Many people suffer from the phenomenon of floaters, which is French for “flying flies”. Those affected see black dots that seem to dance in front of their eyes. Mouches volantes are harmless, but disturb the sense of vision. The symptoms often go away on their own after a while.
What is floaters?
Eye floaters are an entoptic phenomenon. See fun-wiki for What is Keratoacanthoma used for.
This results from the anatomical conditions of the inside of the eye, but is subjectively localized in front of the eye on the outside. Floating floaters are usually used as a synonym for vitreous opacification.
Shadows are cast on the retina. The affected person perceives them as short, long or crooked threads, as streaks that float through his field of vision.
Visual acuity is not affected.
There are different triggers of floaters. Cloquet’s canal is suspected to be a cause as a remnant of the atrophied hyaloid artery that supplies blood to the lens and vitreous body. Other triggers include eye and face injuries, as well as scratching and touching the eyes. Here the pressure on the eyeball, which can arise, plays a decisive role. Blows to the eyes or head, for example, can loosen particles from the vitreous body.
Eye and facial plastic surgeries are another risk factor that opacities of the vitreous body can occur, for example due to swelling that puts pressure on the eyes or small particles are loosened from the vitreous body. Oxidative changes in the collagen fibers, hyaluronic acid or other components of the vitreous body can also promote floaters.
The reason for this are high-energy light rays, which result in free radicals. If their activities accumulate, this is referred to as oxidative stress. Poor diet is also linked to vitreous opacities. A healthy diet is very important because poor diets such as fast food, unsaturated fats, too much cholesterol and not enough essential vitamins and micronutrients lead to disorders in the eye and in the entire body.
Various drugs also play a role in the development of floaters, because the substances they contain cause changes in the chemical balance in the eye, such as psychotropic drugs and preparations for the treatment of skin problems. Stress, high blood pressure, autoimmune diseases, bleeding and foreign objects are other possible causes of “flying gnats”.
Symptoms, Ailments & Signs
With floaters, people see small threads, dots, worms, or spots in front of their eyes, especially when looking at a light background, such as a white wall, computer screen, or sky. Others cannot see them. However, the floaters are not imaginary or an optical illusion. They actually exist.
But they don’t fly in the room, they swim in the eye. The apparitions move as if “swimming” in front of the field of view. The floaters move in a different direction when you change your gaze. They cannot be fixed, for example to take a closer look at them. The more attention is paid to the disorder, the more unpleasant it is usually perceived.
Diagnosis & course of disease
Before treating the floaters, the anamnesis, the detailed discussion between the doctor and the patient, plays an important role. What is the history of the disease? What does the person concerned see when he looks at a white wall? How long have the complaints existed? Have you had any eye treatments or surgeries?
Are there any diseases, such as metabolic disorders or autoimmune diseases? Are medications taken regularly? These questions can provide clues. In addition, a visual acuity determination, a measurement of the intraocular pressure and a retinal scan are carried out. With the latter method, the doctor can visualize the vitreous opacification very well.
In order to be able to look better into the eye, the doctor administers eye drops in advance, which dilate the pupil. Examinations such as X-ray, ultrasound, magnetic resonance imaging or computer tomography are only rarely used if the vitreous opacity cannot be clearly identified.
The floaters are basically harmless. However, if you concentrate on it or suffer from a lot of “flying mosquitoes”, you can feel very disturbed by it. The symptoms will go away on their own over the course of life, as the fibers move away from the retina so that sooner or later they are no longer visible to the eye. The phenomena become increasingly blurred and weaker over time.
Due to the disease floaters, those affected see dots and worms in their field of vision that do not appear in reality. This significantly reduces and restricts the quality of life of those affected. Even everyday activities can no longer be carried out easily, so that the patient’s resilience is reduced. It is not uncommon for floaters to lead to concentration and coordination disorders.
In the worst case, those affected can also lose consciousness through floaters or underestimate or misjudge certain dangers. Furthermore, the patients often see blurred and can no longer carry out normal work. In most cases, the affected person’s everyday work is also restricted by this disease. The further course of this disease depends heavily on its cause and on any previous eye surgery.
In most cases, however, it heals itself. Eye drops are only necessary in severe cases. Furthermore, if left untreated, the affected person can become completely blind. The therapy can take place with the help of a laser and limit the symptoms. There are usually no particular complications.
When should you go to the doctor?
Floating floaters are initially not a reason to see a doctor. Almost everyone perceives them in the course of their life, especially with higher myopia they occur quite regularly. They occur because irregularities in the liquid form in the vitreous body of the eye. This contains collagen fibrils, which are mostly dissolved, but they can also connect to form small threads and clumps. This creates floaters. They are pathological if they are seen very frequently or constantly as a result of damage to the eye and in particular to the vitreous body, or if they can be seen even when the eye is closed.
A doctor should be consulted if more floaters are noticed than before, their size and shape appear different, they take on different colors or move differently than before. This can indicate a vitreous opacity and it needs to be investigated where this is coming from. If, in addition to the floaters, there are more or less large, coarse, dark spots, a foggy veil or streaks like on a dirty window in the field of vision, or bright flashes, this can be an indication of bleeding in the eye or a retinal detachment. These symptoms indicate an emergency and need medical attention as soon as possible, even if they are not causing pain.
Treatment & Therapy
Unfortunately, the best way to prevent floaters is to get used to them and not let them bother you. To a certain extent, the brain is also able to block out this perception. A specific treatment concept is not yet available to patients.
If the floaters lead to a deterioration in visual acuity, which is extremely rare, or if a retinal detachment occurs, an operation can be carried out if necessary, the so-called vitreous body operation (vitrectomy). The detachment can lead to blindness, but this is also extremely rare. During the operation, the central part of the vitreous body is removed along with the opacities. Vitrectomy is a serious operation that can be associated with a total loss of the eye as a complication.
Another option is thermal disruption of the vitreous opacities with a YAG laser. However, the changes must not be close to the lens or retina. This method is gentler than surgery but does not have the same success rates. In addition, new floaters can develop as a result of the bursting.
Outlook & Forecast
The prognosis for floaters is very good. The symptoms associated with vitreous opacity usually improve over time, even without therapeutic measures. The “flying gnats” often disappear completely as the vitreous bodies and fibers gradually move away from the retina. As a result, the triggering irregularities in the vitreous humor are also shifted out of the visual axis and thus out of the field of vision. However, this can take several months or even years. Nevertheless, the eyes and vision should be checked regularly by an ophthalmologist. This is especially true when the “flying gnats” suddenly appear in swarms and in connection with lightning. Because this can be a sign of a retinal defect,
A surgical procedure such as a vitreous body removal (vitrectomy), on the other hand, is associated with possible risks. Retinal holes can occur in 12 to 30 percent. Retinal tears and infections with the threat of blindness are also possible in rare cases. In about 2.5 percent of the operated patients, a net house detachment also occurs. In addition, lens opacities are found in many patients who have undergone surgery.
First of all, a healthy and balanced diet is fundamentally essential, not only to prevent floaters but for the entire organism. In order to prevent vitreous opacities, no sports should be practiced that are associated with a risk of injury to the eyes. Anything that puts pressure on the eyes should be avoided. Excessive rubbing of the eyes is also one of them.
In most cases, those affected with floaters have very few direct follow-up measures available. For this reason, the person concerned should contact a doctor at an early stage so that complications or other symptoms do not arise in the further course. Self-healing can usually not occur with floaters.
In order to prevent complete blindness of the affected person, the patient should consult a doctor at the first symptoms and signs of the disease. In most cases, this disease requires surgery to relieve and limit the symptoms. The patient should take it easy and rest after the operation.
Efforts or stressful activities should be avoided in order not to unnecessarily burden the body. Regular check-ups by a doctor are also very important after the procedure, whereby the affected region should be particularly well protected. Further aftercare measures are usually not available to the person concerned. The disease does not reduce the life expectancy of those affected.
You can do that yourself
The floaters cannot be treated causally so far. After a certain period of getting used to it, slight symptoms will go away on their own. Those affected should visit an ophthalmologist and work out a therapy together with him. In the best case, the brain is able to independently hide the perceptual disturbances.
Since no specific treatment concept is available to date, the most important measure is to work through the symptoms and learn to ignore them. In severe cases, the visual disturbance can be corrected surgically. After such a procedure, it is necessary to take care of the eyes. Especially in the first few days and weeks, the patient must not expose his eyes to any major stimuli such as direct sunlight, cold or heat. Contact with harmful substances should also be avoided if possible. A healthy diet can also aid in recovery. The patient should also not move jerkily to prevent tearing of the suture.
Similar measures apply after laser treatment. Since floaters can always occur, the patient should have regular ophthalmological examinations after treatment is complete. If the visual disturbances recur, the treatment must be restarted immediately.