Five fast facts about floaters

Dr. Stanley J. Berke, founding partner at Ophthalmic Dr. Stanley J. Berke, founding partner at Ophthalmic Consultants of Long Island in Lynbrook. (Nov. 15, 2011) Photo Credit: Newsday/Audrey C. Tiernan

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Seeing spots? Join the club: Almost all people see what are called "floaters" at some time in their lives.

Sometimes they're specks; other times, they look like mini threads. Usually they're harmless, but now and then they can be a sign of a serious eye problem.

Here's what you should know about floaters:




"Floaters are, unfortunately, as common as the belly button," said Dr. Stanley J. Berke, founding partner at Ophthalmic Consultants of Long Island in Lynbrook.

Floaters show up in your line of vision. "They may appear as spots or strands that resemble insects or hair or irregular rings that seem to 'float' around as the eye moves," said Berke, who's also associate clinical professor of ophthalmology at the Hofstra North Shore-LIJ School of Medicine.

You're not imagining them. The spots and strands are bits of cellular debris that float in the vitreous, a gel-like substance between the retina and the lens of the eye. Floaters appear when the vitreous changes over time from "a solid, homogeneous gelatin-like substance into a watery egg-white-like material that shifts around inside the eye with normal body movement," Berke said.

"Flashes," more officially known as photopsias, are a similar phenomenon to floaters. They appear when the vitreous stimulates the retina, he said. "While floaters are typically more pronounced when the background is light, such as a blue sky on a sunny day or a white wall or page, flashes are more commonly seen in a dark environment, such as in a movie theater or at bedtime," Berke said.




New floaters or flashes could be a warning sign that the vitreous is about to pull on the retina and cause retinal detachment, Berke said.

Dr. Richard Nattis, chief of ophthalmology at Good Samaritan Hospital Medical Center in West Islip, explained that "this is why we always recommend that if patients notice a sudden onset of new floaters, they need to have a dilated eye exam to make sure the eye isn't damaged." And if it has been, he said, "that needs to be treated with a laser or surgery."




"Floaters can happen after any kind of eye injury, any kind of trauma to the eye -- a punch or [being hit by] a baseball," Nattis said. "That can dislodge some floaters that weren't already present, and that can create new floaters."

People with certain eye diseases or diabetes sometimes think they have floaters when, in fact, they're seeing evidence of bleeding, he said.




"We highly suggest trying to live with your floaters -- some patients actually have names for them -- but if you're at wit's end, surgery may be considered," Berke said.

A surgical procedure called vitrectomy clears the vitreous from the back of the eye and eliminates floaters, he said. Physicians have experimented with other procedures, such as those that use lasers, but Berke said that "they have not been fully evaluated, are not FDA-approved, require expensive out-of-pocket costs and may actually worsen floaters by increasing the total number in an attempt to 'blow them up,' or even result in retinal detachment."




Floaters can be more than a simple annoyance. "Some people are really haunted by the floaters," Nattis said. "They're right in their line of vision when they're trying to read or watch TV."

Still, relief may be on the horizon if you wait it out. It may take a while -- months or longer -- but "almost always, the floaters sort of settle down to the bottom of the eye, away from the pupil, and you don't notice them as much," Nattis said. "They're still there, but they're not giving you symptoms."

And one simple thing might help: Move your head. "Some people have a habit of moving their head rapidly, moving the floater out of their line of vision," Nattis said. It may work, he said, and it's not harmful.

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