Eye Floaters

Quite often we see shadowy images like dots, “cobwebs”, specks or strands of hairs in our field of visions, sometimes obstructing our concentration when we move our focus or look at a plane space. We wonder what could be the cause of these images. Sometimes we find ourselves moving them around or trying to focus on them but they move quickly away from foveation. These images are called floaters; they are a kind of entoptic phenomena. Floaters are clumps or specks of undissolved gel particles in the more liquid vitreous which cast shadows on the retina when light reaches them. They are often not sight-threatening and just a part of the aging process or a feature of a post cataract operation. However, floaters may be dense and disturbing, this may indicate an infection, diabetic retinopathy, vitreous bleeding, severe ocular injury, hemorrhaging, inflammation, retinal tear or even retinal detachment.

Floaters may be categorized as benign or pathological based on its cause;

Benign eye floaters can occur at any age, over half of humanity at a point in time develops benign floaters. They result from shrinking of the vitreous gel which makes it stringy and makes its strands cast shadows on the retina.

Pathological floaters on the other hand indicates a more serious condition that should be treated as soon as possible. Anterior vitreous attachment can exert tractional forces on the underlying retina but this is usually not enough to cause detachment of the vitreous, since the attachment of the vitreous to the underlying retina at the vitreous base is much stronger. This vitreo-retinal traction may pull on the thin anterior retina strongly enough to create a small hole in the retina. These holes are often associated with a flap of elevated retina still attached to the vitreous base. These holes often create a horseshoe shape around the elevated flap of retinal tissue. These peripheral retinal holes may cause a small amount of blood to escape into the vitreous cavity, which to the patient looks exactly like a benign posterior detachment floater. These small anterior vitreous hemorrhages produce unmistakable signs for the examining eye doctor and frequently necessitate a punctual repair of the retinal hole.
A number of other conditions can less commonly produce vitreous floaters, including hemorrhagic macular degeneration, retained foreign bodies, postoperative matter, or rare parasitic infections, more common in third-world nations

Symptoms of Eye Floaters

Floaters may present a variety of symptoms which may include spiders or insects darting across vision, cobwebs, dirt on the windshield, spots, thread-like strands, black spots in your vision, squiggly lines, and of course floaters. They are often noticed when in bright illumination or when you view a white or lighter background. This is because the intensity of the light increases the contrast between the dark floater and the surrounding light in the vitreous, making the floater more apparent. Floaters generally jiggle or move when the eye moves. This is because the vitreous gel is a dynamic structure and compresses slightly with eye movements. Thus, when the patient looks to the right for example, the floater may first dart to the right and then re-center as the vitreous gel returns to its normal resting position.

A condition known as asteroid hyalosis characterized by numerous yellowish floaters in the vitreous which may occur in one or both eyes. Patients with this condition are often not aware of the opacities in their vitreous. Truck drivers, athletes and other outdoor workers may observe these floaters more because it affects their daily living.

When Do I Need to See a Doctor?

Floaters should not be a bother to you if it has been there, but sudden increase in sizes, shapes, densities or when it is being accompanied by flashes of light should not be overlooked and therefore, medical check-up is required. Sudden onset of floaters should also be attended to not by an intern, a student doctor or a non-eye-care professional, as proper diagnosis of floaters can only be rendered by an eye-care professional, an optometrist or an ophthalmologist because only eye-care professionals have the expensive and complex complement of diagnostic equipment and the expertise to provide a diagnosis.

Other symptoms which might accompany floaters and should be attended to include blurry vision, photophobia, flashes of light, severe eye discharge, red eye and asthenopia. Patients with known diabetes, retinal diseases, bleeding disorders, previous eye surgeries, previous eye inflammation or infections, eyes trauma who are at higher risk of their pathological causation should seek immediate medical attention.