However, a sudden increase in floaters, especially if accompanied by flashes of light or a shadow in your peripheral vision, can be a warning sign of a more serious condition requiring urgent assessment.
What Causes Floaters?
Floaters are caused by changes in the vitreous, the gel-like substance that fills the inside of the eye. As we age, the vitreous gradually liquefies and shrinks, forming clumps or strands that cast shadows on the retina. This is called vitreous syneresis and is a normal part of ageing.
The most common cause of a sudden onset of floaters is a posterior vitreous detachment (PVD), which occurs when the vitreous separates from the retina. PVD is extremely common and is usually harmless. However, when the vitreous separates, it can occasionally pull on the retina and cause a tear or detachment.
Other causes of floaters include:
- Retinal tear or detachment, where the vitreous pulls on or tears the retina and requires urgent treatment
- Vitreous haemorrhage, which can occur with diabetic eye disease or retinal tears
- Uveitis, where inflammation inside the eye produces inflammatory cells visible as floaters
- High myopia, as people with significant short-sightedness are at greater risk of vitreous changes at a younger age
When Are Floaters an Emergency?
Seek urgent assessment if you notice any of the following:
- A sudden, significant increase in floaters
- New flashes of light, particularly in the periphery
- A dark curtain, shadow, or veil appearing in any part of your vision
- A sudden change or loss of central vision
These symptoms may indicate a retinal tear, retinal detachment, or vitreous haemorrhage, all of which require prompt treatment to prevent permanent vision loss. If you experience any of these symptoms, call (02) 9098 1180 immediately or present to your nearest emergency eye service.
Treatment
Observation
In most cases, floaters caused by PVD or age-related vitreous changes do not require treatment. They often become less noticeable over time as the brain learns to ignore them. Your doctor will confirm that the retina is intact and advise on what symptoms to watch for.
Retinal tear treatment
If a retinal tear is detected, it can usually be treated with laser photocoagulation or cryotherapy to seal the tear and prevent a retinal detachment from developing. This is an in-clinic procedure
Vitrectomy
For patients with significant vitreous haemorrhage or severe symptomatic floaters that substantially affect quality of life, surgical removal of the vitreous (vitrectomy) may be an option. At Pure Sight, Dr Adam Plant performs vitrectomy surgery.
Frequently Asked Questions
Are floaters permanent?
Most floaters don’t disappear entirely, but they often become less noticeable as the brain adapts over months. Significant or sudden floaters should always be assessed to rule out a retinal problem.
Can floaters be ignored?
Most longstanding floaters can be monitored without treatment. However, any sudden increase in floaters or new flashes of light should be assessed promptly. Do not wait for a routine appointment.
Do I need a referral to be seen for floaters?
If you are experiencing sudden or severe symptoms, call us directly. For non-urgent assessments, a referral from your GP or optometrist is required.