One of the most frequent questions I receive is, “What are those things floating around in my vision?” Most people don’t find my answer of “annoying” as amusing as I do; they typically want a more informative response. So let’s tackle a common issue that nearly everyone encounters at some point: the visual phenomenon known as floaters.

First, what exactly are floaters? To understand this, it helps to know a little about the vitreous gel that fills most of the eye, where floaters originate. The vitreous gel is primarily composed of water but contains a matrix of substances (specifically collagen and hyaluronic acid) that gives it a jelly-like texture. Think of it more like egg whites than jello. When we’re young, the vitreous is clear and functions optimally. However, as we age, the gel begins to break down, causing water to leak out. The remaining collagen and hyaluronic acid clump together, forming the black or clear blobs we see moving across our field of vision. Essentially, we’re observing shadows created by these clumps. Floaters are most noticeable in bright lighting, particularly against light-colored backgrounds—think a sunny day with a blue sky or a brightly lit computer screen.

So, what can be done about floaters? Honestly, not much. The most effective treatment is a procedure called vitrectomy, which involves removing the entire vitreous gel and replacing it with silicone oil or saline solution. However, this is a highly risky option, and I don’t know any retinal specialists who would recommend it solely for floaters. There is also a laser procedure that can break up floaters, which is generally a better alternative than vitrectomy, though it may not be as effective. Many patients report that they end up with numerous small floaters instead of a few large ones.

Why should we be concerned about floaters? For the most part, we don’t need to be. An occasional floater can be annoying but isn’t harmful. However, there are situations where floaters become a significant concern:

• You suddenly notice a large number of new floaters.
• Along with these new floaters, you experience flashing lights in your peripheral vision, similar to a camera flash or lightning.
• You see a curtain-like shadow moving in and out of your vision.

Any of these symptoms could indicate a tear or detachment of the retina. Retinal detachments are medical emergencies that can lead to complete vision loss within hours. Retinal tears are less urgent but often lead to detachments, so they shouldn’t be ignored.

It’s always best to err on the side of caution. If you notice new floaters and are unsure whether they’re normal, please come in for a dilated eye exam. We’ll use eye drops to get a clear view of the outer edges of your retina, ensuring there are no underlying issues. If we detect a problem, we’ll refer you to a retinal specialist promptly to help protect your vision.