Diseases & Condition--Spots in Vision (Eye Floaters)

Eye floaters are spots in your vision. They may look to you like black or gray specks, strings or cobwebs that drift about when you move your eyes and appear to dart away when you try to look at them directly.

Most eye floaters are caused by age-related changes that occur as the jelly-like substance (vitreous) inside your eyes becomes more liquid. Microscopic fibers within the vitreous tend to clump and can cast tiny shadows on your retina, which appear to you as floaters.

If you notice a sudden increase in eye floaters, contact an eye specialist immediately — especially if you also see light flashes or lose your peripheral vision. These can be symptoms of an emergency that requires prompt attention.

Symptoms

Spots in your vision that appear as dark specks or knobby, transparent strings of floating material

Spots that move when you move your eyes, so when you try to look at them, they move quickly out of your visual field

Spots that are most noticeable when you look at a plain bright background, such as a blue sky or a white wall

Spots that eventually settle down and drift out of the line of vision

Causes

Eye floaters may be caused by:

• Age-related eye changes.Eye floaters most commonly occur as a result of age-related changes in the vitreous, the jelly-like substance that fills your eyeballs and helps maintain their round shape. Over time, the vitreous partially liquefies — a process that causes it to pull away from the eyeball's interior surface. As the vitreous shrinks and sags, it clumps and gets stringy. Bits of this debris block some of the light passing through the eye, casting tiny shadows on your retina.
• Inflammation in the back of the eye. Posterior uveitis is inflammation in the layers of the uvea in the back of the eye. Posterior uveitis, which can cause eye floaters, may be caused by infection or inflammatory diseases, among other causes.
• Bleeding in the eye. Bleeding into the vitreous can have many causes, including injury and blood vessel problems.
• Torn retina. Retinal tears can occur when a sagging vitreous tugs on the retina with enough force to tear it. Without treatment, retinal tear may lead to retinal detachment — an accumulation of fluid behind the retina that causes it to separate from the back of your eye. Untreated retinal detachment can cause permanent vision loss.

Treatments and drugs

Most eye floaters don't require treatment

Eye floaters can be frustrating, and adjusting to them can take time. However, you may eventually be able to ignore them or notice them less often.

Treatments for floaters that impair your vision

If your eye floaters impair your vision, which happens rarely, you and your eye doctor may consider treatment.

Options may include:

• Using a laser to disrupt the floaters. An ophthalmologist aims a special laser at the floaters in the vitreous, which may break them up and make them less noticeable. Some people who have this treatment report improved vision; others notice little or no difference.
  Risks of laser therapy include damage to your retina if the laser is aimed incorrectly. Laser surgery to treat floaters is used infrequently.
• Using surgery to remove the vitreous. An ophthalmologist removes the vitreous through a small incision and replaces it with a solution to help your eye maintain its shape. Surgery may not remove all the floaters, and new floaters can develop after surgery. Risks of vitrectomy include bleeding and retinal tears.