The eye is a sphere composed of a lens at the front and a retina at the back. The sphere is filled with a clear gelatinous substance called the vitreous humour. As we age, the vitreous humour in the eye may become cloudy and small specks may develop in this gel. You see these specks as floating black spots, better known as ‘floaters’. However, in some cases floaters have a different cause.
Black, floating specks, dots or threads, usually noticeable against a bright background (for example, a computer screen, a white surface etc.).
The floaters may be present in one eye or in both eyes.
The black spots are not restricted to one spot; they follow slowly behind the movement of the eyeball. And they return, more or less, to the place where they started.
Normal vitreous humour always contains some small impurities. We see these as dots, circles, tendrils, spider webs etc.
The most commonly occurring cause of these floaters is ageing. As we get older (starting at 45-60 years), the concentration of the irregularities in the vitreous body gradually changes. And this makes the floaters more visible.
Usually, this is a harmless phenomenon, although it can be bothersome, but sometimes it may be an indication of an eye disorder. Near-sighted people have a greater tendency to have impurities in their vitreous humour.
When does the presence of floaters indicate a problem?
If floaters are accompanied by the symptoms of infection, such as redness, significantly impaired vision and painful sensitivity to light, this may indicate an eye infection (uveitis).
If you suddenly notice an increase in the floaters, if you see a larger spot or if your vision becomes blurry, if you see flashes of light or if your vision becomes impaired, this may indicate a torn retina. Early detection of a torn retina is extremely important for avoiding permanently impaired eyesight.
If floaters develop acutely and if a dark grey, immobile spot develops on the edge of your field of vision (as if you were looking out from behind a curtain), this may indicate a detached retina.
If floaters develop suddenly and the eyesight suddenly worsens with black instead of transparent spots and tendrils, you are probably suffering from a vitreous haemorrhage (may occur, for example, in diabetic patients).
If so, we urgently advise you to make an appointment at our eye center.
How are floaters treated? The ophthalmologist will look into your eye to assess the retina and the vitreous humour. To do this, the pupil must first be widened as much as possible using eye drops. After this examination, you may not drive for at least three hours.
Sometimes, it is difficult to adequately assess the retina, due to haemorrhaging in the vitreous humour or a cloudy lens (cataract). Whether or not the retina is detached can then be diagnosed with the help of an ultrasound device. This examination is painless and causes no damage to the eye.
In the case of a posterior vitreous detachment, treatment is not necessary nor is it possible. As time goes by, the floaters will become less bothersome, although they usually do not disappear entirely. The flashes of light usually stop by themselves once the vitreous humour is no longer pulling on the retina. If no further retinal problems are diagnosed, the impaired vision often slowly improves again.
Treatment of floaters with vitreolysis (floater laser treatment)
The goal of vitreolysis is to bring about a “functional improvement”. This means that you are able to once again carry out your daily activities without being hindered by vitreous humour cloudiness, or floaters.
By applying nanosecond-long pulses using a laser, the floaters are vaporized, and the vitreous humour threads are broken down. The end result of this treatment is that the black spots disappear and/or are reduced so that they no longer hinder your sight.
Vitreolysis is performed during an office visit. The eyes are treated one at a time, and eye drops are administered 30 to 40 minutes before the laser therapy to enlarge the pupil.
Therefore, you must have someone else drive you home after this treatment. Right before the treatment, anaesthetic eye drops are administered to ease any discomfort. A contact lens is then placed in the eye, and laser beams are directed at the eye through a specially designed microscope.
During the treatment, you will probably notice small, dark flecks or shadows. These are the floaters which are being dissolved into small gas bubbles. These gas bubbles dissolve quickly and are reabsorbed into the vitreous humour. This treatment is completely painless.
What can I expect after the treatment?
It is possible that immediately following the treatment you will notice small, dark specks at the bottom of your field of vision. These are small gas bubbles, which will dissolve after a short time.
For a time, right after the treatment, you may also experience slight irritation or light may appear hazy. No extra eye drops are needed after the procedure.
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