Dear Alice,

For years, I have been noticing one or more annoying "floating spots" in my right eye. These spots affect only my right eye; when I am reading and they become too much to bear, closing that eye causes them to vanish. A local news report covered "floating eye spot problems" a while back, but their conclusion was that they are normal, and should only be of concern primarily to diabetics (which I am not).

First, were they correct, is this nothing to worry about?
Second, and more importantly: Is there anything that can be done to GET RID of this thing?


Dear Out-Damned-Spot!,

Floaters (the "technical" term for the effect you're describing) can be annoying. Although you are correct that much of the time they aren't a sign of any actual disease, they can sometimes occur with certain serious eye conditions, so you might want to check in with your health care provider, who may refer you to an ophthalmologist to make sure that your eyes are healthy.

Here's the most common reason for floaters: your eyeball is filled with a jelly-like material called vitreous. Sometimes, for no known reason, clumps form within this vitreous. When they drift into view, you see these "floaters." You may also see little flashes of light, specks, squiggles, or "cobwebs." Over the age of 55, the vitreous may actually separate from the back of the eye, allowing you to see what appears to be a very large floater. Again, this is usually not a sign of any serious problem.

Occasionally, floaters occur along with other eye conditions (more common in people with diabetes, as you mentioned; also more common in people with sickle cell anemia), such as bleeding into the vitreous, retinal tear, or retinal detachment. Diagnosing these conditions is relatively easy: your health care provider or ophthalmologist will put drops into your eyes to dilate the pupils, and then use a lighted scope to peer into your eyes. This will allow the provider to diagnose most of the serious causes for floaters; if these reasons are excluded as causes for your symptoms, s/he will probably fall back on a diagnosis of benign vitreous floaters (meaning that you see the floaters, but they aren't due to any serious underlying disease).

Symptoms that should send you quickly to your health care provider include:

  • Blurred vision
  • Double vision
  • Loss of peripheral vision
  • Sudden increase in the number of floaters or sparks of light that you see

This is one of those good news, bad news scenarios. The good news about floaters is that they probably don't mean you have a serious eye condition. It can be a relief to know that there's nothing wrong. The bad news about floaters is that your health care provider probably won't recommend any treatment. There is a procedure, called a vitrectomy, that removes both floaters and the vitreous fluid from the eye (the fluid is then replaced with a salt water solution). However, the procedure holds a significant risk of complications that could interfere with your eyesight, and many health care providers would only perform the procedure if the floaters are seriously affecting your sight. As for prognosis: the floaters may slowly go away, you may become accustomed to seeing them, they may grow worse as you age, or they may not change.

If your floaters are interfering with your daily activity, you may want to start a conversation with your health care provider about options, including vitrectomy.

Wishing you clear vision,


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