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Floaters

Paddy Kalish OD Blog Floaters
Eye floaters are small, shadowy shapes that drift through the field of vision, appearing as spots, threads, or cobwebs. While they seem to be in front of the eye, they are actually tiny clumps of cells or fibers floating inside the vitreous, the jelly-like substance that fills the back of the eye. As they move, these clumps cast shadows on the retina, which is what one perceives as a floater.
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For most people, occasional floaters are a harmless and normal part of the aging process. However, a sudden increase in floaters, especially with other symptoms, can signal a serious condition that requires immediate medical attention. 
 
Common causes
  • Aging: This is the most common cause. Over time, the vitreous gel inside the eye begins to liquefy and shrink. This causes microscopic collagen fibers to clump together and cast shadows on the retina.
  • Posterior vitreous detachment (PVD): As the vitreous shrinks, it pulls away from the back of the eye. This process often causes a sudden increase in floaters and can also cause flashes of light.
  • Nearsightedness: People who are very nearsighted are at a higher risk of developing floaters earlier in life due to the specific shape of their eyes.
  • Eye injury or surgery: Trauma to the eye or certain procedures like cataract surgery can cause floaters.
  • Eye inflammation (uveitis): Inflammation in the back of the eye can release debris into the vitreous that is seen as floaters.
  • Bleeding in the eye: This can be caused by diabetes, high blood pressure, blocked blood vessels, or injury. The blood cells are seen as floaters. 
When to see a doctor
One should see an Optometrist or Ophthalmologist immediately if there is a sudden onset of new floaters, or if they are accompanied by any of these warning signs:
  • A sudden increase in the number of floaters.
  • Flashes of light in the same eye.
  • A gray curtain or shadow blocking part of the vision.
  • Blurry vision.
  • Darkness on the side of visual Field (peripheral vision loss). 
These symptoms could indicate a retinal tear or detachment, a serious condition where the retina is pulled away from the back of the eye. Untreated retinal detachment can lead to permanent vision loss. 
 
Treatment for floaters
For most harmless, age-related floaters, no treatment is needed. Many people learn to ignore them over time. 
For floaters that significantly impair vision, treatments are available, though they are seldom needed:
  • Vitrectomy: In this surgical procedure, a Retina Specialist removes the vitreous gel and replaces it with a saltwater solution. The body then replaces this solution with its own natural fluid. Risks include infection, bleeding, and retinal tears.
  • Laser vitreolysis: In this less common procedure, a laser is used to break up the floaters, making them less noticeable. If the laser is aimed incorrectly, it could damage the retina.
  • Low-dose atropine eye drops are an emerging, off-label treatment for symptomatic eye floaters, but are not a cure. The drops work by slightly enlarging the pupil, which helps to minimize the shadow that floaters cast on the retina, making them less visible. This is a prescription-only treatment that requires consultation with an eye care professional.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


 
 
 
 
 
Author
Paddy Kalish OD, JD and B.Arch Author and Blogger

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