Eye floaters are a common condition where small, dark shapes appear to float in front of the eye when nothing is truly there. They often look like small threads, dots, cobwebs that “float” around in your vision. They are caused by small clumps of protein or other debris that collect in the vitreous humor, the gel-like substance that fills the eye.

Most people will experience floaters at some point in their lives, and they are more common in older adults and are a normal part of the ageing process of the eye. By age 65 about 65% of the population will have experienced a floater. They can also occur as a result of certain medical conditions, such as diabetes or inflammation of the eye, or as a side effect of certain medications.

There are certain warning signs that indicate you should have a floater looked at by your optometrist. It's essential to trust your instincts and seek professional evaluation if you have concerns about your floaters or notice any of these warning signs.

The 3 most important warning signs to look for with eye floaters are:

1. Sudden Increase in Floaters:

   If you notice a sudden onset of new floaters or a significant increase in the number or size of existing floaters, it could be a sign that something inside of the eye has changed that needs to be looked at thoroughly.

2. Flashes of Light:

   The most common cause of flashes of light is the traction or pulling on the retina, typically caused by the gel-like vitreous humor inside the eye. As we age, the vitreous humor undergoes changes, becoming more liquid and less firmly attached to the retina. When the vitreous humor shrinks or separates from the retina, it can create tension on the retina, leading to the perception of light flashes.

   Flashes of light can manifest in various ways. Some people describe them as bright spots, specks, flickering lights, or lightning-like streaks. They can appear in one or both eyes and may occur spontaneously or be triggered by eye movement or changes in lighting conditions.

3. Changes in Vision:

   Any significant changes in your vision, such as blurry or distorted vision, sudden difficulty focusing, or a sudden decrease in visual acuity, should be evaluated by an eye care professional. If you experience a sudden loss of peripheral (side) vision, like a curtain or shadow spreading across your visual field, it may be a symptom of retinal detachment, which requires immediate medical attention.

A dilated fundus exam, also known as a dilated eye exam or dilated retinal exam, is the only way to effectively and accurately assess the health of the retina. During a dilated eye exam eye drops are used to enlarge (dilate) the pupils, allowing your optometrist to have a better view of the structures at the back of the eye.

When looking for floaters, a dilated fundus exam is important because it provides a clear and direct view of the retina and vitreous humor. It enables the eye care professional to assess the size, number, and location of the floaters. More importantly your optometrist will ensure there are no retinal holes, tears or detachments that would require treatment.

Retinal Holes, Teas and Detachments:

A retinal hole or tear refers to a break or opening in the retina, the light-sensitive tissue that lines the back of the eye. A retinal hole is a problem because it can potentially lead to more serious complications, such as retinal detachment, which can cause permanent vision loss if not addressed promptly. Here are a 3 reasons why a retinal hole is a concern:

1. Retinal Detachment:

   A retinal hole provides a pathway for the vitreous humor, the gel-like substance in the eye, to seep through the hole and accumulate behind the retina. This accumulation can lead to the detachment of the retina from the underlying layers of the eye. Retinal detachment disrupts the normal functioning of the retina, causing a significant loss of vision that requires immediate medical attention and even surgery to repair.

2. Vision Impairment:

   Even without progressing to retinal detachment, a retinal hole can cause visual disturbances. The presence of a hole can lead to an increased number of floaters in the visual field, which can be distracting and affect visual clarity. Additionally, flashes of light may be perceived due to the mechanical stimulation of the retina.

3. Progression to Larger Tears:

   If a retinal hole is left untreated, it can potentially enlarge and extend into a more extensive retinal tear. Larger tears pose a higher risk of retinal detachment and may require more complex treatment approaches.

Who gets retinal holes, tears and detachments?

Retinal holes and tears can occur in individuals of any age, but certain factors may increase the risk. Here are some factors that contribute to the likelihood of developing retinal holes or tears:

1. Age:

   The risk of retinal holes and tears increases with age. As we get older, the vitreous humor inside the eye undergoes changes, becoming more liquid and prone to separation from the retina, which can lead to holes or tears.

2. Myopia (Nearsightedness):

   People with high myopia (nearsightedness) have longer eyeballs, which can stretch and thin the retina, making it more susceptible to holes or tears. Every unit (diopter) of nearsightedness increased the risk of a retinal break by about 25%.

3. Eye Trauma:

   Injury or trauma to the eye can cause retinal holes or tears. Impact or penetration of the eye can create forces that result in a break in the retina.

4. Previous Eye Surgery:

   Individuals who have undergone certain eye surgeries, such as cataract surgery or vitrectomy (surgical removal of the vitreous humor), may be at a higher risk of retinal holes or tears.

5. Family History:

   There may be a genetic component to the development of retinal holes and tears, so individuals with a family history of retinal issues may have an increased risk.

6. Other Eye Conditions:

   Certain eye conditions, such as lattice degeneration (thinning of the peripheral retina) or diabetic retinopathy (associated with diabetes), can predispose individuals to retinal holes or tears.

Regular eye examinations and promptly addressing any new visual symptoms are crucial for early detection and appropriate management of retinal holes or tears.

At Helio Optometry we always leave space in our day to day schedule to take in walk-in eye urgencies and emergencies. These appointments are covered by Alberta Health Care.