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Eye Floaters
What they are, why they happen and when to act
Published by Direct Sight | Eye Care Guide
What exactly is going on inside your eye?
Eye floaters are extremely common and, in most cases, completely harmless. But it’s important to understand what causes them and recognise when they may need urgent attention.
Your eyeball is filled with a clear, gel-like substance called the vitreous humour. When you are young, this jelly like substance is firm and tightly packed. Pressed right up against the retina (the light-sensitive layer at the back of your eye).
Over time, due to the ageing process, it gradually changes. The gel begins to liquefy and shrink. As it does, tiny strands of collagen, the protein fibres that give the vitreous its structure, clump together.
These clumps don't affect your eye's health directly, but they do cast shadows onto the retina as light passes through. Those shadows are what you see as floaters. Floaters appear to drift as they are suspended in the gel of your eye, moving with its currents.
Floaters can appear in many shapes, including spots, threads, cobwebs, rings, or tiny dots drifting across your vision.
Why do floaters develop?
Ageing is the most common cause of eye floaters. As we get older, the gel inside the eye (the vitreous) slowly becomes more liquid, a natural process known as vitreous syneresis. This commonly begins from around your 50s onwards.
By the mid-60s, many people experience a posterior vitreous detachment (PVD). This is where the vitreous partially pulls away from the retina. This often causes the sudden appearance of a new floater. Sometimes described as a cobweb, ring, or large shadow drifting across the vision.
Floaters can also develop earlier, especially in people who are short-sighted (myopic). Caused by the shape of the eye placing more strain on the vitreous. Other possible causes include previous eye surgery, eye inflammation or infection, diabetes, and eye injuries.
Treatment for eye floaters
Mostly, they fade into the background but they do not disappear. Over weeks and months, the brain becomes adept at filtering them out. Most people stop actively noticing them. The floaters may also drift lower in the vitreous over time, taking them out of the central field of vision where they're most distracting.
When floaters become bothersome and genuinely affect quality of life, there are two options to remove them.
- A vitrectomy involves surgically removing the vitreous gel and replacing it with a saline solution. Effective, but carries risks including retinal detachment and cataract.
- Laser vitreolysis, uses targeted pulses of laser energy to break larger floaters into smaller, less visible fragments. This is a less invasive alternative.
When to Stop Waiting and Act
Most floaters are nothing to worry about. But certain symptoms alongside or following new floaters need same-day or emergency attention:
• A sudden shower of new floaters you haven't seen before
• Flashes of light, especially at the edges of your vision
• A dark shadow or curtain spreading across part of your visual field
• Any rapid loss of central or peripheral vision
These can be signs of a retinal tear or detachment, a genuine eye emergency.
Call 999, attend an eye casualty unit, or go to A&E. Do not wait to see if it settles.
The importance of getting regular eye tests
The problem with floaters is that PVD and a retinal tear can look identical from the patient's point of view. Both can cause new, prominent floaters. The only way to distinguish between them is a dilated eye examination carried out by an optometrist or ophthalmologist. If you develop sudden, new, or significantly worse floaters, getting your eyes examined promptly is highly recommended.
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Frequently Asked Questions
Are eye floaters dangerous?
In the vast majority of cases, no. Floaters that develop gradually and remain stable are almost always benign, caused by age-related changes to the vitreous gel. The concern arises when new floaters appear suddenly, in large numbers, or alongside flashes of light or visual disturbances. In which case urgent assessment is needed to rule out a retinal tear or detachment.
Why do floaters move when I look at them?
Floaters move along with any movement of the gel itself because they are suspended within the vitreous gel inside your eye. When you shift your gaze quickly, the gel sloshes and the floater lags behind. They always seem to be just slightly ahead of where you're trying to look at them.
Can I get rid of eye floaters?
Not easily, and usually it isn't necessary. Most floaters become much less noticeable over time as the brain adapts.
For severe, persistent cases that genuinely affect everyday life. Laser vitreolysis or vitrectomy surgery may be considered. These procedures carry risks and are not standard NHS treatments for benign floaters.
Why am I more likely to get floaters if I'm short-sighted?
Short-sighted (myopic) eyes are typically slightly longer from front to back than average. This elongated shape creates additional tension on the vitreous gel, causing it to liquefy and detach from the retina earlier than it otherwise would. As a result, people with myopia often notice floaters at a younger age than those without significant refractive error.
Should I see a doctor about floaters I've had for years?
If you are long-standing floaters haven't changed and aren't causing significant problems, a routine eye test with an optometrist is generally sufficient. Especially if you're already having regular checks. However, any sudden change in floaters, a rapid increase in number, or new symptoms alongside them should be checked by an eye specialist as soon as possible.
Can floaters be a sign of diabetes?
Yes, though not directly in the way people sometimes assume. Diabetes can lead to diabetic retinopathy, which causes bleeding within the eye. Blood cells that enter the vitreous can appear as floaters.
If you have diabetes and notice new or worsening floaters, it's particularly important to have your eyes examined. It may indicate changes to the retinal blood vessels that need attention.
References
NHS, floaters and Flashes in the Eye
Manchester Royal Eye Hospital (NHS), flashing Lights & Floaters: PVD Patient Information
Gloucestershire Hospitals NHS, posterior Vitreous Detachment
Cleveland Clinic, eye Floaters (medically reviewed)
Cleveland Clinic, posterior Vitreous Detachment (medically reviewed)
American Society of Retina Specialists, posterior Vitreous Detachment
Macular Society UK, floaters and Changes in Eyesight
East Sussex Healthcare NHS Trust, flashes and Floaters Patient Leaflet