Floaters are clumps of the gel-like vitreous humor that fills your eye. These are very common, and while potentially annoying, they are usually not a cause for concern.
This article will discuss seeing black spots in vision, what seeing flashes might mean, possible causes, when to see a doctor, and treatment options.
Symptoms
You may have noticed black spots in your vision, but you may not have been exactly sure what to call them.
These floaters may appear slightly different depending upon how the vitreous gel clumps together. You might describe these as the following:
SpotsSquiggly linesCobwebsDark blobsRing-shapedStrands of thread
Flashes
Sometimes seeing flashes of light can precede the onset of floaters. That’s because floaters can occur after what’s known as a posterior vitreous detachment. By age 80, more than half of the population has had a posterior vitreous detachment.
It occurs because the central part of the vitreous gel that fills the eye starts to liquefy and can no longer support the gel on the edges. This, in turn, detaches from the sides and collapses into the liquified center.
As this tugs on the retina, the light-sensing layer at the back of the eye, it can cause flashes of light. While many times the posterior vitreous may tug on the vitreous without any problem and then simply detach from this, other times there may be issues that can be more serious such as a retinal tear that can lead to a retinal detachment.
You may also experience flashes if you hit your head and this, in turn, shakes the vitreous, which may pull on the vitreous, causing you to “see stars.”
In some cases, you may see flashes of light akin to a jagged lightning bolt linked to a blood vessel spasm in the brain and usually occurs just in one eye. This is called an ocular migraine and may or may not occur with a headache. Migraine with aura is a type of ocular migraine.
Causes
For many, floaters are a normal part of aging. These occur when some of the gel-like substance that normally fills the eye, known as vitreous, begins to shrink and, in turn, clumps together and forms particles. These particles can float through the vitreous into your line of sight and cast shadows on the retina as they do so.
Many times, these will eventually settle, and you will no longer notice them.
In other cases, floaters may be related to having blood in the eye from leaking blood vessels which are often associated with diabetic retinopathy. Anyone with diabetes should regularly have their eyes examined to check for this condition.
Also, those who experience inflammation and swelling of the middle layer of the eye, known as uveitis, may at times get floaters.
Treatment
Many times no treatment is needed for the black spots in your vision. With time, you become less aware of these, and they become less annoying.
Vitrectomy
If treatment is needed, one possibility is what’s known as a vitrectomy. This at one time was the only treatment available. It involves removing all of the jelly inside of the eye and using clear sterile fluid in its place.
This treatment, however, is not without risks. These include:
Potential for retinal detachmentEye infection (serious)Appearance of new floatersRetinal tearCataract development (clouding of the lens)
Because of these risks, some of which can threaten your sight, your surgeon will have to weigh the potential for these issues with the need to remove the floaters.
Laser
Another treatment option with less risk is laser vitreolysis. With this outpatient procedure, floaters are broken up with the aid of a laser, which is aimed through the dilated pupil at the floater. The floaters are either vaporized or broken up into smaller, less noticeable pieces.
However, keep in mind that not all floaters can be treated with this approach. If the floaters are too close to the retina, as tends to be the case in younger patients, the laser technique can not be used.
In deciding whether to treat your floaters with a laser, your surgeon will likely consider:
Whether your floater has soft borders that make laser treatment possibleIf your floater is located in an area where the laser can be safely usedIf the floater came on recently due to a posterior vitreous detachment
Prevention
Nothing can decisively keep black spots from occurring, but healthcare providers recommend improving your eye health in an attempt to improve your overall vision.
Supplements that may benefit general eye health include:
Vitamins A, C, and EGinkgo bilobaOmega-3 fatty acidsZinc
When to See a Doctor
If you notice a sudden increase in the number of specks or floaters in your line of sight, it’s important to get this immediately checked out.
While many posterior vitreous detachments occur without causing any lasting problems and may even go unnoticed, in other cases this can happen abruptly and can be extremely serious.
Having many new floaters can signal a tear in the retina, which, if diagnosed promptly, can usually be successfully repaired. However, if this is not treated, it can cause a retinal detachment, which can lead to vision loss if not successfully repaired.
Summary
For some people, black spots in vision are simply an annoyance. For others, the spots are noticeable enough to need treatment. In most cases, the spots are caused by what’s known as a posterior vitreous detachment, which happens to many people as they age.
When necessary, treatment for floaters can involve a vitrectomy with removal of the gel-like fluid in the eye and replacement of the fluid. A laser may also be used to vaporize the floaters or break these into smaller pieces.
A Word From Verywell
Floaters are one of those things that many people barely notice over time. While they may start out as an annoyance, these tend to settle from sight. But if they don’t, fortunately, treatment options are available.
Either approach may get rid of your floaters, but there are no non-surgical cures that have been proven to work.
