Choose A Location
Many people occasionally notice floating objects in their field of vision, which may appear as dots, translucent threads, or "tadpoles." These floaters are typically most noticeable in bright lighting conditions, such as against a snowy background, a clear sky, or a white ceiling. Some patients first notice them when looking through a microscope or binoculars. Most such floaters are visible again under similar lighting conditions. These non-worrisome floaters represent flecks of material floating in a liquid pocket within the vitreous gel-bag in the back of the eye.
Posterior vitreous detachment (PVD) is a common condition that can cause new floaters in the vision, which may be of moderate concern. By age 60, approximately 50% of individuals will experience a PVD. The primary symptom of PVD is the sudden onset of new floaters in one eye, often described as cobwebs, commas, or circles. These floaters typically appear slightly off to the side of one's line of sight. In some cases, PVD may also be accompanied by flashes of light in the peripheral vision of the affected eye. These flashes can occur before the vitreous separation takes place, sometimes lasting for days or even weeks. Occasionally, they may persist intermittently for months before gradually subsiding.
In addition to the inconvenience of new floaters, a posterior vitreous detachment (PVD) carries a risk of retinal complications. In approximately 10% of cases, the process of vitreous separation can result in a retinal tear. Of those eyes with a retinal tear, about 50% may progress to a retinal detachment if left untreated. If a retinal detachment is going to occur, it typically happens within the first six weeks following the onset of floaters.
The sudden appearance of a large number of small dots in the field of vision, especially when accompanied by floaters and flashes, raises concern. These dots, which may consist of red blood cells or detached retinal cells, suggest that either a retinal blood vessel has been disrupted or the retina itself has been torn. The likelihood of detecting a retinal tear in the presence of these "dots" is approximately 85%, significantly higher than the 3-15% chance when they are absent.
Since most retinal detachments resulting from PVD-related tears occur within six weeks of the initial onset of floaters, individuals who have experienced symptoms for more than 6-8 weeks are typically past the high-risk period for retinal detachment.
Additionally, a PVD can cause microtrauma to the surface of the retina, potentially leading to the formation of an epiretinal membrane, which can distort vision (see Macular Pucker/Epiretinal Membrane Section).
While occasional spots in the vision are common, they may become more frequent and noticeable with age, particularly when a posterior vitreous detachment occurs. Less common causes of floaters include infection, inflammation, hemorrhage, retinal tears, or eye injury.
Floaters, which appear as specks or threadlike strands drifting across one’s field of vision, are most noticeable when looking at bright surfaces, such as white paper or blue skies. Typically, floaters move away when one tries to focus on them. The sudden appearance of new floaters, flashes of light, or a shower of floaters may indicate a posterior vitreous detachment (PVD) or a potential retinal tear, requiring prompt evaluation.
In most cases, floaters diminish in visibility over several weeks to months, and patients often adapt to their presence, eventually noticing them only when specifically prompted to do so. For those who continue to experience significant discomfort after approximately six months, a straightforward surgical procedure can permanently remove the floaters.
Flashes and floaters are usually not serious conditions that require treatment, but they can sometimes be signs of a vitreous or retinal detachment. If you experience floaters that may suggest a posterior vitreous detachment (PVD), it’s a good idea to see an eye doctor within a few days. In the meantime, avoid strenuous or jarring activities. The proper examination involves dilating the pupils with eye drops (usually in both eyes, though not always) to allow the doctor to examine the retina in detail. This is done with the patient lying down, using a bright light worn on the doctor’s head (an indirect ophthalmoscope) and a hand-held lens. To get a better view of areas where retinal tears are common, the doctor may use a small instrument called a scleral depressor to gently press on the eye through the eyelid.
If no retinal tear is found during the exam, it’s unlikely that one will develop later, though it’s not impossible. Symptoms that should prompt a return visit include:
During the first 6 to 8 weeks after symptoms appear, it’s a good idea to check your peripheral vision daily. You can do this by covering one eye, focusing on an object straight ahead, and moving your fingers off to the side, above, and below to ensure your side vision is still intact. If you notice any changes, see your eye doctor promptly.
The procedure is performed under local anesthesia on an outpatient basis, similar to modern cataract surgery. After administering the anesthetic, the patient is positioned under a microscope. Three small incisions are made in the white part of the eye near the colored iris. Throughout the procedure, the eye's shape is maintained by a fluid infusion.
Using an operating microscope and fiber-optic light, the surgeon removes the vitreous gel through these incisions. In some cases, a delicate layer of vitreous material on the macula is carefully removed. For patients who have undergone cataract surgery, the posterior lens capsule may also be removed to prevent future procedures for floaters.
Once the surgery is complete, the instruments are withdrawn, and the incisions typically self-seal, though sutures may occasionally be required. The patient wears a patch and shield over the eye for 24 hours, and discomfort is usually minimal. The surgical portion of the procedure typically takes less than an hour, though total time, including preparation and anesthesia, may be longer.
There is complete removal of floaters in over 93% of eyes operated on. For those who still have some floaters remaining, their symptoms are much milder than before, and follow-up surgery, if needed, will remove residual floaters.
Vitrectomy offers a definitive solution for floaters but carries some risks, though they are generally minimal. For patients who have not yet undergone cataract surgery, there is a high likelihood of cataract development in the operated eye within a few years. These cataracts can be treated like any standard cataract procedure, performed as an outpatient under local anesthesia.
Other risks are less common. Retinal detachment occurs in approximately 1-2% of cases, with over 90% being repairable through additional surgery. The risk of severe intraocular infection is extremely rare, at about 1 in 10,000. Additional potential complications include transient glaucoma, vitreous or retinal hemorrhage, and macular edema. Advances in 25-gauge instrumentation and modern techniques have significantly reduced these risks.
Shimmering lights that obscure part of the vision, gradually developing and subsiding over 15 minutes to an hour, and often affecting both eyes (if one takes the time to check), are not indicative of floaters. These symptoms are most commonly associated with migraines.
Still have questions? Call or schedule an appointment to get a more in-depth look at your eye health.
Contact UsKnow what to expect from your first comprehensive eye exam.
Still have questions?
A comprehensive eye exam allows us to assess the overall health of your eyes and develop a personalized care plan tailored to your specific needs. The exam includes a series of questions and tests designed to gather detailed information about the various functions and structures of your eyes. This brief video will guide you through the entire process, ensuring you know exactly what to expect.
Located South of EIRMC and Sunnyside Rd in Idaho Falls
Located on Clark St. right off of I-15 take exit 69. Between 16th & 17th Ave.
Right off of Main Street West of HWY-20 across from Valley Wide Country Store & Blister's BBQ.
