One of the most commonly asked questions I get asked is "What are those things I see floating around in my vision." Most people don't think my answer of 'annoying' is nearly as funny as I do and usually would like a real answer about what is happening. So let's address a problem almost everyone experiences at some point in their life, the visual phenomenon known as floaters.
First of all, what are they? To understand that you need to know a bit about the vitreous jelly, which fills most of the eye and is where floaters form. The vitreous jelly is almost entirely water but it does have a matrix of 'stuff' (collagen and hyaluronic acid to be exact) that gives it a jelly like consistency. Don't think of it as jello though, it's more like an egg white. When we're really young the vitreous is really clear and everything is pretty much perfect. Over time though the jelly starts to break down and water leaks away. The collagen and hyaluronic acid are left behind and they clump forming the black or clear jelly blobs that we see moving around in our vision. What we are seeing is really just a shadow caused by these clumps. Floaters are easiest to see when the lighting is bright and the background is a light colour (so a bright sunny day with a blue sky or a brightly lit, white computer screen).
So, what can be done about a floater? Honestly, not much. The most effective therapy is something called a vitrectomy where they literally remove the entire jelly from your eye and replace it with a silicone oil or a saline solution. This is an extremely risky solution and I don't know a single retinal specialist that is willing to do this surgery on someone for floaters. There is a laser procedure as well that blasts the floaters. This is a better solution than a vitrectomy but doesn't work as well. Many patients report that instead of having a few large floaters they now have a lot of small ones.
Why should we care about floaters? Often we don't. The odd floater moving around in your vision is certainly annoying but it isn't harmful. There are situations though where floaters are a huge concern:
- You get a large number of new floaters all at once,
- With those new floaters you also experience a flashing light in your peripheral (side) vision like a camera or lightning flash AND/OR
- With those new floaters you notice a curtain waving in and out of your vision.
Any of those could mean that your retina has a tear or has detached. Retinal detachments are medical emergencies and can lead to complete loss of vision in hours. Retinal tears aren't quite as urgent but usually lead to a retinal detachment so you don't really want to mess around with them either.
Really, it's best to play it safe. If you have floaters and aren't sure if they were there before or you aren't sure if they're normal floaters come in for a dilated eye exam. We'll put drops in your eyes for this type of exam (which is fully covered by Alberta Health Care) to have the best possible look at the very far outer edges of your retina to make sure there aren't any problems. If something is wrong we will get you to a retinal specialist as quickly as possible and keep your vision safe.
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