Eye floaters

Eye floaters are tiny floating specks of different shapes and sizes that you may see in front of your eyes when you look at something bright or lit up in shade like a screen, the sky or a book. 

They are not present on the surface of your eye but inside it, especially in the vitreous humour—a transparent jelly-like substance that is present between the retina and eye lens. 

The retina is a thin film present in the back wall of the eye. It has special cells called rods and cones that help you perceive colours, shapes and patterns. Your eye lens focuses light onto your retina and the rods and cones send signals to your brain that then interprets and tells you what you are seeing. Since floaters are present in the vitreous humour, they appear as shadows in your field of vision.

Eye floaters may appear in different shapes such as:

• Dots
• Threads
• Bubbles
• Webs 
• Squiggly lines

Eye floaters could be peripheral (on the edges) or in the centre of your vision. Floaters usually drift off when you move your eyes or try to look at them. Otherwise, they keep floating in front of your eyes.

Eye floaters appear as a natural part of ageing. This is because the vitreous humour starts to degenerate and pull away from the retina. However, eye floaters can also occur due to conditions such as:

• Bleeding in the eye
• Eye injury or eye infection
• Posterior uveitis: inflammation in the uvea (middle part of the eye, right under the sclera)
• Retinal tears (caused during detachment of sticky vitreous humour from the retina or due to eye trauma)
• Retinal detachment from the back of the eye
• Side effects of eye medications

Eye floaters can also occur with no apparent reason. 

Some risk factors of eye floaters include:

• Diabetes
• Older age (>50 years)
• Cataract surgery
• Nearsightedness
• Eye injury or trauma

While it is not possible to prevent eye floaters, maintaining good eye health can reduce your risk of developing them. Here are some pointers that might help:

• Take a healthy and balanced diet and include regular physical activity in your daily routine to stay fit.
• Get regular eye exams
• Avoid straining your eyes
• Quit smoking (Read more: How to quit smoking: benefits, tips, therapy, exercises)
• Rest your eyes intermittently if you have to spend a lot of time in front of a screen every day. Experts suggest taking a break from the screen and focusing on something at a distance of 20 feet for 20 seconds every 20 minutes, to maintain eye health.
• Make sure to wear sunglasses when you go out to keep your eyes safe from the sun's UV rays.
• Wash and clean your hands properly before you apply or remove contact lenses as this would reduce your risk of infections.

If you've had eye floaters for a long time and they are not affecting your vision and aren't getting worse, they are nothing to worry about. However, you should visit a doctor if:

• You get an accompanying eye pain
• The floaters increase suddenly or get worse
• You get blurry vision along with floaters
• The floaters occur right after you get an eye surgery
• You get a dark curtain in your field of vision 
• You see flashing lights in your field of vision

Your doctor will conduct an eye examination and a proper assessment of your retina and vitreous to diagnose any underlying condition, especially retinal damage. He/she will ask you some questions including: 

• Since when do you have floaters?
• Do you have diabetes or an autoimmune condition?
• Are the floaters worse in one eye?
• Did you recently have eye surgery?
• Did you have a trauma or injury to your eye?
• Do you notice a curtain in front of your vision?
• Are the floaters worsening?

If you have floaters, regular eye exams may help the doctor to keep a check on your vitreous humour so he/she can start appropriate treatment if you show any signs of an eye problem.

Eye floaters that occur with age and do not cause any vision problems do not need treatment. If your floaters are caused by a health condition like diabetes or eye inflammation, your doctor will treat the condition first. 

A surgery called vitrectomy may be recommended in case the floaters cause vision problems and interfere with your everyday life. In this procedure, the surgeon removes the vitreous and replaces it with another fluid like saline or silicone oil. However, the surgery has a lot of risks including increased development of vision defects like myopia or hypermetropia, cataract, problems with eye movement and retinal detachment.

A laser treatment called vitreolysis is sometimes used to reduce the size of the floaters or remove them completely. The procedure takes two to three sittings of about an hour each. Vitreolysis has side effects, including a possible increase in eye pressure and cataract.

It is best to talk to your doctor about the risks and benefits of vitrectomy and vitreolysis before you undergo either of these procedures.