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Eye floaters and when to worry

Grey hair, wrinkles, weight gain … floaters? The beauty industry reminds us daily of some of the more common changes we experience as we age, but our bodies also undergo several more subtle changes.

Floaters are tiny dark spots or squiggly lines that may appear in your field of vision. They might look like a speck of dust, a thread, or even cobwebs. They’re actually a common occurrence as we age and are usually as harmless as grey hair or wrinkles.

You’re more likely to notice floaters when you’re looking at something bright, like the sky or white paper. They move or float across your vision and typically appear after age 50. It’s always a good idea to mention them to us because they can occasionally indicate a more serious problem, especially if they begin to appear when you’re younger or you suddenly experience a lot of floaters. For most patients, they aren’t a concern and rarely cause more than a minor nuisance.

What causes floaters?

Your eyes contain a gel-like fluid called vitreous. This fluid rests in front of your retina, which is the layer of your eye that’s sensitive to light. As we age, vitreous undergoes normal changes and shrinkage. This causes parts of it to solidify and break off, and these pieces cast a shadow over your retina. As a result, you experience floaters in your field of vision.

Floaters may not appear in both eyes at the same time. You’ll also tend to stop noticing them over time as your brain learns to ignore them. Eventually, they’ll slowly sink and settle at the bottom of your eye, but once you have floaters, they’ll never go away entirely without intervention.

Should I be concerned?

We’ve mentioned that floaters are a normal part of aging and are rarely cause for concern. However, in some cases, they can indicate a more serious problem. Let your optometrist know if you have floaters so we can rule out infection, injury, uveitis (inflammation), or bleeding in your eye. 

If floaters appear suddenly and in large quantity, or they’re accompanied by flashes of light, seek care urgently. You could have a tear in your retina or retinal detachment, which can cause serious vision problems if left untreated. A dark shadow or blurry area in your side or central vision should also be evaluated immediately. 

Concerning flashes are like bright spots that suddenly appear in your field of vision. Some people describe them as similar to a camera flash or lightning. They differ from flashes that may accompany a migraine, which are more commonly like a zigzag line and are usually experienced by younger people.

How are they evaluated?

Most floaters don’t require significant evaluation. A dilated eye exam using drops to widen your pupil or pressing on your eyelids can help us keep track of floaters and identify retinal tears or detachment at your regular eye exams. 

Be prepared to answer a few questions. We may ask when you first noticed the floaters and how many you have, whether or not you’ve seen flashes, and if you’ve had any injuries or surgeries. We’ll also ask about your health history, as some conditions can increase the risk for floaters.

If you’re nearsighted, over 50 years of age, have a health condition like diabetes, or have had eye injuries or cataract surgery, your risk for floaters is increased.

Is there treatment?

If your floaters are caused by a health condition, it may require treatment. However, if they’re simply a result of aging, it’s most common to do nothing at all.

Floaters don’t bother most people and become less noticeable over time. If you’re troubled by them, a vitrectomy can be performed to replace your vitreous with a solution. However, this surgery is risky and increases the chance of a retinal tear or detachment. Laser treatment also carries risks, including damage to your sight.

What to do if you have floaters

If you’ve noticed floaters, there’s probably no need to worry, although sudden floaters and flashes should be evaluated urgently. 

It’s a good idea to keep track of any changes you notice in your sight and to share them with your optometrist at your regular eye exams. But like other signs of aging, floaters are usually just something to take in stride, no more than a minor nuisance.