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.
飛蚊症有什麼成因？
飛蚊症主要形成原因可大致分為3種，即是生理性、退化性和病理性。如有懷疑，建議患者儘早尋求眼科醫生進行檢查。
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.
飛蚊症有什麼症狀？
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
玻璃體切除手術通過小切口移除眼內的玻璃體，並以溶液替代以維持眼睛的形狀。手術大約需要10至15分鐘。雖然這種手術可以有效清除纖維，但也有可能導致流血或視網膜撕裂，進而形成新的浮游物。因此，多數醫生不建議使用這種手術來治療飛蚊症。
另外，有許多患者會試圖通過眼藥水去改善眼睛退化症狀，並請求眼科醫生推薦飛蚊症眼藥水。要注意的是，眼藥水並無法滲透到玻璃體內，因此單靠點眼藥水是無法治療玻璃體退化的，湯醫生提醒切記勿隨意聽信非專業人士推薦的飛蚊症眼藥水。
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.
