Consultant Ophthalmic Surgeon
St. James University Hospital, Leeds, UK

Posterior vitreous detachment

What are Floaters?
Floaters are the small specs or clouds that you may see moving in your field of vision. The main volume of your eye is made up of a jelly called the Vitreous. The 'floaters' are within the jelly and cast a shadow on the retina (light sensitive part of the eye).

What causes Floaters?
This jelly has lots of little invisible strands in it that can become visible when they clump together. This is a normal ageing process but can also follow inflammation inside the eye. As we get older the Vitreous becomes more of a liquid and can pull away from the back of the eye leaving a free floating membrane. This occurs at an earlier age in those who are short-sighted (myopic).

Small floaters are common to us all and can be seen especially against a bright light or white surface. The floaters that become more common over the age of 50 are often described as spiders, tadpoles, flies or dots which move around in the vision and occasionally blurring the sharpness of vision should they float over the central line of vision. They can be associated with flashing lights especially in the outer part of the visual field. These flashes can be due to the part of the jelly that is still attached to the back of the eye pulling on the retina. These flashes can take many months to settle.

What can be done about Floaters?
Floaters can be annoying if they come over the central field of vision. There is no treatment unless they are due to inflammation in the eye (Uveitis). Floaters usually become less noticeable with time unless one looks out for them particularly against a bright background.

Are floaters ever serious?
Rarely, as the Vitreous pulls away from the back of the eye, it can cause a small hole or tear in the retina, even a bleed. This can lead to a detached retina. It is for this reason that anyone with a new onset of floaters should be seen by an Ophthalmologist on an urgent basis. If a retinal hole is detected early then laser treatment can help seal around the hole and help prevent a retinal detachment. If a detachment is going to occur it usually does within the first 2 weeks. People who are short-sighted (myopic) are most at risk.
Anyone with new onset of floaters, which can also be associated with flashing lights and a curtain effect coming across the visual field, should get an urgent Ophthalmic opinion.

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