The jelly-like substance called the vitreous fills the eye. The vitreous is a gel that maintains the shape of the eye, supplies it with nutrition and helps with the focusing of light and it is attached to the retina.

The younger we are, the more strongly the vitreous is attached to the retina. As we get older and as part of the normal ageing of the eye, the vitreous starts liquefying and developing pockets of fluid. These pockets of fluid later coalesce and the vitreous body starts to collapse. At the time the vitreous body collapses it starts detaching from the retina; first partially and the totally. This is known as Partial or Total Posterior Vitreous Detachment (PVD). The PVD process can take varying length of time: from hours to months. It is believed by some to take place within 4-6 weeks.

For some patients the PVD process can be symptomatic. Some patients experience flashing lights (photopsiae). Flashing lights can be attributed to the vitreous pulling from the retina as it detaches from it. Other patients experience floaters or a cloud-like image like a lace curtain that moves around with the eye movements, sometimes in combination with flashing lights. Floaters can be perceived in different colours or shapes: spots, thread-like strands, tadpole or cobweb-like.

Should I pay attention to these symptoms?

Yes. It is important to have the eyes checked by a Vitroretinal Surgeon at the earliest opportunity. Occasionally while the PVD is taking place, breaks or tears develop in the retina as a consequence of the vitreous pulling from it while trying to detach. For this reason it is important to have both eyes checked as retinal tears can usually be treated with laser photocoagulation as an out-patient procedure.
Untreated retinal tears can lead to the development of a Retinal Detachment, a potentially blinding condition that requires surgery.

The ocular examination to rule out retinal tears should be preferentially carried out by a Vitreoretinal Surgeon through a fully dilated pupil and usually with the patient lying on the back. An examination technique called Indirect Ophalmoscopy with 360° Scleral Indentation is carried out. During this procedure gentle pressure is applied on the lids to shallowly indent the wall of the eye and therefore move the peripheral retina into view: area of the retina otherwise inaccessible.

Some patients, especially myopes, can suffer from floaters for years and they can find it difficult to know when to consult the specialist. The logical advice is to always contact when in doubt or certainly if you develop new floaters, old floaters become more intrusive or are accompanied by flashing lights. Patients experiencing flashing lights without floaters should also seek prompt consultation.

Can I get rid of my floaters?

Floaters can be very intrusive and annoying but are generally harmless. The brain tends to get used to them after a while. They are usually more evident the more we look for them and especially against a clear background. Usually no treatment is required but sometimes symptoms are so severe that surgery is indicated and they are removed by vitrectomy.