Floaters are a common vision issue where patients see floating dark spots, tadpole-shaped figures, thread-like objects, and other shapes in their field of vision. Floaters come in many forms, and each patient describes them differently. Can floaters be treated? Will they go away on their own? Dr. Tong Wenjie, an ophthalmologist, will address these questions below.
What is floaters?
Floaters are medically known as vitreous degeneration. Inside our eyeball lies a transparent, gel-like substance called the vitreous humor, situated at the center of the eye—behind the lens and in front of the retina.Under normal conditions, the vitreous fills the entire vitreous cavity, maintaining the eye's shape and ensuring light is properly refracted onto the retina to form images. When vitreous degeneration occurs, the gel-like substance within liquefies, forming tiny fibers that float within the vitreous cavity—these are the dark spots patients perceive.
Causes of Floaters
The primary causes of floaters can be broadly categorized into three types: physiological, degenerative, and pathological.
physiological
Physiological floaters commonly occur in individuals under 40 or those who overuse their eyes long-term, such as garment workers, teachers, and office workers who spend extended periods at computers.Generally, up to 80% of floaters cases are physiological. Patients may perceive dark spots or lines within their visual field, which are caused by impurities within the vitreous humor. Currently, there are no medications or surgical procedures to treat this type of floaters. However, there is no need for excessive concern, as these dark spots will typically fade from the visual field over time.
Degenerative
Inside the eyeball is a transparent gel-like substance called the vitreous humor, located behind the lens and in front of the retina.As we age, this vitreous body degenerates and breaks down into tiny fibers. These fibers float within the vitreous, causing us to see dark spots or patches in our vision. Some people may also see thread-like or worm-like shapes. As long as the dark spots in the eye do not increase in number and remain relatively stationary, this is considered benign floaters, and there is no need for excessive worry.
pathological
Pathological floaters arise from other eye conditions or systemic vascular diseases, such as: traction from external force, trauma, or systemic vascular disorders like retinal detachment, diabetes, or hypertension. These can all lead to vitreous detachment and hemorrhage, causing dark spots or even dark patches in the visual field.If left untreated, this type of floater can potentially lead to permanent vision loss. Patients are advised to seek treatment for floaters as early as possible.
Symptoms of Floaters
The initial symptoms of floaters are easily recognizable. Patients perceive floating objects within their field of vision—visible yet elusive—particularly noticeable under bright light or against a light background. Floaters manifest in diverse shapes, so each patient observes different forms:
- Black spots in the eye
- The eyes see lines
- See the mesh
- cloud-like formation
- The eyes see things that look like worms, one after another.
If you experience worsening symptoms of floaters, such as a sudden increase in floaters, flashes of light in the eyes, dark shadows in the eyes, vision obstruction, or blurred vision, you should immediately seek a thorough examination by an ophthalmologist and follow the doctor's recommended treatment plan to improve the floaters.
Treatment Methods for Floaters
Generally, early-stage floaters do not require immediate treatment. Most people adapt to the presence of dark spots over time, or these spots may settle at the bottom of the vitreous over time, no longer affecting vision. However, if you notice an increase in dark spots, experience shadows in your vision, or feel these spots are impacting your daily life, you may consider laser treatment or floater surgery to improve the dark spots in your eyes.
Laser therapy
Laser treatment is suitable for larger, concentrated vitreous fibers. By breaking these fibers into smaller fragments with laser energy, symptoms of floaters can be improved or eliminated.Performed under local anesthesia, the procedure is painless and takes approximately 15 to 20 minutes. However, this treatment is not suitable for everyone. If the fibers are loose or located too close to the macula or lens, laser therapy should be avoided to prevent complications such as cataracts or macular damage.
Vitrectomy
Vitrectomy surgery involves removing the vitreous gel inside the eye through a small incision and replacing it with a solution to maintain the eye's shape. The procedure typically takes about 10 to 15 minutes. While this surgery can effectively clear fibrous debris, it may also cause bleeding or retinal tears, potentially leading to new floaters. Therefore, most physicians do not recommend this surgery for treating floaters.
Additionally, many patients attempt to alleviate symptoms of eye degeneration by using eye drops and request floaters eye drops from ophthalmologists. It is important to note that eye drops cannot penetrate the vitreous humor, so relying solely on eye drops cannot treat vitreous degeneration. Remember not to casually trust floaters eye drops recommended by non-professionals.
Preventing Floaters
Floaters are primarily caused by vitreous degeneration due to aging and high myopia. Currently, there is no way to completely prevent floaters from occurring, but we can slow down the progression of eye degeneration through daily care. Here are some methods to help prevent floaters:
- Avoid excessive use of electronic devices (take a 5- to 10-minute break after every hour of screen time).
- Read or work in well-lit conditions whenever possible to prevent worsening myopia.
- Ensure a balanced diet daily and reduce intake of foods high in oil, salt, and sugar.
- Increase your intake of nutrients such as carotenoids, anthocyanins, and vitamins.
- Get regular physical and eye exams
Frequently Asked Questions
If you feel that the dark spots in your vision are significantly impacting your daily life, you may consider laser treatment or vitrectomy surgery to eliminate floaters.
Floaters may result from physiological, degenerative, or pathological causes. It is recommended to consult a professional ophthalmologist to accurately determine the cause of your floaters and the appropriate treatment method.
Floaters do not disappear on their own, but most people gradually adapt to their presence over time.
Benign floaters generally require no intervention. However, monitor whether the number of dark spots increases. If you experience significant visual obstruction, seek prompt medical attention to avoid delayed treatment that could lead to blindness.
The side effects of cataract surgery do not include floaters. Some patients notice floaters after cataract surgery because their vision was too blurry before the procedure to detect the pre-existing floaters.
