What is Vitreous Floaters?
Vitreous floaters are tiny strands of a protein called collagen in the jelly-like substance (the vitreous) inside our eyes. Sometimes, these strands bunch together and cast little shadows on the light-sensitive layer on the back of the eye (the retina). This makes them appear like floating specks or ‘floaters’ to the person.
The main cause of these floaters, in the eye-care field, is something called posterior vitreous detachment (PVD). PVD is when the back part of the vitreous pulls away from the retina. Usually, this isn’t harmful for vision. However, if you notice signs of vitreous floaters, it is important to see an eye doctor (ophthalmologist) to get checked out.
What Causes Vitreous Floaters?
Vitreous floaters, also known as posterior vitreous detachment (PVD), happen due to a process called vitreous syneresis. This means that as we age, the jelly-like substance in our eyes, known as the vitreous, starts to liquify and shrink. Trauma or injury to the eye can also cause these floaters.
Risk Factors and Frequency for Vitreous Floaters
Vitreous detachment is more common in people over the age of 50 and the likelihood of getting it rises when people reach 80. Those who are nearsighted or have suffered from an eye inflammatory disease, eye injury or recent eye surgery are more prone to experience vitreous floaters. These floaters can affect both men and women equally.
Signs and Symptoms of Vitreous Floaters
People frequently notice small, floating objects in their vision, often described as bubbles, bugs, cobwebs, or dark spots. These floaters tend to move around when the eyes move and are most noticeable in dim light or when looking to the side. They are caused by changes in the vitreous, a gel-like substance in the eye, which scatters light and casts shadows on the retina. This results in the perception of grey objects floating in the visual field. Additionally, a person may experience flashes of light, a symptom known as photopsias. This happens because the retina, which is the light-sensitive layer at the back of the eye, gets stimulated due to the pulling and drawing of the vitreous.
To identify the root cause of these symptoms, your doctor might ask you questions about the duration and frequency of these episodes, your history of eye surgeries, and whether anyone in your family has had retinal detachment. They aim to distinguish these symptoms from those associated with migraines, which can also cause visual changes and new floaters.
To examine your eyes, the doctor may use a tool called a slit lamp to inspect the front part of the vitreous, looking for pigmented cells known as the Shaffer sign. Another test called indirect ophthalmoscopy with scleral indentation helps to determine whether there is a tear or break in the retina. During the slit lamp exam, the doctor may ask you to look up, down, and straight ahead to locate the floater. The presence of the Shaffer’s sign and bleeding in the vitreous can increase the probability of a retinal tear over a common condition known as posterior vitreous detachment.
Testing for Vitreous Floaters
If your doctor can’t see the back of your eye due to an issue with part of your eye structure, or if there is bleeding that blocks this view, an ultrasound of your eye may be needed. This is done to check for any retinal detachments – when the retina at the back of the eye pulls away from the blood vessels that supply it with oxygen and nutrients, and also to confirm the presence of the eye issue.
Treatment Options for Vitreous Floaters
You don’t really need to worry about treating vitreous floaters or a PVD (Posterior Vitreous Detachment), which is when the jelly-like substance inside your eyes pulls away from the retina, the light-sensitive tissue at the back of the eye. However, if a tear or break in this tissue is found, it needs specific treatment.
The best thing you can do is understand the signs of a detached retina. Symptoms include seeing more floaters (little specks or ‘cobwebs’ that float around in your field of vision), flashing lights, worsening vision, or seeing a curtain or shadow appear in your vision. If you start experiencing any of these symptoms, you should immediately get in touch with an eye doctor, or ophthalmologist.
If no tear or internal bleeding is found during your eye examination, you’ll need to have your eyes checked again in 2 to 4 weeks. This involves dilating, or widening, your pupils and applying gentle pressure to the whites (sclera) of your eyes. If no problems are found at this check-up, then you’ll need to have your eyes examined again after 3 months and 6 months since you first started noticing symptoms.
Now, if you don’t have any tear or break in your retina, but you do have mild blood spots in the vitreous (jelly-like substance) or the retina’s edges, an eye doctor needs to examine your dilated eyes in 1 week, after 2 to 4 weeks, and 3 months and 6 months after you started noticing symptoms.
If no tear or break is discovered, but you have a lot of bleeding into the eye jelly or dark, pigmented cells in the front part of the eye jelly, this is a reason to return for another check-up the next day. This is because these signs increase the chances that you might have a tear in your retina. And this examination should ideally be done by a retina specialist.
What else can Vitreous Floaters be?
When it comes to diagnosing eye problems, there are several conditions that the doctor might consider. These include:
- Vitreous floater or posterior vitreous detachment: These are tiny specks that float in your vision, caused by small bits of the eye’s tissue that break loose within the inner back portion of the eye.
- Vitreous hemorrhage: This is when blood leaks into the areas in and around the vitreous humor of the eye.
- Retinal tear or detachment: This condition happens when the retina – the layer at the back of your eye that processes light – separates from the back of the eye.
What to expect with Vitreous Floaters
Generally, conditions such as vitreous floaters or posterior vitreous detachments (PVDs) have a positive outcome. However, the outlook can be less favorable if a patient has more serious conditions like vitreous hemorrhage (bleeding into the clear, jelly-like substance in the back of the eye) or retinal detachments (when the retina – the light-sensitive layer of tissue at the back of the eye – detaches from its normal position).
Typically, the symptoms of floaters may lessen within a three-month period. However, not all patients will experience a reduction in symptoms. If the symptoms persist and significantly disrupt a patient’s vision, they can consider speaking with a retinal specialist for further evaluation and options.
