Eye Floaters:
When to Panic,
When Not To

Floaters are one of the most common complaints in ophthalmology — and one of the most misunderstood. The vast majority of people who notice floaters have nothing threatening happening in their eyes. But a small proportion are experiencing the early manifestation of something that needs urgent attention. The challenge for patients is that floaters, from the inside, can feel alarming even when they are benign, and genuinely dangerous floaters can look very similar to harmless ones.

This guide gives you a clear framework for understanding what floaters are, what causes them, and — most importantly — which symptoms should prompt you to seek same-day review.

What Are Floaters?

Floaters are shadows cast on the retina by particles within the vitreous — the clear gel that fills the bulk of the eye behind the lens. When you look at a bright, uniform background (a white wall, a blue sky, a computer screen), these particles move across your visual field as dark spots, strands, rings, or cobwebs.

The vitreous gel is approximately 99% water, with the remaining 1% composed of collagen fibrils and hyaluronic acid. Over time — and this begins as early as the mid-thirties — the gel undergoes syneresis: liquefaction and structural breakdown. Pockets of liquid develop within the gel, and the remaining collagen fibres aggregate into clumps and strands. These aggregates cast shadows — floaters.

This process is entirely normal and universal. If you live long enough, you will have floaters. The question is whether yours are caused by this benign ageing process, or by something else.

Harmless Floaters: What They Look Like

Benign floaters caused by vitreous degeneration tend to have characteristic features. They may be annoying, but they do not indicate retinal danger.

The brain is remarkably good at adapting to persistent floaters — most people find that longstanding floaters become less noticeable over months as the brain learns to suppress them. The ones that remain persistently bothersome in the long term are in the minority.

Posterior Vitreous Detachment: The Common Event

The most significant vitreous event in adult life is posterior vitreous detachment (PVD) — the separation of the vitreous gel from the retinal surface. In a young eye, the vitreous adheres firmly to the retina. As the gel liquefies with age, this adhesion weakens and eventually the gel peels away from the retinal surface entirely, collapsing forward.

PVD occurs in virtually everyone — it is the inevitable consequence of vitreous ageing, typically happening between ages 55 and 75. When it occurs, patients typically experience:

• A sudden onset of new floaters — often more prominent than anything noticed before
• A distinctive large ring-shaped floater (a Weiss ring) — this is the attachment point at the optic disc, now floating freely in the vitreous cavity
• Flashes of light, particularly when moving the eye in a dark room — caused by the vitreous tugging on the retina as it separates

PVD itself, when uncomplicated, is harmless. The vast majority of patients who experience PVD have no adverse retinal consequences. However, in 10–15% of symptomatic PVD cases, the vitreous tears the retina as it separates — creating a retinal tear that can lead to detachment.

Warning Signs: When Floaters Signal Danger

These features distinguish dangerous floaters from benign ones. Any of the following should prompt same-day or next-day review with an ophthalmologist who can perform a dilated retinal examination.

What Happens at the Doctor

When you attend for assessment of floaters, the essential investigation is a dilated fundus examination — eye drops are used to widen the pupils, and the ophthalmologist examines the full extent of the retina, including the peripheral zones where tears are most likely to occur. This cannot be adequately performed without dilation; a quick assessment with an undilated pupil is insufficient.

The examination includes:

• Indirect ophthalmoscopy — a wide-field view of the peripheral retina using a headband lens and bright light
• Slit-lamp biomicroscopy with a contact lens — detailed assessment of the posterior pole and mid-peripheral retina
• Scleral indentation if indicated — gentle pressure applied to the outside of the eye to examine the extreme periphery where small tears may hide

If a retinal tear is found, it can typically be treated immediately or within 24 hours using laser photocoagulation or cryotherapy — straightforward outpatient procedures that seal the tear and prevent it from progressing to a detachment.

Treatment Options for Floaters

For benign, non-threatening floaters, the majority of patients require no treatment — reassurance, explanation, and time. The brain adapts remarkably well, and most patients find floaters significantly less intrusive 6–12 months after onset.

For patients with persistently debilitating floaters that do not improve and significantly affect quality of life, two intervention options exist:

Frequently Asked Questions

My floaters have been there for years. Do I still need to have them checked?

Longstanding, stable floaters that have been present for years without change are almost certainly benign. If you have never had a dilated examination to confirm this, it is worth having one — but it is not an emergency. The time to be concerned is when floaters are new, suddenly worse, or accompanied by flashes or visual field changes.

I was told my floaters would go away. Why are they still there?

Most floaters do not disappear — they become less noticeable. This happens because the brain's visual cortex learns to suppress the signals from persistent stationary opacities, and because the floaters themselves gradually sink to the bottom of the vitreous cavity over months to years. "Going away" is rarely literal — fading from awareness is the more accurate description.

Do floaters affect my vision test at the optometrist?

For the purpose of spectacle prescriptions, no — floaters do not alter refractive error and the letter chart is unaffected. However, very dense or numerous floaters can reduce contrast sensitivity and may cause measurable changes on formal visual field testing.

Can I exercise with floaters?

For benign established floaters, there is no restriction on physical activity. If you have been recently assessed for a new PVD or retinal tear, your ophthalmologist may advise a brief period of reduced exertion while the situation is monitored — ask specifically at your consultation.

Are eye floaters dangerous?

Most floaters are harmless and are caused by normal age-related changes in the vitreous gel inside your eye. However, a sudden shower of new floaters, especially with flashes of light or a shadow in your vision, can indicate a retinal tear or detachment, which requires urgent evaluation.

When should I see a doctor about floaters?

See an eye doctor urgently (ideally within 24 hours) if you experience a sudden increase in floaters, new flashes of light, a shadow or curtain spreading across your vision, or any sudden change in your visual field. For long-standing, stable floaters without other symptoms, mention them at your next routine eye check-up.

Can floaters go away on their own?

Floaters do not typically disappear completely, but many become much less noticeable over time. The brain adapts and learns to filter them out, and the floaters themselves often settle away from your central line of sight. Most people find that floaters bother them less after several weeks to months.

Can laser treatment remove floaters?

YAG laser vitreolysis can break up certain types of large, isolated floaters into smaller, less noticeable fragments. However, it is not effective for all floater types, particularly small, diffuse floaters. Vitrectomy (surgical removal of the vitreous gel) is more definitive but carries greater surgical risks and is reserved for severe cases.

Are floaters more common if you have high myopia?

Yes. People with high myopia tend to develop floaters earlier and more frequently because the vitreous gel in elongated myopic eyes undergoes degenerative changes at a younger age. If you are highly myopic and notice new floaters, it is especially important to have a prompt dilated eye examination, as myopic eyes are also at higher risk for retinal tears.