What is Vitreous Detachment or what causes Floaters?

Most of the eye’s interior is filled with ‘vitreous’, a gel or jelly-like substance that helps the eye maintain a round shape. There are millions of fine fibers entwined within the vitreous that are attached to the surface of the retina, the eye’s light-sensitive tissue. As we age, the vitreous slowly shrinks, and these fine fibers pull on the retinal surface. Usually the fibers break, allowing the vitreous to separate and shrink from the retina. This is a ‘vitreous detachment’. In most cases, a vitreous detachment is not sight-threatening and requires no treatment.

As the vitreous shrinks, it becomes somewhat stringy, and the strands can cast tiny shadows on the retina that you may notice as ‘floaters’, which appear as little “cobwebs” or specks that seem to float about in your field of vision. If you try to look at these shadows they appear to quickly dart out of the way. One symptom of a vitreous detachment is a small but sudden increase in the number of new floaters. This increase in floaters may be accompanied by flashes of light (lightning streaks) in your peripheral, or side, vision. In most cases, either you will not notice a vitreous detachment, or you will find it merely annoying because of the increase in floaters.

Who is at risk?

It is a common condition that usually affects people over age 50, and is very common after age 80. People who are nearsighted are also at increased risk. Those who have a vitreous detachment in one eye are likely to have one in the other, although it may not happen until years later.

Is it sight threatening? Will I lose any sight?

Vitreous detachment does not in itself cause any permanent loss of vision. Your visual acuity should remain the same that is you will be able to see just as you could before the vitreous detachment started. You may have some difficulties to begin with because of the floaters and flashing lights though these do not cause permanent sight loss.

The only threat to vision is the small chance of a retinal tear leading to a retinal detachment.

Once in a while some of the vitreous fibers pull so hard on the retina that they create a macular hole or lead to a retinal detachment. Both of these conditions are sight-threatening and should be treated immediately. If left untreated, a macular hole or detached retina can lead to permanent vision loss in the affected eye. Warning signs of a retinal tear or detachment could be an increase in size and number of your floaters, a change / increase in the flashing lights you experience or a blurring of vision. his is particularly important if you notice a dark “curtain” falling across your vision, as this may mean that the retina has already partially detached. Those who experience this should have a dilated eye examination with an eye doctor immediately. Early treatment can help prevent loss of vision.

Can anything be done to treat floaters?

Unfortunately at the moment nothing can be done medically for this condition, usually people find that the symptoms calm down after about six months and people do eventually get used to living with the floaters. The brain tends to adapt to the floaters and eventually is able to ignore them, so they then only become a problem in very bright light.

Is there anything I can do to cope with these annoying symptoms?

There is a way of trying to cope with this that some people find useful. If you move your eyes around (dart them from left to right very quickly without moving your head) you can create currents in the jelly within your eyes this can sometimes move the floater out of your direct field of vision. This works best if you have one large floater rather than lots of small ones. However most people find that with time the floaters becomes less and less of a problem.