blindness if left untreated. Fortunately, when caught early, both retinal tears and detachments are treatable, with good preservation of vision..
What is the treatment for floaters?
Floaters usually do not require treatment, although surgical removal is possible. Most floaters resolve with time, and some of them are ‘blocked out’ by your brain!! Most patients, over time, find that they have a few easily recognizable floaters that they hardly ever see. Under certain lighting conditions, those floaters may become visible, but remain unchanged. When patients recognize their old ‘familiar’ floaters, they realize that this does not represent a new problem, and does not require another examination.
What about retinal tears or detachments?
Retinal tears can be treated using either laser or cryotherapy to ‘wall off’ the tear and prevent progression to a retinal detachment. Most of the time, that laser can be performed in the office of your ophthalmologist. Retinal detachments usually require surgical repair by a retinal specialist. There are several techniques for repair of this problem, and each has its advantages and disadvantages.
So what’s the bottom line with floaters?
Call your eye doctor!! The key to dealing with floaters is finding out why they are there, and if they are related to more serious problems. At that point, early treatment is the best method of avoiding further problems.