Q: I am noticing little “gnats” in my vision lately. Should I be concerned?
A: This is, without doubt, the most common question that adults ask me, whether in the office or not! These are usually called “floaters,” because they do seem to float and move as you move your eyes. As with most things in life, there is no simple answer to your question.
However, most of the time the development of “floaters” is harmless, and leads to no vision loss. The key word is “most” — because we see a handful of patients each year with nothing more than “floaters” as a symptom, and yet have a retinal detachment. I believe that if the retina is truly tearing or detaching (which can lead to permanent loss of sight), most people will also experience flashes of light as well. These flashes are also a bit elusive, in that they occur not constantly, and generally are more prominent in your peripheral or side vision.
So typically, a patient with absolutely no pain or discomfort, and no change in visual clarity, will present with “floaters.” To sort out the cause and discern the proper treatment plan, we generally use eyedrops to enlarge, or dilate, your pupils. This simply gives us a bigger “window” to better see inside your eye(s). Most often, we will find collagen fibers or particles suspended in the vitreous humor of the eye. This vitreous is a dense jelly that becomes more watery over the years, allowing tiny collagen fibers to clump together and “float” in the watery vitreous. So what you are actually seeing are the shadows of those particles! In our exam, we can actually see the particles.
Our job is to determine if this fairly normal process has also begun to pull on tear the delicate nerve layer, called the retina. If that is occurring, steps must be taken to monitor this traction on the retina, or to repair the area that is loosened and/or torn. Repair is very time sensitive, meaning that if you see “floaters” you should see your eye doctor immediately. Referral to a retinal specialist, and treatment, should occur right away. Some retinal detachments progress rapidly, and some very slowly. Your eye doctor, after careful dilated examination will be able to guide you care more specifically.
So, you should ignore the “expert” advice of your friends and family — call your eye doctor and schedule a checkup right away. Be sure to tell the office about your symptoms, as most offices will keep a few appointment slots available each day for this sort of urgently needed exam.
DR. THOMAS STOUT, OD, FAAO is an eye physician in private practice at Morgantown Eye Associates. Info: MorgantownEye.com.