What’s that floating in my eye? When to worry about eye floaters

Stare off into a clear blue sky or at any blank surface for long enough, and you’ll notice them creeping across your vision. Translucent black or gray squiggles—sometimes shaped like rods or crescents, hooks or threads—that seem to drift on the surface of your eye, even changing position if you move your eyeball.

Firstly, relax: yes, they’re really there (kind of), and they are almost certainly harmless.

What you’re seeing are eye floaters, often just called floaters. Joseph Newman, MD, an ophthalmologist and retinal specialist on the medical staff at Baylor Scott & White Medical Center – Temple, said that in the vast majority of cases, they aren’t dangerous, only annoying or distracting.

However, floaters can be a sign of a more serious problem if they’re also accompanied by certain other symptoms. In those times, it’s important to have your eyes examined.

Here’s everything you need to know about floaters, why they happen and what to do about them.

What causes eye floaters?

“We all have a gel inside the center of our eyes called the vitreous,” Dr. Newman said. “For everybody, as we age, this gel turns to a liquid. As it becomes more liquefied, little proteins condense out of it. As the gel liquefies, it pulls away from your retina, which is brain tissue that lines the inner part of your eye.”

When the gel detaches from the retina, that’s typically where you’ll see the floater. Floaters are often shaped like a crescent, U, rod or hook.

“When the gel pops off, these little proteins are condensed and sit right in front of your retina,” Dr. Newman said. “As light passes through that little floater, it casts a shadow on your retina. Your retina is basically detecting light, though it will seem like a little black spot where that floater is floating right in front of the retina.”

That may sound dramatic but, by itself, it’s of no harm. What might indicate a problem is the existence of other symptoms.

“If you have floaters plus flashes and a loss of side vision, it’s an urgent matter and you need to see an eye specialist or go to the emergency room immediately,” Dr. Newman said.

Who is at risk for developing floaters?

Most everyone will experience floaters at some point in his or her life. Dr. Newman said they’re highly common and a natural part of aging. However, certain people are at greater risk of developing floaters at a younger age:

• Nearsighted people
• Boxers and others at high risk for concussion or head injury
• People who received trauma to the head, such as in a car accident

When to see an eye specialist

At the first onset of floaters, you should have an eye exam, Dr. Newman said.

“Floaters themselves aren’t bad, but it’s good to have them checked when they first start because they could be a sign that something else might be going wrong in your eye,” he said.

If you’ve had floaters for a while, be sure to mention that you have them at your next annual eye exam.

If you are experiencing these symptoms, you should see an eye specialist immediately:

• A sudden onset of many floaters
• Flashes
• Loss of peripheral vision

Floaters, flashes and vision loss can be signs of these very rare but more serious eye problems:

• Macular holes
• Vitreous hemorrhage
• Retinal tear
• Retinal detachment

Even though the vast majority of floaters cause no problems, having an eye exam is the best way to be certain you don’t have macular or retinal damage that can lead to loss of vision. If your floaters are caused by a problem with your macula or retina, the quicker your eye doctor can repair the damage, the greater the chance you will retain some or all vision.

Eye exams and treatment for floaters

• Indirect optoscope: Your eye doctor (an optometrist or ophthalmologist) will conduct an eye exam using a slit lamp—the little stand that you put your chin on—and an indirect optoscope. Your eye doctor will check for damage to your macula and retina. If your eye doctor has concerns, he or she may refer you to a retinal specialist, who will conduct a scleral depressed exam.
• Scleral depressed exam: In this slightly uncomfortable but thorough test, your retinal specialist will numb your eyes and then use a scleral depressor (metal probe) to see the furthest extent of the peripheral retina to look for tears or to see weaknesses that set you up for having retinal tears.

“Probably 99% of the time, floaters are no big deal,” Dr. Newman said. “Retinal detachment is 1 in 10,000 cases, and macular holes are close to that.”

There is no treatment for floaters, unless they’re caused by one of the more serious problems listed above.

Worried about your floaters? Find an eye doctor near you.