Eye floaters - what are they and why do they happen?

Written by: Mr Mahi Muqit
Published: | Updated: 06/06/2019
Edited by: Top Doctors®

Eye floaters are shapes that people may see drift across their vision. They are small pieces of debris floating in the vitreous jelly, a substance that helps the eye maintain a round shape. They may exist in a variety of forms, such as small black dots, short wavy lines, hair-like shapes, tadpole or fly-like, or even resembling a cobweb. Mr Mahi Muqit, expert ophthalmologist, explains more.

The causes of floaters

Vitreous jelly is made mainly of water, held together by a meshwork system, and it forms 80% of the eyeball volume. As we age, the meshwork begins to break down, which in turn causes debris as it becomes solid. The debris casts shadows onto the retina, which is what we see as floaters. In 70% of people between the ages of 40 to 70, the vitreous gel can lose its support framework, which causes it to collapse. This is known as a posterior vitreous detachment (PVD).

 

Treatment for floaters

 

Floaters are considered to be harmless, and represent a natural process of ageing – natural, but occasionally annoying. Floaters become less apparent over time as our eyes and brain adjust to the change, filtering them out.

In very rare cases, the vitreous gel can become stuck to a patch of retina and cause a retinal tear. This can occur in up to 10% of PVD patients. This means fluid can start to appear behind the retina, causing it to detach (retinal detachment) from the back of the eye. If a tear develops, then people experience a marked shower of floaters with flashes of light, usually occurring in daylight. This requires urgent attention from an eye doctor.

Floaters, however, do not harm the eye, or cause significant problems, so no treatment is generally recommended. If the patient has very severe floaters or cannot adapt, this can affect their quality of vision and interfere with their daily lives. Therefore, an operation to remove the vitreous gel (a vitrectormy) can be performed.

 

Vitrectomy surgery

 

Vitrectomy surgery carries with it various risks, such as developing cataracts at an earlier stage than they would have otherwise done. Cataracts rarely develop immediately after surgery, but rather 2-3 years later.

Severe complications include blindness in the eye, because of severe bleeding during surgery or an eye infection after the operation. This is extremely rare, but patients should be aware that the risk does exist.

Vitrectomy surgery can be performed under local or general anaesthetic. Even though it is a major operation, it is rarely painful. Discomfort in the eye may be experienced afterwards, but this is easily relieved with painkillers. Eye drops will be prescribed to reduce inflammation and prevent infection. Most people choose to take at least two weeks off work after surgery, and during recovery process decide not to drive, as the ability to judge distance is affected.

After surgery, you can bath or shower, but avoid splashing water near the eye. Any instructions your specialist gives you should also be followed. 

By Mr Mahi Muqit
Ophthalmology

Mr Mahi Muqit is a consultant ophthalmologist, cataract and vitreoretinal surgeon based at Moorfields Eye Hospital and at two private London hospitals in Harley Street. After two advanced vitreoretinal fellowships and a PhD in medical retina, he has established himself as one of the best specialist retinal surgeons in the country. He is part of national and global advisory boards, and a member of the UK and Ireland Society of Cataract and Refractive Surgeons and the British and Eire Vitreoretinal Society. He has won numerous awards in his field, and is an expert in complex cataract surgery, diabetic eye disease, macular hole and retinal detachment surgery. He also gives his time to Helen Keller International (HKI) as well as collaborating in many international training projects in diabetic eye disease. His current research interests at Moorfields include: artificial vision, age-related macular degeneration, retinal lasers, diabetic eye screening and diabetic retinopathy.

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