Picture this: you are sitting at your office getting some work done and all of a sudden you see a fly. You swat and swat at it, but it keeps moving around until you eventually figure out it’s not a real fly at all! Floaters, also known as floaties or bugs, are one of the most common problems that my patients bring up. These can range from mildly annoying to severely debilitating. What exactly are they and why do we have to deal with them?
Floaters Eye Anatomy
To understand what they are, we need to do a little ocular anatomy lesson. The inside of the eye is filled with a jelly-like substance called the vitreous. This is where the floaters form. The vitreous is colorless and transparent and is mostly composed of water with a small percentage of collagen, sugars, salt, and protein. It has a few functions which include maintaining the shape of the eye, helping with clarity of vision, and absorbing any shock to the head or eye to help prevent damage.
When we are younger, the vitreous is working well and is really clear. Over time, the water goes away and leaves behind the other components (collagen, sugars, salt, and protein). These form into clumps. When light comes into the eye instead of passing through a nice, clear vitreous, it instead hits one of these clumps and casts a shadow onto the back of the eye. The image you are seeing as the “floater” is actually from the shadow. They are easier to see in bright lighting conditions, for example a bright sunny day, computer screen, or anything bright and light in color.
Eye Floaters Treatment
So, is there anything to do about them? Not really. For most people these floaters are pretty mild, and you only notice them every once in a while. Eventually you get used to them. Some people even name theirs and become friends! For some people, these clumps can be so large that they are unable to see past them.
If quality of life is decreased because of floaters, a vitrectomy may be recommended. A vitrectomy is where a surgeon will remove all the vitreous from the eye and replace it with silicone or saline, which in turn will remove the floaters. This is a very risky procedure and I have never recommended it for any of my patients for floaters. There is a newer procedure called vitreolysis which uses a laser to “zap” floaters, but it doesn’t work as well. Sometimes when they “zap” a floater it will break-up into smaller floaters which can cause more of a problem.
Floaters in Vision Conclusion
The normal, every once in a while, floater is not cause for concern. Yes, they are annoying, but it isn’t harmful to your eye. When should you worry? If you are seeing flashing lights, like a lightning streak, you get a lot of new floaters at once (like a bee swarm), or you see a curtain coming down over your vision. These can be signs of retinal detachments that need to be seen and treated immediately. If you aren’t sure if what you are seeing is “normal”, I always air on the side of being cautious.
If you are at all concerned, call and we will check it out. We will have to dilate your eyes to look at the retina to make sure there are no holes or tears. It is definitely better to be safe than sorry when we are dealing with these sight threatening emergencies.
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