The retina is the inside lining of the back of the eye. It is composed of many layers of light sensitive nerve cells. Light entering the eye is focused on the retina and is converted to electrical impulses which are carried to the brain by the optic nerve. The centre of the retina is called the macula. It is the most sensitive part of the retina and is used for day light and colour vision. This is in contrast to the rest of the retina which is more sensitive in the dark and is mainly used for navigational black and white vision at night.

The retina is supplied by one main artery and one main vein which enter through the optic nerve and branch all over the retina to smaller arteries and veins that cross each other like railway tracks.

source – American Academy Ophthalmology

The cavity of the eye is filled with a clear gel like material called the vitreous. At a young age, the vitreous is well formed and adheres to the inner surface of the retina.

With aging, the vitreous gel starts to degenerate and small opacites develop that move across the retina and are perceived as small spots or lines across the vision. The symptoms usually develop slowly over many months or years and are generally well tolerated.

Another type of floaters can develop rather suddenly with other symptoms of seeing flashes in the peripheral vision especially in the dark. This condition develops when the back surface of the vitreous gel suddenly contracts and pulls away from the retinal surface, a condition called posterior hayloid detachment. In this case a retinal tear or even retinal detachment can also occur.

Large vitreous floater across the centre of the retina

  • Age
  • Short sightedness (Myopia)
  • Retinal tear and detachment
  • Trauma
  • Inflammation
  • Vitreous haemorrhage
  • Dilated retina examination: This is the standard test to check the back of your eye (retina). You will have your pupil dilated with drops so your vision will be blurry for an hour or two after the examination. Our specialist will check your eyes on the microscope (slit lamp) and use a special lens to see the details of the retina. The peripheral retina will be checked with another instrument called an indirect ophthalmoscope to exclude retinal tears or retinal detachment. You will also receive a full examination of both eyes including the front of the eye (anterior segment).
  • OCT (optical coherence tomography); this is a fast scan of the retina centre (macula) which shows cross section details of its layers. It will show the floaters as opacities in front of the retina.
  • In most cases, patients can tolerate the presence of floaters and no treatment is necessary; unless there is an associated cause such as inflammation of the back of the eye or the presence of a retinal tear or retinal detachment.
  • However, in some patients, the symptoms of floaters are considerable making reading or driving quite difficult. In these cases, vitrectomy surgery can be considered after discussing the risks and benefits with the patient.

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