Eye Floaters: Ophthalmologists Explain Causes, Symptoms, and Treatment

Picture it: You're going about your day, minding your own business, when all of a sudden, a tiny speck floats across your field of vision. But what the heck was it?

The likeliest scenario: You just spotted an eye floater—an often harmless quirk of being a human being with a pair of eyes. But it'd still be nice to know what those little specks are and what causes them, right? Ophthalmologists (aka, eye doctors) explain what exactly eye floaters are, what causes eye floaters, and when you might need to worry about them. Here's what you need to know.

What Are Eye Floaters?

Eye floaters are basically specks that float around in your field of vision. They can appear as spots, threads, squiggly lines, or cobwebs. But they're not actually cobwebs; they crop up when the jelly-like substance filling the back of your eye, called the vitreous, begins to liquefy—a process that happens over time, said Shameema Sikder, MD, an assistant professor of ophthalmology at Johns Hopkins University's Wilmer Eye Institute and director of the Center of Excellence for Ophthalmic Surgical Education and Training.

Some people notice floaters very easily. They might be because of your personality, job, or simply how visually aware you are—and some people hardly ever notice them, Dr. Sikder said.

In general, floaters don't cause pain or discomfort, said Doug Wisner, MD, a cataract surgeon at Wills Eye Hospital. People often head to the eye doctor saying they're swatting at an insect that's not really there, or they say they see a speck in their vision, Dr. Wisner said.

Causes

Really, floaters are part of the aging process, said Dr. Sikder. "A newborn has completely coherent jelly and someone who's 100 years old basically has this cavity filled with fluid because the jelly has liquefied," Dr. Sikder said. "The transition is kind of like a lava lamp where the bits of jelly are floating around bathed in bits of liquid." And essentially, that's what a floater is: a glob or conglomeration of this jelly floating around in the fluid.

Other than normal changes in your vision due to aging, there can be other, more serious, causes of eye floaters.

Inflammation of the Eye (Uveitis)

Inflammation of the eye, called uveitis, typically occurs when you have an eye infection. This condition damages a part of the eye called the uvea—hence the name. Uveitis can be chronic or temporary, affect one or both eyes, and come back after treatment. If you have uveitis, you may experience floaters as well as the following symptoms:

• Blurry vision
• Eye pain
• Red eyes
• Light sensitivity
• Vision loss
  

Retinal Detachment

Retinal detachment happens when, as the jelly is floating around, it actually lifts off the surface of the retina—the wallpaper of your eye—releasing a little flash.

If it pulls hard enough, your retina could tear or detach (this might look like a swarm of bugs with a flash of lights), Dr. Sikder said. Retinal detachments are serious conditions and should be treated immediately, said Dr. Sikder; if left untreated, they could lead to blindness.

Vitreous Detachment

The vitreous is another part of the eye that can be pulled away due to aging. The vitreous is a gel-like fluid in your eye that attaches to your retina. As you age, the fibers slowly pull away from the retina, and these strands can cast shadows that will appear as floaters—and there can be many of them.

Risk Factors

Trauma to the head or eye (like a sports injury or a car accident) can also precipitate floaters, as can health issues like diabetes or other eye conditions such as macular degeneration, added Dr. Wisner.

And if you're very near-sighted (sometimes that means that the eyeball itself is a little longer than the average eyeball), your jelly could liquefy a little faster simply due to the anatomy of your eye, which means you might notice floaters earlier, said Dr. Sikder.

People who are pregnant, and undergoing hormonal changes, can have some visual changes, too, and can sometimes have floaters, said Dr. Wisner.

Do You Need To Worry About Eye Floaters?

Small floaters coming and going over time with no other symptoms are not abnormal or cause for alarm, said Dr. Wisner.

That said, if you notice a sudden onset of floaters or a floater persisting for over 24 hours, call the eye doctor for further evaluation, Dr. Wisner said. Floaters of that magnitude, which occur with flashing lights or a "curtain" coming down on your vision, could be an early sign of retinal detachment, said Dr. Sidker.

Treatment

For most people, most of the time, there's no real treatment for floaters, said Dr. Sikder. There is the possibility of a retinal surgery to remove the jelly with lasers, essentially eliminating the floaters, but surgeries come with risks, and Dr. Sikder said that it isn't necessary or worthwhile.

It is worthwhile, however, to have an eye exam. The American Academy of Ophthalmology recommends a baseline screening at age 40 (and earlier if you have eye disease risk factors such as diabetes or high blood pressure) and again every few years, depending on your risk factors. You are more at risk for eye problems if you have:

• Diabetes
• High blood pressure
• A family history of eye disease

If you're unsure what course of treatment is best for you, talk to your eye doctor. "An eye doctor can actually see the floaters that are there and determine exactly what may be causing them—whether they're just an age-related change, whether there is bleeding in the eye, a retinal issue, or whether there's something else entirely going on," said Dr. Wisner.

A Quick Review

Floaters in your eye can be a normal part of the aging process. But sometimes, they can be caused by other serious conditions like retinal detachment, uveitis, vitreous detachment, or eye injury.

If the floaters are affecting your vision greatly, discuss your symptoms with an eye doctor to determine if surgical treatment may be beneficial to you.