From the Guidelines
Vitreous floaters are typically caused by age-related changes in the vitreous gel inside the eye, and their symptoms can include seeing spots or cobwebs in the visual field, which are usually harmless but can be a sign of a serious underlying condition in some cases. The causes of vitreous floaters can be attributed to various factors, including:
- Age-related changes in the vitreous gel, which can become more liquid and develop clumps or strands that cast shadows on the retina, appearing as floaters in our vision 1
- Posterior vitreous detachment (PVD), which can cause the vitreous to detach from the optic nerve head, leading to the acute onset of floaters or even flashes or photopsia 1
- Vitreomacular adhesion, which can represent the normal evolution of a PVD, but can also lead to vitreomacular traction, causing traction and potentially leading to thickening, distortion, intraretinal cystoid changes, and even subretinal fluid or tractional detachment at the macula 1
- Epiretinal membranes, which can lead to macular traction and similar visual symptoms, including loss in visual acuity, metamorphopsia, difficulty in using both eyes together, and even diplopia 1
The symptoms of vitreous floaters can vary, but common symptoms include:
- Seeing spots or cobwebs in the visual field
- Flashes of light or photopsia
- Vision loss or distortion
- Metamorphopsia, or distorted vision
- Difficulty in using both eyes together
- Diplopia, or double vision
It is essential to note that while vitreous floaters are usually harmless, a sudden increase in floaters, especially accompanied by flashes of light or vision loss, can indicate a retinal tear or detachment, and immediate medical attention is necessary in such cases 1. If eye floaters are severely affecting your vision or causing distress, it is recommended to see an eye doctor for a comprehensive eye exam to rule out any serious underlying conditions.
From the Research
Causes of Vitreous Floaters
- Benign, age-related changes of the vitreous 2
- Posterior vitreous detachment (PVD), which may be associated with a retinal tear in up to 14% of cases 3
- Retinal detachment, which can lead to vision loss 4
- Uveitis, a more serious underlying pathology 5
Symptoms of Vitreous Floaters
- Visual obstruction that moves with the movement of the eye 4
- Flashes and floaters, which can be a sign of benign age-related changes or more serious retinal detachment 2, 3
- Significant persistent visual impairment from floaters, although many patients may not experience this 5
- Effects on visual function, which can be significant for some patients 5
Examination and Diagnosis
- Key examination features include the nature of the flashes and floaters, whether one or both eyes are affected, and changes in visual acuity or visual field 2
- Peripheral retinal exam is imperative, and techniques such as scleral depression may be used 3
- Proper diagnosis and referral to an ophthalmologist are necessary to rule out sight-threatening conditions 2, 3