Eye floaters come in all shapes and sizes. They can be spots, threads, rings, cobwebs, or even spider shapes—or virtually any other form.
A floater is a common term for muscae volitantes. Most are harmless, but sometimes they can be a sign of a more serious eye condition. Seeing your optometrist or ophthalmologist is the only way to know for certain.
Everyone has some spots and floaters. Their frequency tends to increase with age. The vitreous, or gelatinous fluid that gives the eyeball its shape, can change over time.
This natural part of getting older means that proteins do not always slip easily past each other and can become clumped together.
These protein clumps are denser and harder to see through. The retina, which is the light-sensitive lining of the eye, interprets them as shadows. They can be clear to opaque, light to dark, barely visible to bothersome. Because they are floating freely through the gel-like vitreous, they move as your eyeball moves, so it is not possible to focus on them directly. This is called PVD—posterior vitreous detachment—and happens naturally during aging.
Other times, floaters are formed before birth during the formation of the eyeball itself. If tiny specks or small protein clumps are present in the vitreous while the eye is forming, they do not generally get worked out. They can remain at float within the vitreous for the duration of a person’s life.
Another cause of floaters is bleeding. Sometimes this is serious, and sometimes it’s not.
As the eye ages, the vitreous gel usually shrinks a small amount. The smaller volume of gel means that the vitreous can pull slightly away from the retinal wall. When this happens, a small amount of bleeding may occur. The blood can appear as floaters. This is especially true for people who have extreme myopia (nearsightedness) or who have undergone cataract surgery.
Britain’s National Health Service counsels that floaters are not likely to be indicative of a serious condition if these things are true:
- They have been present for a long time,
- They are not getting worse or more numerous,
- They do not affect vision.
While most of the causes of floaters are not serious, sudden changes in floaters can signal the presence of a medical condition.
In this case, immediate medical attention from a specialist is necessary to prevent permanent vision loss. Serious conditions include retinal tears or detachment, uveitis, hemorrhaging from diabetic retinopathy, or even high blood pressure.
Vitreous detachment is NOT the same as retinal detachment. PVD is usually not serious, while retinal detachment can lead to blindness if left untreated. The Mayo Clinic recommends contacting an eye care specialist immediately in the case of any of the following:
- A sudden change or increase in the number, frequency, or appearance of floaters
- Darkness at the periphery of the visual field
- Flashes of light in the same eye as the floaters
Pain or blurred vision can also be signs of a more serious condition. For people who have had eye surgery or procedures recently, floaters could be a sign of a complication. Doctors should be made aware of changes to floaters following such treatment.
While some people seek treatment first from their general practitioner or primary care physician, the best option is to go directly to an eye care specialist such as an optometrist or ophthalmologist. Time is of the essence in the more serious cases.