Floaters
If You See Floaters, a Thorough Examination Is Needed
What Are Floaters?
Floaters are a condition in which small spots, threads, cobweb-like shapes, or insect-like objects appear to float in your field of vision. They are more noticeable against bright backgrounds or the sky and characteristically move when you shift your gaze.
Most floaters are a harmless part of natural aging. However, in some cases, they may be a warning sign of serious conditions such as retinal tears or retinal detachment, so a sudden onset of new floaters warrants an immediate eye examination.
Causes of Floaters
Vitreous Degeneration (Most Common Cause)
The vitreous (a transparent, gel-like substance filling the eye) gradually liquefies and shrinks with age. During this process, collagen fibers within the vitreous clump or condense, casting shadows that appear as floaters.
Posterior Vitreous Detachment (PVD)
This occurs when the vitreous shrinks and separates from the retinal surface. It is common after age 50 and typically presents as a sudden appearance of a large ring-shaped floater. While usually benign, the separation process can create retinal tears, requiring careful monitoring.
Other Causes
- Myopia: Vitreous degeneration occurs earlier in high myopia
- Eye trauma or post-surgical occurrence
- Intraocular inflammation (uveitis)
- Vitreous hemorrhage (diabetes, vascular disease, etc.)
- Retinal tears or retinal detachment
Seek Immediate Medical Attention for These Symptoms!
The following symptoms may be warning signs of emergency conditions such as retinal detachment.
Sudden Increase in Floaters
A large number of floaters appearing all at once
Flashing Lights (Photopsia)
Lightning-like flashes of light in the peripheral vision
Curtain-Like Visual Field Obstruction
One side of the visual field appears darkened as if a curtain has descended
Sudden Vision Loss
Vision suddenly worsens along with floaters
If you experience any of the above symptoms, please visit an eye clinic for a dilated fundus examination within 72 hours, as soon as possible. Early surgery is critical for visual prognosis in cases of retinal detachment.
Treatment Options
Observation (In Most Cases)
Most floaters become less noticeable over time as the brain adapts. If fundus examination shows no abnormalities, observation without specific treatment is sufficient. However, re-examination is necessary if new symptoms appear or existing symptoms worsen.
Laser Treatment (Laser Vitreolysis)
A YAG laser is used to break up vitreous opacities causing floaters. It is effective for large, prominent floaters, and the procedure is quick and relatively safe. However, it is not applicable to all floaters and requires specialist evaluation.
Vitrectomy
Considered only when floaters severely interfere with daily life. The clouded vitreous is removed and replaced with a clear solution. While effective, there are risks of complications such as cataracts and retinal detachment, so careful consideration is necessary.
If a Retinal Tear Is Found: Laser Photocoagulation
If a retinal tear is discovered during floater examination, laser coagulation is applied around the tear to prevent progression to retinal detachment. It can be performed on an outpatient basis and is a critically important treatment for preventing retinal detachment.
The Relationship Between Floaters and Retinal Detachment
Floaters themselves are mostly harmless, but when posterior vitreous detachment occurs, the vitreous can pull on the retina and create a retinal tear (a hole in the retina). If vitreous fluid flows beneath the retina through this tear, retinal detachment occurs.
Floaters / Photopsia
Symptom onset
Retinal Tear
Laser treatment possible
Retinal Detachment
Emergency surgery required
If a retinal tear is treated with laser at that stage, retinal detachment can be prevented. Therefore, it is extremely important to get a fundus examination promptly when floaters suddenly increase or are accompanied by photopsia.