Why Do I Keep Seeing Floaters? Should I Be Worried? By Dr Rupal Morjaria

You notice a small dark spot drifting across your vision.

You blink.

It moves away.

You try to look directly at it.

It seems to disappear.

Then, moments later, it floats back into view.

For many people, floaters are a normal part of ageing. However, in some cases, they can be an important warning sign of a more serious retinal problem.

Knowing the difference can make all the difference.

As a Consultant Ophthalmologist and Medical Retina Specialist, one of the most common questions I hear is:

"Should I be worried about these floaters?"

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What are floaters?

Floaters are small shadows cast onto the retina by tiny clumps of collagen or cells suspended within the vitreous gel that fills the inside of the eye.

People often describe them as:

• Black or grey spots

• Tiny cobwebs

• Strings or threads

• Circles or rings

• Small floating specks

They usually move as your eyes move and often drift away when you try to focus directly on them.

Although floaters can be frustrating, they are extremely common and often become more noticeable when looking at a bright sky, a white wall or a computer screen.

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Why do floaters develop?

The most common reason is simply ageing.

As we get older, the vitreous gel inside the eye naturally becomes more liquid and begins to shrink.

Eventually, it can separate from the retina in a process known as a posterior vitreous detachment (PVD).

This is a very common age related change and, in most cases, does not threaten vision.

However, as the vitreous pulls away, it can occasionally tug on the retina.

In some people, this can lead to a retinal tear or retinal detachment, which requires urgent assessment and treatment.

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When should floaters become a concern?

Most floaters are harmless.

However, you should seek urgent assessment if you suddenly notice:

• A sudden shower of new floaters

• Flashes of light

• A curtain or shadow coming across your vision

• Sudden loss of part of your vision

• Floaters following an eye injury

These symptoms may indicate that the retina has developed a tear or has started to detach.

Retinal tears and retinal detachments are time sensitive conditions, and early treatment can help preserve vision.

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Can diabetes cause floaters?

Yes.

People living with diabetes may develop floaters for a different reason.

Diabetic retinopathy can cause fragile blood vessels within the retina to bleed into the vitreous.

When this happens, patients may suddenly notice new floaters, dark spots or cloudy vision.

For this reason, anyone with diabetes who experiences a sudden change in vision should arrange prompt assessment.

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Could floaters be caused by something else?

Yes.

Although ageing is the most common cause, floaters can also occur with other eye conditions, including:

• Retinal tears

• Retinal detachment

• Vitreous haemorrhage

• Inflammation inside the eye (uveitis)

• Diabetic retinopathy

• Following eye surgery or injury

This is why a specialist retinal examination is so important if symptoms develop suddenly or change significantly.

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What tests may be needed?

The first step is a comprehensive retinal examination.

During your consultation, I will carefully examine both the vitreous and the retina to identify the cause of your symptoms.

As one of the few specialists in the UK offering a comprehensive retinal assessment using both OCT and Optos widefield imaging, I am able to assess both the central retina and the retinal periphery using advanced diagnostic technology.

Using forefront retinal imaging technology allows for a more detailed and comprehensive assessment of the retina than is possible with conventional retinal photography alone.

This provides a more complete understanding of your retinal health and can help identify subtle changes at an earlier stage, allowing the most appropriate management plan to be recommended.

What is an OCT scan?

OCT stands for Optical Coherence Tomography.

It is a quick, painless scan that uses light waves to produce highly detailed cross sectional images of the retina.

An OCT scan allows me to assess:

• The health of the macula

• Retinal swelling

• Early retinal disease

• Changes associated with diabetic eye disease

The scan takes only a few seconds, does not involve touching the eye and provides incredibly detailed information about the health of the central retina.

What is Optos widefield imaging?

Optos widefield imaging is an advanced retinal imaging technology that captures an ultra wide view of the retina in a single scan.

Unlike standard retinal photographs, which only show a small portion of the retina, Optos imaging allows much more of the retina to be examined, including the far peripheral areas where important retinal changes can occur.

This technology can help detect:

• Retinal tears

• Retinal holes

• Diabetic retinopathy

• Retinal vein occlusions

• Peripheral retinal degeneration

• Other retinal conditions affecting the far edges of the retina

The scan is quick, comfortable and provides a detailed view of areas that may not always be visible using conventional retinal photography.

In some cases, pupil dilating drops may also be recommended to allow an even more detailed examination of the peripheral retina when clinically appropriate.

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Can floaters be treated?

In many cases, no treatment is needed.

The brain often learns to ignore long standing floaters, making them much less noticeable over time.

However, treatment depends entirely on the underlying cause.

For example:

• Retinal tears can often be treated with laser therapy.

• Retinal detachment may require urgent surgery.

• Diabetic eye disease may require retinal injections or laser treatment.

The most important step is identifying whether your floaters are simply part of the normal ageing process or a sign of a more serious retinal condition.

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Why choosing the right specialist matters

Although floaters are common, distinguishing between harmless vitreous changes and sight threatening retinal disease requires specialist assessment.

As a Medical Retina Specialist, I regularly diagnose and manage a wide range of retinal conditions, including retinal tears, diabetic retinopathy, macular degeneration and retinal vein occlusions.

In my practice, I provide:

• Comprehensive retinal examinations

• Advanced OCT imaging

• Specialist assessment of new floaters and flashes

• Diagnosis and management of retinal disease

• Personalised treatment plans tailored to your individual needs

Having the correct diagnosis provides reassurance when symptoms are harmless and allows prompt treatment when intervention is needed.

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The bottom line

Most floaters are a normal part of ageing and are not usually a cause for concern.

However, it is important to remember:

• Floaters are common and often harmless

• A sudden increase in floaters should never be ignored

• Flashes of light may indicate traction on the retina

• Retinal tears and retinal detachment require urgent assessment

• Early diagnosis offers the best opportunity to protect your sight

Often, the most important question is not:

"Will these floaters disappear?"

But rather:

"Could they be a sign that my retina needs urgent attention?"

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Considering your next step

If you have recently noticed new floaters, flashes of light or any sudden change in your vision, a specialist retinal assessment can help determine the cause and provide reassurance or treatment where appropriate.

Understanding whether your symptoms are part of the normal ageing process or a sign of retinal disease is an important first step in protecting your sight.

A consultation with me will provide:

• A comprehensive retinal examination

• Advanced OCT imaging where appropriate

• A clear explanation of your diagnosis

• Expert guidance on monitoring or treatment if required

• A personalised management plan tailored to your individual eye health

I see patients privately at Chamberlain Clinic in Edgbaston, The Priory Hospital in Birmingham, and clinics in Sutton Coldfield and Leicester.

If you would like clarity, reassurance and a plan you feel confident in, I would be very happy to see you in clinic and guide you through your options.

Contact details and appointments, click here.