Something Obstructing Your Vision or Eye Floaters?
You know the feeling – you’re staring ahead, and suddenly something starts “floating” in your field of vision, distracting you. Then it disappears. And the cycle repeats. This may be due to vitreous floaters or opacities. They appear as small floating shapes in our field of vision – dots, specks, or thread-like strands, sometimes perceived as flies or snowfall.
What Are Vitreous Floaters?
Vitreous floaters or opacities are small irregular shapes that float in the vitreous body – the gel-like substance filling the rear two-thirds of the eyeball.
“They can be quite bothersome for sensitive individuals. They’re a physiological phenomenon, appearing naturally with age – like grey hair,” explains retinal surgeon Dr. Peter Böhm Jr.
Most patients adapt to them without major problems, but more sensitive people may become very focused on them. Floaters are caused by changes in the natural structure of hyaluronic acid, or sometimes by the accumulation of cholesterol – a condition medically known as synchysis scintillans. This is a chemical reaction where hyaluronic acid breaks down in the vitreous, which manifests as a “snowfall” effect when looking at light. During this process, the vitreous partly liquefies and spreads back into the eye, changing its composition.
Floaters are usually benign and harmless, not causing any serious complications. They are more common with age, but can also occur in younger people, especially after trauma or in those with nearsightedness (myopia).
How Do They Form?
Naturally – through aging and physiological processes. However, floaters can also be influenced by vascular issues or inflammatory eye diseases. The vitreous may become cloudy following a retinal tear, eye injury, or vitreous hemorrhage. Some eye surgeries can also alter the vitreous. Metabolic disorders, such as diabetes, can significantly increase the risk, especially due to diabetic retinopathy.
How Are Floaters Diagnosed?
The ophthalmologist examines the patient under mydriasis (dilated pupils), using special eye drops. Once the pupil is dilated, the doctor thoroughly examines the posterior segment of the eye using a slit lamp. This allows direct visualization of the number and density of floaters and helps determine the appropriate course of action.
In certain cases, the doctor may recommend additional tests, such as an ocular ultrasound (B-scan), particularly if the eye’s transparency is reduced or there’s bleeding. Some patients may also undergo OCT (Optical Coherence Tomography) to rule out possible retinal damage.
What Can Be Done?
In cases of significant floaters, or those that persist over time and affect vision quality, we recommend consulting an eye specialist. Based on the severity, the doctor may suggest laser therapy or, in more serious cases, surgical intervention.
For smaller floaters, laser treatment is often used. The principle involves breaking up the floater into smaller parts with a laser, which in most cases no longer disturb the patient’s vision. At our eye center, we offer YAG laser vitreolysis. This treatment is indicated when a floater appears as a sheet-like structure – a larger, cohesive floating object that can temporarily obscure vision when it drifts into the field of view. If floaters are located close to the retina, laser treatment is not recommended.
In more serious cases, the doctor may propose a surgical procedure called vitrectomy – the removal of the vitreous from the eye. At Dr. Böhm’s Eye Center, we perform a proven surgical method called PPV – Pars Plana Vitrectomy. This technique is reserved for severe cases. The procedure involves the surgeon accessing the eye through a specific location called the pars plana and removing the vitreous using a surgical instrument called a vitrectome, all without damaging the retina.
Our Recommendation
Vitreous floaters are a common occurrence, especially among older or nearsighted individuals. In most cases, these are harmless floating particles that do not require treatment. However, if they significantly disrupt daily life, there are options available. The key is a professional eye examination, which rules out more serious conditions.
If you notice sudden changes in your vision, flashes of light, or a “curtain-like” shadow, do not delay visiting an eye doctor – it could be an emergency.