Dear Doctors: I was recently diagnosed with "floaters" in my right eye. I am told it just happens and is not my diabetes or high blood pressure. The floaters are constant and only get better with sunglasses. They make eye-involved activities difficult, and I get somewhat carsick. Any suggestions?
Dear Reader: Eye floaters are common enough that most people reading this already understand what you are asking about. They are the specks, blobs and weblike shapes that drift through the field of vision.
Floaters are made of minute bits of cellular debris and are suspended in the vitreous. That's the translucent gel-like substance that fills the rear part of the eye. As light enters the front of the eye, those bits of debris block its path. That means you're not seeing the floaters themselves -- you are seeing the shadows they cast on the retina.
As your eye specialist assured you, floaters do not pose a risk to eye health. They often develop as a natural part of the ageing process. An estimated 70% of adults develop floaters to some degree. The reason begins with the vitreous. This is a substance made mostly of water that fills the back of the eyeball. The vitreous provides the eye with nutrients and keeps it hydrated. It also allows the eyeball to maintain its orblike shape. A matrix of collagen fibres, proteins and other cellular compounds also helps maintain the eye.
When we grow older, changes to the structure of the vitreous cause it to contract. This makes the gel less uniform, with some pockets becoming more liquid. At the same time, the matrix of fibres that helps stabilise the vitreous can begin to clump together and degrade. Strands and particles can break free.
For some people, floaters are easy to ignore. But for many, they become a source of constant distraction, irritation and even emotional distress. They can interfere with daily activities such as reading or driving and even lower visual clarity in low light. As has happened to you, they can create a separate layer of visual motion, which can contribute to motion sensitivity.
Unfortunately, treatment for floaters is quite limited at this time. For severe cases where the condition interferes with quality of life, a surgical procedure may be considered.
Known as a vitrectomy, it is an outpatient procedure in which the debris-filled vitreous is removed. The vitreous contributes to eye volume, so it must be replaced. This is usually done with a sterile saline solution. If the retina is at risk, a bubble of air, gas or silicone oil may be used.
Needless to say, this is a significant surgery and carries inherent risks. These include bleeding, infection, retinal detachment, glaucoma, cataract formation and possible changes to vision. Not surprisingly, vitrectomy is reserved for severe cases. Someone considering the surgery would begin with an ophthalmologist who specialises in this condition. For now, consider regular follow-ups with your ophthalmologist and report any new symptoms. Universal Features Syndicate
Dr Eve Glazier is an internist and professor of medicine at UCLA Health Sciences. She hosts the Medically Speaking podcast for UCLA Health. Dr Elizabeth Ko is an internist and associate professor of medicine at UCLA Health.
