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Q: I have been noticing lately little dark spots, like gnats, and sometimes sort of "cobwebs" moving in my left eye vision. Nothing hurts and I think I am seeing as clearly as ever, but these are annoying and a friend told me it could mean a retinal detachment. What should I do?
A: This is a very common, and usually benign, visual change as we age. Briefly, our eye is filled with a thick, jelly-like substance called the "vitreous". This is very firm, like Jello, when we are young, but becomes more watery each year.
What gives the vitreous its gel composition are tiny fibrils dispersed within the gel. They dissolve over time and allow the gel to act more like water. The fibrils also clump together sometimes to create a lump or "gnat" of tissue. Sometimes they form longer "cobwebs", and actually can make almost any shape.
These lumps or strands literally float within the watery vitreous and can get in our way. These can be very annoying and can temporarily float in our line of sight, causing momentary vision blur. Good news is that they will someday dissolve and you will no longer be bothered by them. But we cannot predict how long they will last, or when they will dissolve. I hear there are products sold online to "cure" floaters......do not waste your money, as they do not work.
One critical caveat.....if you also notice flashes of light in your vision, that could indicate the likelihood of a retinal detachment beginning. Generally the flashes will be in the same area of your vision, and usually more off to the sides or top or bottom....not right in the center. Retinal detachments are a sight-threatening medical emergency and must be treated quickly. To better find and diagnose such, we will dilate your pupils with eyedrops to give us a bigger, better view inside. Treatment is usually urgent and may involve a laser or a tissue freezing procedure or more true eye surgery procedures to re-attach the delicate retinal nerve layer to your internal blood supply.
Even without flashes, sometimes a detachment can begin and require treatment to preserve your central eyesight. While all of these problems are totally painless, the potential for permanent vision loss is real. The bottom line: see your eye doctor as soon as possible.
Treatment is usually successful and can preserve your central eyesight, but time is of the essence.
Dr. Thomas Stout, OD, FAAO, is an optometric physician at Morgantown Eye Associates.