7/18/2017 9:25:00 AM Eye floaters can usually be ignored
DEAR DOCTOR: I know that as far as medical problems go, eye "floaters" are pretty minor. But I've just noticed some new ones, and they're really annoying. What are they? Is there any way to get rid of them?
DEAR READER: Floaters are those tiny specks, strands or cobwebs that drift across your field of vision. Try to look right at them and they'll skitter away. Move your eyes away from them and they'll follow. Hold your gaze still and they'll gently float about, which is the trait that gives them their name.
Floaters develop in the vitreous -- the clear, gel-like fluid that fills the space between the lens at the front of the eye and the retina at the rear. It's composed mostly of water, with a small amount of collagen, other proteins, salts and sugars. The job of the vitreous is to protect the delicate structures of the eye, support the eyeball's spherical shape and hold the light-sensitive cells of the retina in place.
Although people of any age can develop floaters, they do tend to be more common in adults 40 and over. That's because as we age, the vitreous gradually softens and shrinks. Portions of the collagen can become stringy, and the other proteins dissolved in the vitreous form tiny clumps. As these bits and strands float in the jelly-like vitreous, they cast shadows on the retina. The retina then sends this information to the brain via the optical nerve. The result is a visual image of the changes taking place within our eyes.
For the most part, the presence of floaters is a normal part of aging. However, if the number of floaters suddenly increases, and if the increase is accompanied by flashes of light within the field of vision, it's time to check in with your eye doctor. These can be the signs of more serious problems.
We understand your frustration with floaters -- no matter where you look, there they are. However, at this time, there are no good solutions for dealing with them. For those (extremely) rare individuals for whom floaters are so numerous that they interfere with vision, treatment options do exist.
One choice, which is rarely used, is laser therapy. In this approach, an ophthalmologist targets the floaters with a special laser. The idea is that the energy of the radiation will break up the floaters so they become less visible. The risk is that the laser can cause damage to the retina.
The other option is a surgical procedure known as a vitrectomy. The vitreous -- along with all the floaters -- is removed via an incision, and is replaced with a saline solution. This also carries serious risk. Complications include retinal detachment, retinal tears and cataracts.
Do-it-yourself approaches to dealing with floaters, which, unfortunately, don't have much effect, range from harmless (eye exercises, eating more blueberries or broccoli) to potentially dangerous. Your eyesight is far too precious to risk, so don't try anything without checking with your doctor first.
Given time, your brain will tag floaters as unimportant information and, for the most part, will let you forget them.
(Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.)
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