Eye floaters: What causes them and when to see a doctor

Do you sometimes notice small floating specks, shadowy shapes or blurry spots in your line of vision? If you do, eye floaters may be the culprit. You may try to blink them away but when you look in a different direction they move with you. While they can be annoying, eye floaters often happen naturally over time and are a common occurrence as we age. 

What are eye floaters and where do they come from?

To better understand eye floaters, it helps to understand basic eye anatomy. The middle of the eye is filled with a gel-like fluid called the vitreous. This is where eye floaters live. 

As we age, the natural gel-like fluid in the vitreous starts to shrink, creating tiny clumps or strands. When you experience floaters, you are seeing the shadows created by these clumps as they slowly drift through the vitreous and pass by or hover in front of the retina. The retina is located in the back of the eye and sends signals to the brain where they become images. How they appear depends on if they are close to or further away from the retina. 

Head position, movement, brightness, background and fatigue can all be factors when seeing eye floaters. "From an optical standpoint, the pupil is the light source within the eye," says Martin Worrall, MD, Nebraska Medicine ophthalmologist at the Truhlsen Eye Institute. "Brighter light causes pupil constriction which makes the light source smaller. A complex visual image will tend to hide floaters. A perfectly homogeneous background such as the blue sky will make every floater stand out. Floaters also become more noticeable when you are tired."

Eye floaters don't go away but can become less noticeable over time. 

Who is more likely to develop eye floaters?

Many people have no family history of retinal detachment or tears when they start noticing eye floaters. For many, floaters may begin showing up between 50 and 70 years old.

"Vitreous degeneration is accelerated by nearsightedness (myopia), inflammation, trauma and rare inherited abnormalities," adds Dr. Worrall. "Highly nearsighted patients tend to have more floaters than average."

Can eye floaters signal something more serious?

While much of the time eye floaters are a normal part of aging, there are circumstances when they can be a symptom of a more serious condition. Retinal detachment is a condition where the shrinking and pulling away of the vitreous causes the retina to detach. Causing serious vision problems, posterior vitreous detachment and retinal tears can cause a sudden increase of floaters or bursts of light across your field of vision. Contact your doctor right away if you experience these symptoms.

Should I let my doctor know if I'm experiencing eye floaters?

Although common as we get older, let your eye doctor know if you are experiencing eye floaters. Maintaining regular eye exams is always a good idea, but especially important if you notice an increase of new floaters, flashes or significant vision changes.  
"Many people have stable floaters starting at a young age," explains Dr. Worrall. "Sudden onset of new floaters with or without flashes should prompt a patient to seek evaluation by an ophthalmologist. The presence of a peripheral shadow may indicate the development of a retinal detachment."

If you have certain medical conditions like diabetes, high blood pressure, multiple sclerosis or cataract surgery, be especially diligent to notify your doctor of any vision changes or problems.

A complete evaluation may include:

• Vision exam 
• Pupil and retina exam
• Confrontation visual fields
• Eye movement exam 
• Intraocular pressure measurement 
• Slit-lamp microscope exam 
• Vitreous exam

It's important to have your eyes checked regularly, especially as you age. If you notice new symptoms or a sudden or unusual increase in flashes or floaters, don't wait to call your doctor. If you need to make an appointment, please call 402.559.2020.