Eye floaters are solidified parts of the vitreous humor. With aging, the vitreous normally starts to shrink, creating small particles, which are clumps of collagen protein that slowly drift through the vitreous. When the particles pass in front of the macula, they cast a shadow. What we actually perceive is the shadow, we can’t see the particles themselves. The image disappears when the particle has passed the macula. Eventually we can learn to ignore them, but floaters are permanent, staying in the eye.
Changes to the vitreous can happen at any age, but usually occur between 50 and 75. They are more likely to occur with myopia or after cataract surgery. In most cases they don’t need treatment, but floaters can also result from eye disease, eye injury, diabetic retinopathy, and crystal-like deposits that form in the vitreous. Serious eye disorders associated with floaters include detached retina, torn retina, bleeding in the vitreous, inflamed vitreous or retina caused by infections or an autoimmune condition, and eye tumors.
If there are only a few floaters that don't change over time, there’s no cause for concern. However, the issue is emergent if there is a sudden increase in the number of floaters, flashes of light, loss of peripheral vision, changes that come on quickly and get worse over time, floaters after eye surgery or eye trauma, or eye pain. Of course, those symptoms require urgent attention even without floaters.
For benign floaters that are annoying, some treatments are available. Try to get them out of the field of vision by moving the eyes - this shifts the fluid around. Looking up and down usually works better than side to side. If there are so many that they interfere with vision, the eye doctor may suggest a vitrectomy. This is a surgery to remove the vitreous and replace it with a salt solution. Laser treatments have also been used to break up the clumps to make them less noticeable.
Floaters are very common and, for many people, are a part of the natural aging process (add them to the list), but it’s important to know what they are and when they require professional attention. Learn more about age-related changes to the eye with our CE, The Mature Contact Lens Patient, at 2020mag.com/ce.