Floaters in the eye – should I be worried?

FLOATERS ARE little black things that move in the vision that can take many forms – spots, lines, cobweb or lacy patterns. They move as the eyes move because they are suspended in a gel (vitreous humour at the back of the eye).

Floaters typically occur in people 60 years or older. This is because the vitreous is like a gel, consisting of collagen in young people. As we age, the collagen in the eye breaks down (just like the collagen in the skin) and the gel undergoes ‘liquefaction’, becoming liquefied. Therefore, as your eyes move, the liquefied vitreous and floaters move around with the movement.

Floaters can be due to condensation of vitreous, pigment, blood (red blood cells) and inflammation (white blood cells). Floaters are WARNING SIGNS. If you develop new floaters it may be due to a simple ageing change (liquefaction), resulting in the vitreous pulling off from the retina, a posterior vitreous

Detachment, a normal process usually occurring after 60 years old. However, it can occur in younger patients such as myopes (nearsightedness), post YAG laser treatment after cataract surgery or previous eye injury.

Floaters can be due to bleeding into the vitreous, which can occur in diabetics and hypertensive patients who are not taking their medications consistently, or in sickle cell patients. Floaters can suggest that the retina is torn. A retinal tear is very serious and can present with bleeding (floaters). Patients may also have flashing lights (photopsia) due to pulling

on the retina. Retinal tears can lead to retinal detachments which, if not treated urgently, will result in permanent visual loss.

If you experience floaters and/or flashing lights, you should visit your ophthalmologist for a dilated eye examination. This is to rule out any serious problems with the retina that could result in loss of vision. This examination is different from a glasses test. It requires special dilating drops that are used to make the pupil of the eye bigger (this can take 40 minutes for the drops to work) so that the ophthalmologist can check for retinal problems. If the retina is normal, the floaters may persist but become smaller and less obvious with time. The main point to remember is that floaters are a warning sign of retinal problems which can affect your vision. If you have them, you must see your ophthalmologist for a dilated eye examination.