Eye Conditions

Floaters

What is it?

A floater is an object that appears to float around in your vision.

Most of us have experienced this at some stage and it becomes more prevalent as we get older. It is usually caused by something inside the eye and in most cases it is benign.

What causes it?

The floater is caused by an opacity in the eye. It is frequently located in the vitreous (gel) that fills the eye. The majority of floaters, particularly those that have been present for a long time, are benign. However, they may also be the result of more serious conditions that require urgent examination to prevent complications. A detailed explanation can be found here.

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The eye is filled with gel called vitreous. This consists of a watery liquid mixed with proteins. At birth these proteins are evenly dispersed in the liquid and the vitreous is firm and clear. As we age the proteins start to break up and stick together. Eventually these clumps of protein are large enough to become visible (although it usually requires specific viewing conditionse.g. looking at a white computer screen or lying on the beach and looking at a clear blue sky).

When the eye moves the vitreous rotates with it. As the vitreous becomes weaker there is a lag between the eye movement and the rotation of the vitreous. The floaters will start to follow shortly after the eye movement starts and tend to “overshoot” the point at which the eye movement stops.

These floaters appear gradually and increase slowly. They may seem to appear from nowhere because they are only noticed in particular circumstances. This is part of normal ageing and does not pose a direct threat to vision. It is rare for these floaters to be debilitating and no treatment is required.

There are other, less common, conditions that cause floaters. They usually occur suddenly and are more obvious and intrusive. These floaters are more serious and should alert you to the possibility that there may be a problem. Numerous eye conditions may cause a sudden onset of floaters and they all need to be seen urgently by an ophthalmologist. Delay in presentation may result in irreversible loss in vision.

However, not all of these conditions are sinister. In fact, most will not cause vision loss or require treatment, but they do need urgent evaluation. (see retinal detachment)

Do I Have it?

If you notice something floating around in your vision you have a floater. If it is a blurred, irregular, translucent shape that is barely visible and has been present for years it is likely to be benign. However, if you are unsure, get it checked by your ophthalmologist. If it is new, appeared suddenly or is obtrusive get an urgent referral to see your ophthalmologist.

How is it treated?

We have established that floaters may be a normal benign condition that requires no treatment, or it may be more complicated, appearing as an early indicator of a serious underlying eye problem.

Benign floaters require no treatment.

More sinister causes of floaters are numerous, and the treatment depends on the underlying problem. The important message is that a new floater should lead to an urgent eye examination to determine the diagnosis and treatment required.