Ophthalmologist Questions Eye Exam

Constant eye floaters--what's wrong?

I haven't had an eye exam in 10+ years and recently I have been getting eye "floaters" very often. Is this something that happens with old age? What's going on?

21 Answers

Vitreous floaters are more common as we age because the vitreous gel in behind the lens begins to liquefy and condensations form which move as we move the eyes. Eye examinations should be done when new floaters occur to rule out tars in the retina which could lead to a retinal detachment.
Floaters - benign particles that appear in the visual space -are common over the years. Unless there is a change in the vision, or the floaters are too numerous to count, then they usually are annoying but benign. It would be worthwhile to have an ophthalmologist examine the back of your eye(s) to see if there is any cause.
as we age the vitreous gel in our eyes degenerates sometimes causing flashes and floaters
- recommend evaluation by eye professional to rule out visual significant pathology
Get yourself to an Eye MD ophthalmologist for a complete exam and dilation of your pupils. This evaluation will let you know if you have any pathology in the retina such as a tear or hole.
The back of the eye is filled with a clear collagen mass known as the vitreous body. Think of it as a solid jello mold at birth. As we get older this jello mold slowly melts away, much like we lose the collagen in our faces leading to wrinkles. Imagine that as the jello mold melts, it eventually collapses onto itself. When this jello finally collapses, it releases itself from the parts of the retina that it was attached to at birth. The retina is the neurosensory material at the back of the eye that converts light into an electrical signal that travels through the optic nerve to the brain; it’s the most important part of the eye. Well, as the vitreous collapses, or “detaches”, it releases pigment or condensations in the back of the eye that casts tiny shadows onto the retina. These are interpreted as “floaters”. Although floaters are extremely common and we all experience them at some point in our lives, they still require an examination. The reason is that very rarely, when this vitreous detachment occurs, the retina gets torn. This small tear results in a detachment, which can cause permanent blindness if not repaired quickly. So even if the odds are low that your new floaters could be an indication of a retinal tear, you still need to be examined. When caught early, the tear can be spot welded in the clinic with an argon laser. This is quick and painless, and well worth the effort. The symptoms to look out for, in particular, are many small floating dots (an ocean of black or clear dots), a dark veil coming over your vision, a black curtain coming from the sides of your visual field, or flashes of light (arcs of light) going off in your peripheral vision. These are all signs of impending or active detachments and should prompt an exam right away.

- Lee Katzman MD
Floaters are result of an entity called posterior vitreous detachment. Please have your eye check by an eye professional to rule out retinal detachment. If you do not have retinal detachment do not worry about it too much. The floaters usually go away.
you are experiencing a common event as you age. it can be dangerous as you can verify on the WWW. it may simply be a condensation of the vitreous in the posterior cavity of your eye. it may also be a sign that your retina is beginning to detach. i would recommend that you get into your ophthalmologist for a dilated exam.
Most eye floaters are caused by age related changes that occur with age. I would recommend that you see an ophthalmologist to make sure the floaters are related to age and no other condition.

Hope this has been helpful.
Floaters & Flashes

What are floaters?
You may sometimes see small specks or clouds moving in your field of vision. They are called floaters. You can often see them when looking at a plain background, like a blank wall or blue sky. Floaters are actually tiny clumps of gel or cells inside the vitreous, the clear jelly-like fluid that fills the inside of your eye.

Although the floaters appear to be in front of the eye, they are actually floating in the vitreous fluid inside the eye. While these objects look like they are in front of your eye, they are actually floating inside. What you see are the shadows they cast on the retina, the nerve layer at the back of the eye that senses light and allows you to see. Floaters can have different shapes: little dots, circles, lines, clouds or cobwebs.

What causes floaters?
When people reach middle age, the vitreous gel may start to thicken or shrink, forming clumps or strands inside the eye. The vitreous gel pulls away from the back wall of the eye, causing a posterior vitreous detachment. It is a common cause of floaters. Posterior vitreous detachment is more common for people who:

- are nearsighted;
- have undergone cataract operations;
- have had YAG laser surgery of the eye;
- have had inflammation inside the eye.

The appearance of floaters may be alarming, especially if they develop suddenly. You should see an ophthalmologist (Eye M.D.) right away if you suddenly develop new floaters, especially if you are over 45 years of age.

Are floaters ever serious?
The retina can tear if the shrinking vitreous gel pulls away from the wall of the eye. This sometimes causes a small amount of bleeding in the eye that may appear as new floaters. A torn retina is always a serious problem, since it can lead to a retinal detachment. You should see your ophthalmologist as soon as possible if:

- even one new floater appears suddenly;
- You see sudden flashes of light.

If you notice other symptoms, like the loss of side vision, you should see your ophthalmologist.

What can be done about floaters?
Because you need to know if your retina is torn, call your ophthalmologist if a new floater appears suddenly. Floaters can get in the way of clear vision, which may be quite annoying, especially if you are trying to read. You can try moving your eyes, looking up and then down to move the floaters out of the way. While some floaters may remain in your vision, many of them will fade over time and become less bothersome. Even if you have had some floaters for years, you should have an eye examination immediately if you notice new ones.

What causes flashing lights?
When the vitreous gel rubs or pulls on the retina, you may see what look like flashing lights or lightning streaks. You may have experienced this same sensation if you have ever been hit in the eye and seen "stars." When the vitreous rubs or pulls on the retina, it creates a sensation of flashing lights.

The flashes of light can appear off and on for several weeks or months. As we grow older, it is more common to experience flashes. If you notice the sudden appearance of light flashes, you should visit your ophthalmologist immediately to see if the retina has been torn.

Some people experience flashes of light that appear as jagged lines or "heat waves" in both eyes, often lasting 10-20 minutes. These types of flashes are usually caused by a spasm of blood vessels in the brain, which is called migraine. If a headache follows the flashes, it is called a migraine headache. However, jagged lines or "heat waves" can occur without a headache. In this case, the light flashes are called ophthalmic migraine, or migraine without headache.

How are your eyes examined?
When an ophthalmologist examines your eyes, your pupils will be dilated with eye drops. During this painless examination, your ophthalmologist will carefully observe your retina and vitreous. Because your eyes have been dilated, you may need to make arrangements for someone to drive you home afterwards. Floaters and flashes of light become more common as we grow older. While not all floaters and flashes are serious, you should always have a medical eye examination by an ophthalmologist to make sure there has been no damage to your retina. 

Amjad Khokhar, M.D., F.A.A.O.
Houston Lasik & Eye
Eye examinations help to detect preventable diseases. Floaters are due to degenerate vitreous particulates. Under certain lighting houses them. It's normal in older people. Examination to exclude retinal diseases is important. Hence, go for an examination.
It is usually a normal problem associated with degeneration of the vitreous (the jelly-like substance that fills the back cavity of the eye) you need to be checked as soon as you can because you can get a retinal tear or detachment from the jelly liquefying
Floaters might be related to senile changes in your vitreous (jelly that filling the back of the eye). some times is because of blood cells or inflammatory cells floating in the eye. It's good to have a dilated eye exam.
In general everyone should have a complete eye exam every year, in 10 years a lots of diseases might happen (like glaucoma). Please see an eye doctor!
There are a variety of possible causes for floaters. While most are non-harmful and just from the breakdown or liquifying of the vitreous gel in the back of our eye, some sources can be harmful, and a dilated eye exam is critical to rule these out. Even if the floaters are not harmful, there is typically a solution for them, the most definitive of which is pars plana vitrectomy surgery. Given this surgery has risks it is only advised for a small subset of patients that are severely impacted by this and a thorough exam with a retina specialist would be required prior to taking this step.
Yes, floaters appear with aging, in most of the cases they are not pathological, and do not compromise vision. The best thing you can do, is getting your eyes checked by an ophthalmologist once every year.
Floaters are caused by the contracture of the gel within the eye with aging. This "vitreous" gel fills the inside of the eye when we are born and are young, but then contracts progressively with aging until it pulls away from the back of the eye (the retina= the film that lays flat agains the back of the eye". This may pull bits and pieces from the retina that are then floating inside the eye, but sometimes it can pull hard enough that it tears the retina and and then produce a detachment of the retina, which is serious and can cause blindness. You need to have your eyes examined right away to rule out a retinal tear. If there is no tear, the eye is usually left alone as the floaters diminish with time over months. If the floaters remain burdensome, the gel can be removed with vitreous surgery.
Yes, having eye floaters is unfortunately more common as we age. It is due to the natural degeneration of the vitreous jelly in the back of the eye. The proteins degenerate and can form clumps. Sometimes, there is a sudden increase in floaters due to the vitreous jelly pulling forward from where it is attached to the retina. When this happens, people can suddenly experience "hair-like" floaters or even what looks like a fly or spider. The shape of the floaters can vary and can change with time.

What's important to note is that if there are lots of flashes of light in the vision, or if there is a darker curtain starting to affect the vision, then an eye examination is required usually within a day or two. This is to make sure there is no retinal tear or detachment.

If there are large floaters which are affecting the vision, there is now a safe and novel laser treatment which can break down and vaporise these floaters. I have had good results using this laser on many patients, but an assessment is needed to make sure you are suitable for such laser therapy.
Floaters are more common as we age. They are usually due to clumping together of the collagen fibres in the vitreous gel that fills the back portion of the eye and this is a normal ageing process. However, a sudden increase in floaters, especially if associated with flashes or shadows can be due to a separation of the vitreous gel from the retina known as posterior vitreous detachment. Posterior vitreous detachment can be associated with a tear in the retina and retinal detachment, so it should be checked by an ophthalmologist. There are also other less common causes of increased floaters that can be serious. An ophthalmologist can advise you if your floaters are serious.
You must be seen to make sure you don't have any retinal issues.
This is consistent with vitreous gel degeneration and possible separation. The posterior 2/3 of the eye cavity is occupied by a solid clear gel structure known as "vitreous". As we age it liquefies and will "collapse" into itself, sometimes suddenly with large "floaters" which are condensations of the gel.

However, when the gel separates, there is sudden traction on the inner visual eye tissue known as the "retina". Small retinal tears can occur, which, if left untreated, can progress to retinal detachment and visual loss.

So, any "new" onset of floaters, light flashes, "specks" or "blobs" in your vision do warrant a complete dilated eye and retina exam. The vast majority of "floaters" will be benign, but a small percentage of people will have issues that need to be medically addressed.
A new floater in one eye requires an urgent eye examination by an ophthalmologist (EYE MD) to rule out retinal tear and/or detachment. Old floaters are not urgent, but a complete medical eye exam (not for glasses) can usually pin point the reason for the floaters.
If this came on suddenly, and you are over 50, it probably represents a vitreous detachment. I would recommend an eye exam within a week

Edwin H. Ryan, MD