Threads, dots, or small cobwebs that drift and move as you move your eyes: floaters are very common and usually benign. But certain associated signs mean you should seek advice without delay.
In brief: floaters most often result from the natural ageing of the gel that fills the eye (the vitreous). They are generally benign. However, their sudden appearance, especially with flashes of light or a dark shadow, should prompt an urgent consultation to rule out a retinal tear or detachment.
The inside of the eye is filled with a transparent gel, the vitreous. Over time, this gel changes and tiny condensations form: they cast a shadow on the retina. These are the shadows perceived as threads, dark dots, or small "flies" that move with the gaze and are most visible against a bright background (sky, white wall, screen).
The most common cause is the natural ageing of the vitreous, which progressively detaches from the retina: this is a posterior vitreous detachment, a common phenomenon that typically occurs with age. High myopia and certain other conditions can bring it on earlier.
Floaters that have been present for a long time, are stable, and cause no other symptoms are generally harmless. They may be bothersome at first, but the brain often learns to ignore them. This does not preclude a retinal check to ensure there is no abnormality.
Seek advice without delay in the event of the sudden onset of: a shower of new floaters, flashes of light (like camera flashes), or a dark shadow descending like a curtain over part of the visual field. These signs may herald a retinal tear or retinal detachment.
Prompt management is critical: a tear identified in time can often be treated before a detachment develops.
Examination of the fundus, most often following pupil dilation, allows the vitreous and the entire retina to be examined for any tears. It is painless and is the key investigation; retinal imaging can complement it. This is where Dr Gattoussi's expertise in retinal imaging and retinal surgery comes fully into its own.
For benign floaters, watchful waiting and monitoring are the rule: they often become less bothersome over time. In the presence of a retinal tear, treatment (often with laser) may be offered to secure it. Very debilitating cases may warrant specialist advice.
Usually benign and related to the ageing of the vitreous. They become a warning sign if they appear suddenly, with flashes or a dark shadow: seek urgent advice.
They do not truly disappear, but one often learns to ignore them. Very troublesome cases may warrant specialist advice.
Flashes of recent onset, especially with floaters, may indicate traction on the retina and warrant a prompt fundus examination.
Yes, high myopia can predispose to their earlier onset and justifies retinal monitoring.
This article is for general information purposes and does not replace a consultation. It does not constitute individual medical advice.
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