A 50 year old woman calls our office complaining about little spots and fly like things floating in her vision and occasional flashing lights.
We tell her to come in as soon as possible and we do a complete eye and retinal exam. She suffers from Vitreous Floaters, a normal condition.
This case scenario is played out many times every month, but should not be ignored if any one experiences these visual disturbances.
Eye Floaters are deposits of various size, shape, consistency, refractive index, and motility within the eye's normally transparent vitreous humour. They may be of embryonic origin or acquired due to degenerative changes of the vitreous humour or retina. They may appear as spots, threads, or fragments of cobwebs, which float slowly before your eyes.
Floaters are particularly noticeable when looking at a blank surface or an open space, such as blue sky. Many of these specks have a tendency to sink toward the bottom of the eyeball, in whichever way the eyeball is oriented.
The most common cause of floaters is shrinkage of the vitreous humour: this gel-like substance consists of 99% water and 1% solid elements. The solid portion consists of a network of collagen and hyaluronic acid, with the latter retaining water molecules.
In most cases this is a benign condition, but can represent a much more serious condition. These bits of retinal tissue may have come from an area that left a small retinal hole or tear behind and the floater is the result of the tear. In all cases when there are floaters a complete dilated retinal exam must be performed as soon as possible. That is the only way to properly evaluate the retina.
When there are flashes of light present as well the level of concern goes up since that may also indicate traction on the retina and can be more serious. If a hole or tear is discovered then usually laser treatment must be done in order to seal the anomaly and prevent further damage.
In some cases vitreous fluid or blood will fill the area where the floater originated resulting in a retinal detachment. This is a much more complicated condition and frequently requires retinal surgery to correct the problem. If left untreated it can result in total blindness in that eye.
Most often, the floaters either dissolve or reattach themselves some where in the eye and are no longer a visual issue. The problem is that over the course of our lives new ones are constantly forming. Thus even if one goes away, a new one is starting.
Vitrectomy may be successful in treating more severe cases, however, the procedure is typically not warranted in those with lesser symptoms due to the potential for complications as severe as blindness. Floaters may become less annoying as sufferers grow accustomed to them, even to the extent that they may no longer notice them.
In short, if an individual sees floaters he/she should see the eye doctor as soon as possible to rule out any retinal hole or tear. If there are flashes as well the level of urgency increases. A complete evaluation must include a dilated exam as well.
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