Welcome to Am I Dying, a column that hopes to save you from your late-night WebMD spiraling. You can email us your hypochondriac questions at amidying@nymag.com.
If I’m seeing more “eye floaters” than usual, does it mean I am … going blind?? You know, those translucent stringy things that drift back and forth across your eye all day. Or maybe you don’t know; I have no idea how common they are. I swear an eye doc long ago told me that if I started to see more of these things it is potentially very bad/means I am going blind. Did I make that up? How can you TELL if you’re seeing more, or if you’re just noticing them more? What ARE they, anyway, and is there any way to get rid of them??
This is just my personal opinion as the owner of a pair of eyeballs that require -7.00 corrective lenses, but doesn’t it seem like the things we use to see with should be better evolved by now? I was wearing glasses by age 11, and my brother, by 5. One should be able to reach one’s full adulthood, at least, with 20/20 vision. I think that would be fair. From there, one’s eyesight can get worse, as the rest of the body inevitably does. (Which, on second thought, I would prefer not to happen either.)
Unfortunately, the world does not operate in the way I think best for everyone, and the eyes (like all that is human) age. That’s not particularly great news, but it does account for the vast majority of “floater” cases. Floaters, by the way, are little specks that appear to “float” in your field of vision, and follow your eyes as they move, though not always precisely. But allow Dr. Yasha Modi, an ophthalmologist at NYU Langone Health, to explain in more detail.
“The thing we think about when we use the word ‘floaters’ is just the natural aging process of the vitreous, which is this solid ball of jelly that forms in the middle space of our eye, between the back of the lens and the retina,” says Modi. (I don’t know about you, but for me, the mental image was instantaneous: a lava lamp.) The vitreous, says Modi, takes up the vast majority of the eye’s “real estate,” so to speak, and serves as the blood supply to the eye when we’re fetuses. Later, once we develop blood vessels, what remains is a vascular structure that is “full of jelly” when we’re young. As we get older (and/or more near-sighted), says Modi, that jelly begins to … liquefy.
In the liquefying process — called vitreous liquefaction, in case that comes up on Jeopardy — the goo turns stringy, and this is what causes the sensation of having floaters. Sorry. I really didn’t expect the explanation to be this gross. Near-sighted people tend to get floaters earlier in life than other people, but “everybody will have floaters to a certain degree,” says Modi. Most often, they’ll surface somewhere between one’s 40s and one’s 80s. In most cases, they’re not problematic, and relatively unobtrusive. But eventually, the vitreous will move away from the retina (by a process called vitreous posterior detachment), and it’s in that window of time in which there are risks, says Modi. “If the vitreous pulls too hard, we can get a hole or a tear in the retina,” he says, which can lead to retinal detachment, which may require surgery. (So many things, detaching from one another, all the time, apparently.)
Floaters are often preceded by the perception of extremely brief flashing lights, particularly noticeable in the dark, says Modi. Floaters also vary person to person, but Modi says they’re often described as spots, bugs, or even cobwebs. And while most cases are harmless, if you experience floaters, Modi recommends seeing a retinal specialist if possible, and if not, a general ophthalmologist. They can then examine you for retinal tears and/or detachment. But it’s the detachment process you have to watch out for; once the vitreous is separated from the retina, you’re actually at a lower risk for floaters, Modi says. Vitreous detachment and retinal detachment look similar initially, and floaters are a symptom of both, and in some cases, vitreous detachment can lead to retinal detachment. But once the vitreous has successfully detached itself from the retina, your risk of retinal detachment is “arguably the lowest point in your entire life,” says Modi. The caveat, though, is that during that vitreous detachment period (which typically lasts a few months), the risk is highest.
Even after the separation process, the floaters never really go away — or, at least, the perception of them doesn’t. After vitreous detachment, what we perceive as floaters is actually a shadow of that detachment, says Modi. Even still, our brains generally come to ignore the floaters over time, after which time the person notices them less. In rare cases, in which the floaters are extremely bothersome, they can be removed via surgery, in a process called vitrectomy, says Modi — but it’s rarely recommended, because the vast majority of people adapt on their own.
It’s also worth noting that there are a few much rarer causes of floaters, including inflammation in the eye (uveitis), an eye infection like tuberculosis or syphilis, says Modi. Long-time diabetics may experience bleeding in the eye, which can be misconstrued as floaters. A clinical exam can easily clarify the root causes of the floaters.
The bottom line is that we are all getting older, every second of every day, and floaters will come for us all. You may notice them or not, but in most cases, they won’t cause problems, and they won’t make you go blind. And hopefully, eventually, like so many other persistent aches and sensations, your brain will learn to ignore it. Ha.
