Vitreous Floaters and Retinal Detachment

Floaters, sometimes called spots, are small, semitransparent or cloudy particles that float within the vitreous, the clear, jelly-like fluid that fills the inner portion of your eyes. Floaters are usually harmless and are seen by many of us at one time or another.

They generally look like specks of various shapes and sizes, or like cobwebs. They are frequently visible when you are looking at a plain-lighted background like a blank light colored wall, a blue sky or the white pages of a book.

Floaters become visible when they fall within the line of sight and cast a shadow on the retina (the light sensitive portion of the back of the eye).

Figure 1: Floaters are seen as small specks in your vision and are usually harmless.

There are a number of possible causes for floaters. They may be small flecks of protein or other matter that were trapped during the formation of your eyes before birth and remain suspended in the clear fluid of the vitreous.

Deterioration of the vitreous fluid as the eye ages may also cause floaters to develop. This is a part of the natural aging process and is often not serious, though it can be very annoying. Certain eye diseases or injuries can also cause floaters.

Sometimes flashes or streaks of light may appear. This may be happening because the jelly-like vitreous is shrinking and pulling on the retina. The retinal receptor cells are stimulated to “fire” by this tugging action and cause the perception of light flashes.

Vitreous shrinkage can continue and result in a part of the vitreous actually becoming detached or peeled away from the back of your eye. Flashes, floaters and vitreous detachment are common and only infrequently lead to serious eye problems.

Figure 2: Posterior Vitreous Detachment. The separation of the vitreous gel from the attachment to back of the eye at the optic nerve causes the sudden appearance of a large number of floaters and sometimes flashes.

On rare occasions, vitreous detachment can cause small tears or holes in the retina. The damaged part of the retina subsequently does not work properly and a blind or blurred spot in vision can result. If untreated, retinal tears or holes can continue to worsen and severe vision loss can result if the retina becomes detached.

While flashes and floaters can be symptoms or signs of either vitreous detachment or retinal detachment, vitreous involvement occurs far more frequently and usually requires no treatment. However, until the vitreous has completely detached, your eye doctor will need to see you several times to monitor the progression of the detachment.

It is important to have a comprehensive eye health examination soon after experiencing flashes or floaters, or if you become aware of an increase in the number or intensity of flashes or floaters. In a comprehensive examination, your doctor of optometry can use a variety of special instruments to look at the vitreous, the retina and the other interior parts of your eyes to determine the causes of the flashes and floaters that you see.

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