What are eye floaters in older adults?

Laura C. Fine, MD
Older people often notice occasional spots or opaque flecks drifting across their line of vision, particularly when they are looking at a page of a book, a computer screen, or a solid, light background. These floaters are tiny clusters of cells or gel in the vitreous cavity, where the clear jelly-like substance called vitreous humor fills your eyeball. What you actually see is the shadow these little clumps cast on the retina (the innermost layer of the eye). In some cases, the vitreous gel may detach from the retina, suddenly causing more floaters, an event called posterior vitreous detachment.

About 25% of people have these vitreous detachments and floaters by their 60s, and 65% by their 80s. Floaters also appear more often in people who are nearsighted or have had cataract surgery. These phenomena are usually nothing more than an annoyance and often dissipate on their own. If they occur suddenly, however, consult an ophthalmologist. Certain eye diseases or injuries can cause them. Floaters can also be small drops of blood from a torn retinal vessel. Less commonly, new floaters are the sign of a retinal tear, which should be evaluated.

Once floaters have been checked and declared harmless, one of three things may happen. The floater may disappear as it breaks apart or settles; the floater may become less noticeable with time; or it may stay and become bothersome. Floaters can be removed, but the surgical risk is greater than that of the floater itself. If floaters become a nuisance to central vision, moving the eye up and down or left and right may shift the floaters and provide temporary relief.

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