Do you see little black specks in your vision? These annoying spots are called “floaters” because they seem to drift around in your vision. They are easiest to see when looking up into the sky or at a blank wall, and often drift away into your peripheral vision if you try to stare at them. Floaters are very common, and though they can be annoying, they are almost always harmless. To understand how floaters occur, it may be helpful to review the contents of the eyeball and use a couple of culinary metaphors!
How the eye changes with age
When we are born, our eyes are filled with a clear fluid called the vitreous jelly. This vitreous jelly is crystal clear (it has to be clear so that light can pass into your eye), and has a consistency similar to dessert Jell-O gelatin. That is to say, if you theoretically squeezed out the contents of a young person’s eye, the contents wouldn’t squirt out like a jet of water, but instead would come out as a lump of wobbly, clear jelly … like a little blob of clear Jell-O!
As we age, the vitreous jelly inside our eyes begins to liquefy and becomes watery in some places. A similar process occurs if you take a dessert bowl full of Jell-O from your refrigerator and sit it out in the sun … it also becomes a little “runny.” In the eye, small particles of debris can float inside these watery areas and these particles look like little “specks” drifting in your vision. One way to visualize these floaters is to think of them as small pieces of fruit-salad suspended in the Jell-O inside your eye! Fortunately, floaters are harmless. However, if you have new floaters or other symptoms such as flashing lights, you should have your eyes checked by a doctor.
Are there any dangers to floaters?
While floaters are not inherently dangerous, the jelly inside the eye can cause problems if it liquefies and begins pulling on delicate structures. This tugging-action can cause a detachment in the eye: either a harmless “vitreous jelly detachment,” or a more dangerous “retinal detachment.”
Vitreous Jelly Detachment
As we continue to age, the vitreous jelly in our eyes becomes more watery. At some point, you may end up with more “water” inside your eye than “jelly,” and the remaining jelly can suddenly contract inwards upon itself. This leaves you with an eye filled mostly with water, but with a small blob of “Jell-O” floating in the middle. This event is called a “vitreous detachment,” and though this term sounds scary, vitreous detachments are quite common and have already occurred in the majority of people over the age of 55. Some people describe seeing a bright flash of light, but most people don’t realize their vitreous has “detached” because it doesn’t cause any visual problems.
When the vitreous jelly contracts, it peels off the inner walls of the eye. This tugging/peeling action can rarely create a hole in the retina. The retina is the light-sensitive structure that forms the inner walls of the eye, like film in a camera (or like wallpaper on a wall). If a retinal hole forms, water can track under the retina and progress to a full retinal detachment with severe visual consequences. Fortunately, this sequence of events is rare.
What should you do about your floaters?
If you have new floaters, flashing lights, or a change in your vision, you need to see an eye doctor for a dilated eye exam. We can look into the back of your eye and make sure that your vitreous jelly and your retina are in good condition. Depending upon the onset of your symptoms, your doctor may want you to return in 4-6 weeks to recheck your eye to make sure the retina is still healthy.
Can anything be done to get rid of floaters?
No. Unfortunately, floaters are almost impossible to treat. The surgery that would be required to remove the vitreous jelly debris from your eye would put your eye at risk for other problems, including infection, retinal detachment, cataracts, and need for future surgery. When it comes to floaters, the treatment is almost always worse than the symptoms, and very few eye doctors would consider surgical or laser correction a safe endeavor.
You’re not alone
Floaters are very common. Vitreous detachments (i.e., the liquefaction and contraction of the jelly inside your eye) are very common in people over 65 and are a major source of “annoying floaters” in this population. Most people over 65 have already had a vitreous detachment and didn’t even realize it!
If Life is like a box of chocolates,
then your eye is like a bowl full of Jell-O!
– Tomoka Eye Associates