Floaters are small specks or cobweb-like shapes that drift across your field of vision. They are shadows cast by tiny pieces of debris floating inside the vitreous humor, the clear gel that fills the cavity between your lens and retina. Here are some common questions about whether a doctor can see floaters in your eyes during an eye exam.
What causes eye floaters?
There are a few common causes of eye floaters:
- Aging: As you age, the vitreous gel in your eyes begins to liquefy and clump together. The clumps cast shadows on your retina, which you see as eye floaters.
- PVD (posterior vitreous detachment): As the vitreous gel liquefies, it can detach from the retina, causing clumps and strands of collagen to float in your vitreous cavity. This often causes a sudden increase in floaters.
- Injury: Trauma to your eye can cause bleeding inside the eye that leads to debris floating in the vitreous gel.
- Inflammation: Eye inflammation can sometimes cause proteins and other debris to build up in the vitreous.
In most cases, floaters are part of the natural aging process and are harmless. However, sometimes they can indicate more serious eye conditions like a retinal tear or detached retina. That’s why it’s important to get them evaluated by an eye doctor.
Can the doctor actually see the eye floaters?
Yes, an eye doctor can often see eye floaters during an eye exam. Here’s how:
- Slit lamp exam: This microscope shines a bright slit light into your eye. The doctor examines the front of your eye under high magnification. The bright light illuminates debris and opacities in the vitreous gel, allowing floaters to be visualized.
- Dilated eye exam: Drops are used to dilate the pupils. The doctor then examines the back of the eye with an ophthalmoscope. This allows a view of the retina and vitreous gel. Moving floaters can be seen as shadows passing over the retina.
- Optical coherence tomography (OCT): This imaging test uses light waves to take cross-sectional pictures of the retina. It can detect vitreous opacities and floaters.
So in summary, yes an eye doctor has several methods to directly visualize and evaluate any eye floaters you may be experiencing during a comprehensive eye exam.
What does the eye doctor look for with floaters?
When examining eye floaters, the doctor will assess several factors:
- Duration: How long have you had the floaters? New onset floaters need to be evaluated urgently.
- Quantity: How many floaters do you see? A sudden increase in floaters is concerning.
- Pattern: What do the floaters look like – small dots, cobwebs, squiggly lines? Certain shapes may indicate different causes.
- Vision: Do the floaters affect your vision? Worsening vision needs prompt evaluation.
- Flashes: Do you have any light flashes along with the floaters? Flashes indicate the retina is affected.
- Vitreous traction: Does the doctor see vitreous bands tugging on the retina? This points to a PVD.
- Retinal tears: Carefully examine the retina periphery for any tears or holes.
- Retinal detachment: Look for signs like shifting fluid or retinal thickening.
Finding any of these worrying features means further tests like an ultrasound or referral to a retina specialist may be needed.
What kinds of eye floaters are concerning?
Most eye floaters are caused by normal vitreous degeneration and aren’t concerning. However, there are some warning signs that require prompt medical attention:
- Sudden increase: A large, sudden increase in floaters may signal a posterior vitreous detachment or retinal tear.
- Flashes: Light flashes in your vision along with new floaters are worrying and need urgent evaluation.
- Curtain effect: Gray shadows that look like a curtain coming down over your vision warrant immediate exam.
- Lots of tiny dots: Myriad tiny dots filling your vision could indicate bleeding inside the eye.
- New floaters with loss of vision: This combination indicates a potentially serious problem like a detached retina.
Any new floaters associated with light flashes, vision loss, or a curtain-like appearance should be evaluated same-day by an ophthalmologist. It could represent an ocular emergency.
What other eye diseases can cause floaters?
While most floaters are due to vitreous changes, some other eye conditions can also manifest with spots in vision. These include:
- Diabetic retinopathy: Uncontrolled diabetes can cause bleeding into the vitreous due to damaged retina vessels.
- Retinal detachment: A detached retina allows vitreous fluid to seep under the retina, casting shadows.
- Uveitis: This inner eye inflammation creates protein deposits that appear as floaters.
- Eye hemorrhage: Bleeding into the eye from injury or high blood pressure can create floaters.
- Eye tumor: Rare eye tumors like lymphoma or melanoma can have debris cast shadows.
- Eye infections: Severe infections cause pus and inflammation inside the eye.
An eye doctor will evaluate all these potential causes during a dilated eye exam. Advanced tests like an ultrasound or eye biopsy may be needed for diagnosis.
When should you see a doctor for eye floaters?
Here are some general guidelines on when to seek medical care for new eye floaters:
- Sudden onset of a large amount of floaters
- New floaters associated with light flashes in vision
- Floaters accompanied by loss of side vision or peripheral vision loss
- Severely worsening vision along with new floaters
- Curtain-like shadow suddenly falling over vision
- Appearance of tiny black dots swarming vision
- Worsening headache and eye pain with new onset of floaters
In these situations, you should see an ophthalmologist right away or go to the emergency room. It could indicate a serious problem like an impending retinal detachment.
For less severe symptoms like a few new floaters without other issues, make an appointment with your eye doctor for evaluation within the next several days.
What will the doctor do for eye floaters?
At your eye exam for floaters, the ophthalmologist will likely:
- Take a full history about your symptoms and duration
- Test your vision acuity
- Check eye movements and peripheral vision
- Perform a slit lamp exam to look for signs of PVD, inflammation, or hemorrhage
- Dilate your eyes to closely inspect the vitreous and retina
- Examine the retina periphery for any tears, holes or detachments
- Test eye pressure for glaucoma
- Recommend treatment options based on exam findings
You may need additional tests like an ultrasound or OCT depending on the initial results. Prompt treatment is key for any retinal problems uncovered by floaters.
How are eye floaters treated?
Unfortunately, there is no treatment to permanently eliminate normal age-related vitreous floaters. However, some options to minimize bothersome floaters include:
- Vitrectomy surgery: This removes the vitreous gel and replaces it with a saline solution. Risky procedure reserved for severe, debilitating cases.
- Laser vitreolysis: Uses laser to vaporize floaters. Still considered experimental without robust evidence.
- Reduce LASIK: Can potentially improve tolerated luminance of floaters.
- Ignore them: The brain often adapts to filter out longstanding floaters.
- Control lighting: Use sunglasses or wide-brimmed hats to decrease contrast.
If a serious cause like retinal tears or detachment is found, surgery like pneumatic retinopexy, cryopexy or scleral buckling will be urgently needed.
Can eye floaters go away on their own?
Small amounts of eye floaters caused by normal age-related vitreous changes typically do not go away completely. However, there are some instances where floaters may diminish or go away over time without treatment:
- PVD floaters often settle within a few weeks to months as the vitreous liquefies.
- Inflammation-related floaters can resolve with eye drop or systemic medication treatment.
- Minor vitreous hemorrhage floaters are slowly reabsorbed over several months.
- The brain learns to ignore benign floaters so they fade out of awareness.
- Moving your eyes can temporarily disperse vitreous floaters.
However, new floaters related to serious pathology like a retinal tear require prompt treatment. If in doubt about the cause, always get your eyes fully evaluated.
Can eye floaters be prevented?
Unfortunately, most common age-related eye floaters cannot be prevented. They arise from natural breakdown of the vitreous gel that occurs in most people eventually. However, some tips to potentially minimize floaters include:
- Get routine eye exams to treat conditions early that cause floaters
- Control diabetes to prevent diabetic retinopathy
- Wear protective eyewear during sports or risky activities
- Don’t smoke, which is linked with more severe vitreous liquefaction
- Eat a healthy diet rich in antioxidants to support eye health
- Take supplements that may protect the eyes like lutein, zeaxanthin and omega-3s
While these measures may help reduce your risk, there is no guaranteed way to prevent vitreous floaters. Remember that most mild floaters are harmless, but always get checked out for sudden or severe onset.
Conclusion
In summary, eye doctors can directly visualize and evaluate eye floaters during a comprehensive eye exam using a slit lamp microscope and dilated eye exam. Concerning floaters involve a sudden increase with light flashes or vision loss, which require urgent assessment to rule out retinal tears, holes or detachment. While bothersome vitreous floaters from aging can’t be eliminated, their impact often diminishes over time as the brain adapts and the vitreous further liquefies. Prompt evaluation and treatment of any worrisome floaters is key to prevent permanent vision problems.