You’ve probably seen these little buggers sometime or another in your eyesight. Everyone has them. Perhaps you've seen them when reading the paper or working outside in bright sunlight -- these small, moving spots in your field of vision are called “floaters.”
Generally speaking, they won’t interfere with your sight, although some large ones can cast shadows over your internal vision --- this typically happens in certain lighting conditions. People usually get used to floaters, and they are barely noticeable much of the time.
Floaters tend to dart away as you attempt to look at them and may consist of black or gray dots, squiggly lines, ring-shaped, web-like, or thread-like strands. Most floaters are caused by small flecks of the protein collagen. They are typically benign.
How They Become Floaters
The back two-thirds compartment of the eyeball is filled with a gel-like substance known as the vitreous humor. This provides a pathway for light coming through the eyeball lens. The vitreous connects to the retina, a group of light-sensitive cells, which catch images and relay them to the brain.
As we age, the vitreous and its millions of collagen fibers begin to shred. These fibers then begin to accumulate in the vitreous humor, causing floaters. Vitreous fluid changes begin to happen between 50 and 75 years of age, and the gel begins to shrink, pulling away from the retina. Floaters are a natural part of the aging process. By age 60, a quarter of us will have floaters with two-thirds of us experiencing floaters by our 80s. Floaters are more prevalent in the near-sighted, diabetics or those who have had cataract surgery.
Conditions Associated with Floaters
Floaters are linked to a multitude of disorders, typically as symptoms of the following: eye diseases, eye injury, crystal-like deposits that form in the vitreous humor, and rarely, eye tumors. Serious disorders include retinal tears, retinal detachment, vitreous and retinal inflammation caused by viral infections, bleeding in the eye, fungal infections or autoimmune inflammation. Migraine sufferers often experience eye floaters with a visual aura that has more kaleidoscope-like qualities than floaters.
Inflammatory diseases of the eye that could generate floaters are tuberculosis, syphilis, toxoplasmosis, acute retinal necrosis of the eye, sarcoidosis and the extremely rare incidence of tumors in the eye from lymphoma and leukemia.
See Your Doctor If…
If there is a sudden increase in the number of floaters in your eyesight, flashes of light or loss of peripheral vision as well, see your health care provider right away. Choose an ophthalmologist with retinal expertise. Without immediate treatment, there may be a permanent loss of sight. These signs may be indicative of retinal tear, retinal detachment or bleeding within the eye.
A torn retina can be caused by a flagging vitreous humor tugging on the retina with enough force to tear it. Without treatment, a torn retina could lead to retinal detachment and possible loss of vision.
One study found that one out of seven who experiences a sudden appearance of floaters and light flashes may have retina tears. It was further found that 50 percent of those with tears will progress to detached retinas.
Light flashes, or photopsia, occur when the retina is getting mechanical, non-visual stimulation, as in the case of a retina getting tugged, pulled or detached. That’s what causes the light flashes and should not be ignored.
Diabetes-based Eye Disease
Diabetic retinopathy is simply a disease of the retina caused by diabetes. It is one of the most common eye diseases and is the leading cause of blindness in American adults. Some 40 percent to 45 percent of diabetics have a degree of retinopathy, which is caused by changes in blood vessels in the eye’s retina.
There’s a type of diabetic retinopathy where the blood vessel walls in the eyeball get weak which leads to blood and other fluids leaking into the retina. This could lead to distortion of the eyeball causing blurred vision. If blood sugar continues to rise, the disease will get worse.
Another type of retinopathy is called “proliferative retinopathy.” In this condition, blood vessels regrow on the retina but are weak and typically abnormally fragile. These vessels break open very easily, often while one sleeps. Blood seeps to the middle section of the eye, resulting in blurred vision. Bleeding can cause scar tissue to develop and retinal detachment.
As is easy to envision, retinopathy can cause swelling of the eye's macula. The macula is in the back part of the eyeball, located above the retina, where sharp, straight-ahead vision occurs.
As you can imagine, any increase in blood pressure in a patient with proliferative diabetic retinopathy endangers the[AZ1] frail blood vessels in the eye. An increase in blood pressure can cause more damage to weakened blood vessels, resulting in more leaking blood or other fluids. This can further cloud your eyesight, leading to permanent blindness.
Other Problems
If a sudden and rapid decline in central vision occurs, there is a good chance that the macula detached. See your doctor right away because it can be reattached by laser treatment.
Posterior vitreous detachment, (PVD) occurs when the vitreous shrinks, typically because of advancing years and begins to separate away from the back of the vitreous. This is not the same as retinal detachment. In 65 year olds, about 50 percent have PVD in one or both eyes. If a person develops PVD in one eye, there is a chance of having PVD in the other eye within 18 months.
So now that you know how to separate the good floaters from the “bad, symptomatic” floaters, enjoy those cloud-gazing days.