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As a retina doc, I see a lot of people who have floaters in their vision. These are small specks, strands, clouds or webs in your vision that move around and seem to “float” around. Occasionally, floaters will disappear, but then come back — especially if you look at a white or light background like a computer screen or the blue sky (sound familiar??).
The eyeball is a hollow structure (think: basketball). Inside the eye, there is a viscous liquid called vitreous. The vitreous serves no important purpose in the eye and is actually a remnant of a prenatal blood vessel that dissolves before birth. Sometime before the age of 10, the vitreous begins to melt (kind of like Jello that has been left out in the sun). As the vitreous degenerates, tiny clumps and strands of cells form that float around in the center of your eye. These structures cast a shadow on your retina that you perceive as the floater. Eventually (usually around 50+ years of age), the vitreous will degenerate to the point of separating from the retina and lead to a posterior vitreous detachment (PVD). This is a process that happens in every eye at some point. At that time, you may experience a lot of new floaters, larger floaters, some flashing light or a shadow in your visual field. It is possible that the new floaters could be blood from a torn retina. The flashing light is caused by the retina being tugged by the detaching vitreous on the inside of your eye.
Dilated Eye Exam
It is important to have a dilated eye exam when the vitreous detachment occurs because there is a chance (~1%) that the retina could tear or detach at that time. PVDs are more common and happen earlier in people who are nearsighted, have had eye surgery (e.g. cataract surgery) and have had inflammation or bleeding in the eye. So if you you have a sudden new floater or flashing lights or a shadow in your vision, it is important to have a dilated eye exam right away. If your retina is torn, it is possible to repair it with a laser or freezing therapy in the office. If the retina is detached, it is likely that you will need a surgery to fix it. Fortunately, retinal detachments can be repaired and vision restored (especially if they are caught quickly).
Getting Rid of Floaters
Floaters are harmless and can fade over time and become less bothersome. In rare instances, we can perform surgery to remove the floaters. Surgery is usually not needed and we typically recommend against routine surgery to get rid of floaters.
This is such a clear explanation , especially for the layperson – thank you. Was just discussing floaters recently with a friend who had experienced a retinal detachment. I will share this with her. Hope all is well with you – best wishes, Nicole
Hi Dr. Leng,
I am very happy that you shared this most informative article. Your descriptions and explanations are concise and understandable to me as a patient. A deeper understanding of the subject gives me increased peace of mind. Many thanks!
My son just had a dilated eye exam as he has noticed increased amount of floaters and a shadow that appears in his vision – but may come and go. So, we saw the doctor, who verified the retina was still attached, although my son (30 yoa) has had partially detached retina’s and surgery in both eyes. The doctor was a retina specialist, and did not even mention PVD as a possible cause, although my son is very nearsighted, and has had retina issues. I really appreciate this article shedding some light on what he may be experiencing. Thank you so much!
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