Joel Kestenbaum O.D. is a VSP provider in Long Island, NY.
Today we welcome VSP provider Joel Kestenbaum, O.D. from Long Island N.Y. His guest blog gives an overview of those annoying floating spots we sometimes see …
Often patients either complain of or casually mention that they see little floating spots in front of their eyes. They are described as worms, dust, feathers, spiders, mites, flies on a wall, or just plain floaters. What makes these floaters and why do we see them?
Did you ever put your hand in front of a beam of light and see its projection on a screen? Lets think of the inside of the eye just like the inside of a movie theater. If you stand up and get in the way of the projection, you are seen as a shadow on the screen. In the same way, if something gets in the way of the beam of light coming into the eye, the image is projected onto the retina, the eyes’ movie screen, and seen as a floater with a particular shape.
Where do floaters come from? This is a complicated question and there are two basic answers:
The first is that there is a jelly inside the eye called the vitreous humor that occupies about 80% of the eyes structure. As we age, the consistency of the vitreous changes, part of it gets harder and other part gets more liquid. Sometimes parts of the harder gel break off and float around in the liquid causing a shadow on the retina that will move when you move your eye. The second is that a tear can occur in the retina causing pieces of the retina to float around inside the eye.
Are floaters dangerous? The answer is no and yes. The first type mentioned above is likely not vision threatening, just annoying. The second type has potential sight threatening consequences and must be addressed quickly by your eye doctor. In either case, go see your eye doctor immediately so that treatment, if necessary can begin as soon as possible.
Dr. Joel Kestenbaum
www.optixeyecare.com
Editor’s Note: Have a question for Dr. Kestenbaum? Ask in the comments below.
Dr. Thomas is your description of a floaters and general examination advice is spot on. I have to say, though, that you missed the last paragraph, which should have been added to your narrative. The big question that people have is, what can be done for them. The traditional dogma and culture amongst eye care professionals is that after you have ruled out any retina pathology that the patient be given the advice or suggestion that they will learn to live with it. This may be true for minor or mild floaters where the patient really just needs reassurance. The reality, though, is that there are some very significant floaters that cannot be ignored by the patient. There are two interventional procedures that may offer hope for some of the more severe floaters. The first is using the YAG laser to ablate and vaporize the filter material, and the other is the more invasive surgical vitrectomy. Both have their pros and cons and the decision to treat must weigh the potential benefits versus the potential risks as with any procedure. I am a board certified ophthalmologist with the only practice in the world exclusively treating I floaters. I use an FDA approved YAG laser for this purpose. Not everybody can be treated, and the most frustrating and least treatable patients are generally those younger than age 30 to 35 were the vitreous has not overall degenerated. Those older than 40 to 45 with a posterior vitreous detachment are much more likely to be treatable.
If you are looking for much more extensive information as to the anatomy of the eye, the types of floaters, the physics of the laser treatment, expectations, as well as alternatives to treatment, I encourage you to visit my website at VitreousFloaterSolutions [dot] com
Cheers, Dr. James Johnson
Hi Dr. Kestenbaum. I recently bought a new pair of prescription glasses. (nearsighted) I am having a difficult time adjusting to the new glasses. My eyes become more tired with the new prescription. I have also noticed an increase in the amount of eye floaters. Prior to the new glasses I would sometimes get eye floaters, but now it is for most of the day. I am 31 years old. The articles I have been reading mentions that eye floaters generally occur later in life. I haven’t gotten a new pair of glasses in about 4.5 years. Is this part of adjusting to the new glasses or do you think there is something wrong with the glasses. Thank you.
Dear Mike,
Floaters are not due to new eyeglasses… Do yourself a favor and tell your eye doctor. You should have a full examination of your retina by a qualified optometrist or ophthalmologist. Age doesn’t make a difference. Don’t wait. Get it checked out.
Dr. Kestenbaum
i have floaters but am only 14 why cant they just go away? is it because am near sighted and i straigh too much?
I have floaters, emiretinal membrane and traction on retina with floaters. Can low vision help? and what type?
My doctor has done a couple of Optomap retinal scans, especially since recently I had a an incident of a flash and many more floaters showing up and which have now become quite a nuisance with my vision (blurs unless I blink to move them). She said that the Optomap does not show any retinal tears and she determined it was a vitreous detachment that caused the increase in floaters. Also, my reading vision has been greatly reduced just within the last month and the floaters make it more difficult as well for reading. She did say that the Optomap has some limitations as to showing the far edges of the retina, but she did a simple peripheral vision test (using my hand), and determined I had not lost any vision. I just thought I would get your opinion as well. Thanks.
Your doctor was quite right as far as the Optomap’s limitations. A thorough dilated retinal exam should be done by a qualified optometrist or ophthalmologist to evaluate the integrity of the peripheral retina. Floaters are truly annoying, but you can’t be conclusive of a simple vitreous detachment until you have ruled out peripheral retinal breaks. If you continue to see flashes, ask your doctor to perform a peripheral exam or to refer you to a colleague who can do this for you.
Happy Thanksgiving.
This has nothing at all to do with floaters even though I do have one large floater in my left eye. It appears like a fluffy cat’s tail waving in the breeze.
My real concern is the fact that I was diagnosed with a retinal vein occlusion in my left eye. That did not help my vision in that eye. Then one day, for no apparent reason, I fell. I tore up both knees, scratched my face and most of all broke my glasses.
The next day I had a TIA. After this, my doctor kept treating the eye until he felt it was stable, which was following the removal of cataracts from both eyes.
Now, finally, I was ready for new glasses! New eyes, New eyesight, New glasses. NO! NO! says VSP it is ionly September and you must wait until December 1 before you can get new glasses. I argued that my were broken, and even if they were not then due to my surgery they were rendered useless.
VSP then tells me that I used an out of network Doctor the last time, so as my punishment, I must not only wait the full year before getting new glasses, but that if I had used a VSP provider my broken glasses would have been replaced.
Okay, so I go out get a new exam and buy new glasses from the doctor who found the swelling and bleeding behind my eye to start with. True he is not a network doctor, and my glasses cost almost $600 but I had to see.
Now two months down the road I am working, I again cannot see, remove my glasses to use a magnifier and low and behold, someone steals my glasses!
It is still not December 1, 2009, and since my swelling and bleeding are back and my ‘out of network’ doctor found it, again, I think I’ll stick with him. Again.
Hi Judith,
Thanks for the comment. We’re glad you have an eye doctor that you are comfortable with. December 1 is just a few weeks away! Hopefully you’ll have better luck with your glasses this year. Customer care is always available if you need advice on how to maximize your benefits with in and out of network providers. 800.877.7195.
Dear Vernon,
Unfortunately, floaters are not preventable and yes, you may see more of them in the future. On the other hand, if you have just a few, you will likely learn to ignore them with time. Importantly though, don’t ignore new floaters, especially if you are highly nearsighted, have had an eye or head injury recently or in the past, or see flashes or sparks of light when you know there is no reason to have seen flashes. The best advice I can give you is to have your eyes examined to determine the origin of the floaters. Your eye doctor can best advise you if these are normal for you or if you have a condition that must be treated.
I recently (3 months ago) visited my eye doctor for a comprehensive exam and nothing stood out. I’ve been so accustomed to the floaters that I forgot to ask about it.
In high school I did go the emergency room after a guy poked me in the eye during wrestling practice, but it didn’t turn out to be anything serious.. Wait, I did have to wear an eye patch for a week, but don’t think it was serious – it wasn’t noticeable in any of my eye exams….
Well, thanks for your advice! At least I know what I’m dealing with…
_Vernon
Your welcome
Hi Dr. Joel – After reading this I realize that I do have floaters, and see them often. You’re right, it is annoying. Do you know if this condition is somewhat preventable? I’m only 26 and don’t want to see more of these in the near future. Anything you can recommend or is it just an aging process?
_Vernon