Floaters: Symptoms, Causes, Treatments, and Natural Approaches

About 30 percent of Americans notice eye floaters, the flecks, cobwebs, or squiggly shadows drifting across one’s visual field.

Floaters may have many causes, including aging, injury or inflammation, and environmental factors. Illustration by Minghui Zhang

Floaters are small dark shapes, such as spots or threads, that appear to drift across your vision. While they are typically harmless and do not require treatment, they can occasionally signal a more serious eye condition. Their other names include eye floaters, vitreous floaters, floating spots, myodesopsias, and muscae volitantes (“flying flies” in Latin).

Floaters are quite common. Approximately 30 percent of the population in the United States is estimated to notice them.

Floaters are most often a part of normal aging. They are cell fragments or debris suspended in the vitreous humor of the eye, casting shadows on the retina as light enters the eye. Illustration by The Epoch Times, Shutterstock

What Are the Symptoms of Floaters?

Eye floaters also come in various forms and sizes. Often, they are more noticeable when looking at plain backgrounds, like a blue sky or white wall. Common manifestations include the following:

• Spots or dots
• Threads, strands, or squiggles
• Cobwebs or clouds
• Rings or circles

One should see an eye doctor immediately if noticing the following:

• A sudden increase in floaters. The sudden appearance of floaters or black dots may indicate hemorrhage, wherein a retinal blood vessel breaks and bleeds into the eye.
• Floaters accompanied by bright flashes of light. This may indicate serious conditions such as retinal tears, hemorrhaging from diabetes, high blood pressure, or uveitis (a type of eye inflammation), all of which can lead to vision loss.
• Blurry areas in peripheral or central vision.
• A dark shadow resembling a curtain covering part of your field of vision.
• Eye pain or redness accompanied by floaters.
• New floaters if the individual has diabetes.

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What Causes Floaters?

The eye contains vitreous humor, a clear, gel-like substance found primarily in the vitreous chamber, the largest of the eye’s three chambers. The vitreous chamber is between the eye lens and the optic nerve; it makes up the bulk of the eyeball. It helps maintain the eyeball’s shape and acts as a shock absorber, protecting the eye when it’s compressed or deformed. Although more than 98 percent of the vitreous humor is water, it is about three times more viscous.

Floaters are clumps of cell fragments (protein, fats, calcium) from inflammation, a retinal tear, or debris suspended within the vitreous humor. They move in tandem with eye movements, making them appear to shift away when one attempts to look at them directly, with a slight lag. Even after the eyes cease moving, the floaters continue to drift across the field of vision. They are typically painless and may not affect a person’s ability to see beyond them.

As clumps of microscopic collagen fibers and other debris within the vitreous humor, floaters hinder the passage of light through the eye, thus creating shadowy shapes on the retina, the light-sensitive nerve layer at the back of the eye responsible for vision.

Floaters may have many causes, including aging, injury or inflammation, and environmental factors.

1. Age-Related Changes

One of the most common causes of floaters is aging. In early adulthood, some individuals may notice occasional floating strands in their vision caused by age-related shrinking of the vitreous humor. These floaters, known as idiopathic vitreous floaters, are generally harmless and rarely indicate any serious issues. They are translucent and typically more noticeable under certain lighting conditions, such as bright sunlight. They can occur in both eyes, although not necessarily simultaneously.

When a person is between 50 and 75, the vitreous humor naturally shrinks and undergoes structural changes due to aging, tugging on the retina. These tugs can stimulate the retina, creating flashes of light (photopsias). Over time, the vitreous may detach from the retina entirely, a common age-related condition known as posterior vitreous detachment (PVD). A 2017 study noted that floaters are primarily linked to aging-related PVD in people in their 50s or later.

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For most people, these changes happen gradually and cause mild symptoms that often go unnoticed. However, if the vitreous pulls too forcefully on a specific area of the retina or if there is abnormal adhesion between the vitreous and retina, it can lead to tears in the retina or damage to retinal blood vessels.

In most cases, PVD does not threaten vision and is part of the normal aging process. Approximately 80 percent of patients with PVD do not experience complications.

2. Damage, Inflammation, and Infection

In some individuals, age-related vitreous detachment can cause retinal tears, leading to new floaters and tiny blood droplets on the retina. People with myopia (nearsightedness) or who have had cataract surgery are at higher risk for retinal tears. When a retinal tear takes place, sudden, spontaneous flashes of light, often described as a continuous shower of lightning-like flashes, can occur in the peripheral areas of the retina. These flashes may not always be noticeable in regular vision but can be seen during a detailed eye exam using indirect ophthalmoscopy.

The following are other damage-related causes of floaters:

• Retinal detachment: If untreated, retinal tears can lead to retinal detachment, where the retina separates from the back of the eye. If a larger portion of the retina becomes detached, vision may become blurry, and several sudden symptoms may appear, including a significant increase in floaters, photopsias in one or both eyes, and a dark shadow or “curtain” appearing on the sides or in the middle of the visual field. Possible risk factors for retinal detachment include recent eye trauma, eye surgery, or severe myopia. If only a small part of the retina detaches, there may be no noticeable symptoms.
• Vitreous hemorrhage: Vitreous hemorrhage occurs when the vitreous gel inside the eye pulls on the retina, leading to bleeding. It is often associated with conditions such as proliferative diabetic retinopathy or eye trauma. The hemorrhage can result in significant vision loss, potentially affecting the entire visual field. It may cause the loss of the red reflex (the normal red appearance seen when light is shined into the eye). Central retinal vein occlusion (CRVO) may also cause bleeding. CRVO occurs when the main vein that drains blood from the retina becomes partially or wholly blocked, causing floaters, blurry vision, or sudden loss of vision.
• Inflammation: Vitreous inflammation, caused by infections such as cytomegalovirus, toxoplasma, or fungal chorioretinitis (inflammation of the retina and choroid), can lead to pain, blurred vision, floaters, and even loss of vision. This condition can affect both eyes and is more common in people with weakened immune systems or those who use injectable drugs.
• Eye infections: One example is endophthalmitis.
• Injuries: Eye injuries can result from various causes, including blunt-force trauma, penetrating objects, or chemical burns. Eye contusions, in particular, can lead to complications such as cataracts, glaucoma, inflammation, hemorrhages, and tears or ruptures in the retina or choroid. Retinal detachment occurs in up to 5 percent of eye contusion cases.
• Uveitis: Uveitis is inflammation of the uvea, the middle layer of the eye. It may result from the immune system fighting an infection or mistakenly attacking healthy eye tissue. If untreated, it can damage eye structures and cause permanent vision loss.
• Intraocular tumors: One example is lymphoma. This is a rare cause of floaters.

3. Environmental Factors

Certain eye procedures like posterior capsulotomy, a laser procedure sometimes needed to clean the posterior capsule after cataract surgery, may result in floaters as a side effect.

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Foreign objects in the eye can sometimes cause floaters, but the floaters typically accompany other symptoms, like eye pain.

Vaccination has also been associated with floaters. Many different types of ocular adverse effects have been reported after COVID-19 vaccination, including floaters. The vaccines implicated include AstraZeneca, Pfizer-BioNTech, and Sinopharm BBIBP-CorV vaccines.

Who Is at Risk of Developing Floaters?

Floaters seem to affect men and women equally. Aside from the factors mentioned above, the following risk factors make one more likely to experience floaters:

• Age: As people age, the vitreous humor may contract and detach from the retina. This change typically occurs between ages 50 and 75, although the timing can vary.
• Nearsightedness: Highly nearsighted individuals are more likely to develop floaters at a younger age and face an increased risk of retinal tears or detachment. As nearsighted people have longer-than-average eyes, the vitreous humor must fill a larger space. This makes it more likely for someone to develop strands and a liquid consistency earlier than someone with shorter eyes (more farsighted).

How Are Floaters Diagnosed?

Identifying floaters early can help prevent vision loss or blindness. Individuals exhibiting signs or symptoms of floaters should undergo evaluation by an ophthalmologist.

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The eye doctor will ask the patient to describe their floaters, including when symptoms began, their characteristics (such as shape, movement, or recurrence), and whether they occur in one or both eyes. They will also inquire about the presence of flashing lights, vision loss, eye injuries, surgeries, or other symptoms, including blurred vision, eye redness, pain, or headaches. Additionally, the doctor will ask if the patient is nearsighted or has conditions such as diabetes or immune system disorders that may affect vision. Family medical history that may include retinal detachment is also discussed.

Eye Exam

The dilated eye examination is a crucial component of the physical examination. To perform a dilated eye exam, the doctor will apply eye drops to dilate (widen) the patient’s pupils, making examining the inside of the eyes easier. The exam includes the following:

• Visual acuity test: This measures clarity of vision by asking the patient to read letters from various distances.
• Visual field test: This test assesses peripheral vision by testing how well the patient detects objects to the side without eye movement.
• Eye muscle function test: This checks the muscles around the eyes by having the patient follow a moving object with their gaze.
• Pupil response test: This test examines the pupil’s reaction to light using a flashlight to observe how light enters the eyes.
• Tonometry test: This painless test measures eye pressure with a puff of air or a gentle touch using a specialized tool.

After a dilated eye exam, the patient’s vision may be blurry, and there may be increased sensitivity to light for a few hours.

Other Tests

Depending on the suspected cause of floaters, additional tests may be necessary. For instance, the following may be performed:

• Slit lamp exam: To check for serious issues such as a retinal tear, doctors use a slit lamp and other tools to examine the eye.
• Eyelid pressing: If retinal tears or other serious conditions are suspected during a floater diagnosis, the doctor may gently press on the eyelids to better examine the retina and identify any underlying issues.
• Microbiological testing: Patients suspected of having chorioretinitis may need microbiologic testing to identify the specific infection or microorganism causing the inflammation in the eye.
• Ultrasonography: If the doctor can’t see the back of the eye due to floaters or bleeding, he or she may use ultrasound to check for a retinal detachment and to better understand the condition of the vitreous.

What Are the Possible Complications of Floaters?

Most floaters do not cause other diseases or conditions. However, some of the underlying causes of floaters, such as inflammation and retinal detachment, may lead to vision problems or even permanent vision loss.

What Are the Treatments for Floaters?

Most eye floaters become less noticeable over time as the vitreous humor naturally liquefies and separates from the retina with age. As time passes, the brain may adjust to the floaters and stop drawing attention to their presence. Therefore, idiopathic vitreous floaters usually do not require treatment when underlying disorders causing symptoms are addressed accordingly.

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Treatments for floaters may include:

• Vitrectomy: This surgical procedure treats severe cases of floaters that significantly impair vision. During the operation, the doctor makes a tiny incision in the eye to remove the vitreous humor and potentially replace it with a clear fluid (such as saline) or gas. While the procedure can reduce floaters, it may not remove all of them and is typically only recommended in exceptional cases due to risks. Potential complications include bleeding, cataracts, retinal tears, and retinal detachment. Most doctors consider it too risky for a minor issue such as floaters.
• Vitreolysis: Vitreolysis is a type of noninvasive yttrium-aluminum-garnet (YAG) laser treatment specifically designed to treat eye floaters. It uses quick pulses of laser light applied through a contact lens to break up or shrink floaters by converting their collagen into gas. This can make the floaters less noticeable or eliminate them. The procedure usually takes 20 to 60 minutes, and most people require two or three sessions for optimal results. Vitreolysis carries risks and is typically reserved for cases where floaters significantly affect vision.
• Femtosecond laser: A femtosecond laser is an advanced infrared laser that works similarly to a YAG laser and is commonly used in LASIK. It uses precise, ultra-fast bursts of energy to break apart floaters. Research into the use of femtosecond lasers is ongoing, as this technique may offer a safer alternative to YAG laser treatment.
• Atropine eye drops: Atropine eye drops, which mildly dilate the pupil, can help reduce the visibility of floaters but may also cause blurred vision.
• Laser photocoagulation: Laser photocoagulation is commonly used to treat retinal tears. During the treatment, the doctor applies numbing medicine to the eye and uses a laser to make minor burns around the tear or hole in the retina. These burns create scar tissue that seals the tear, prevents it from worsening, and helps keep the retina in place.
• Freezing therapy: Cryopexy, or freeze treatment, is another method for treating retinal tears. The doctor applies numbing medicine and uses a freezing probe on the sclera (the white part of the eye) near the tear. The freezing creates a scar around the tear, sealing it and keeping the retina in place.
• Antimicrobial medications: Doctors may prescribe antimicrobial drugs to treat infections that cause inflammation in the vitreous.
• Eye movements: If a floater appears in the line of vision, moving the eyes around can help shift it out of the way by causing the vitreous humor to swirl. Looking up and down may be more effective than side to side in creating currents that move the floater away from the visual field.

How Does Mindset Affect Floaters?

Although it doesn’t directly affect the physical presence of floaters, mindset can significantly influence how individuals perceive and cope with them. Those with heightened anxiety or negative mindset may be more likely to notice floaters and perceive them as more bothersome since stress and worry can increase sensitivity to visual disturbances, making floaters appear more prominent. Conversely, a calm and focused mindset may help people pay less attention to floaters, reducing their perceived intensity.

A positive or adaptable mindset can also play a key role in coping with floaters. People who embrace acceptance and resilience are more likely to adapt to the presence of floaters. Mental strategies such as mindfulness, meditation, and relaxation techniques can reduce stress and anxiety associated with floaters, enhancing overall well-being and helping individuals manage the condition better.

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In terms of treatment and recovery, mindset can influence motivation. Those with a proactive, positive outlook are more likely to seek medical advice and pursue treatment options such as supplements or procedures. On the other hand, a pessimistic mindset may reduce the drive to explore helpful treatments or lifestyle changes, potentially prolonging the emotional discomfort associated with floaters.

What Are the Natural Approaches to Floaters?

The following natural methods may help alleviate floaters. However, consulting your eye doctor before trying any of them is advised.

1. Supplements

• Micronutrient supplement: A 2021 clinical trial involving 61 patients with symptomatic eye floaters evaluated the effects of a daily active supplement of antioxidative and anti-glycation micronutrients (125 milligrams L-lysine, 40 milligrams vitamin C, 26.3 milligrams Vitis vinifera extract, 5 milligrams zinc, and 100 milligrams Citrus aurantium) versus placebo over six months. Compared to the control group, the group that took the supplements had significantly less visual discomfort and improved visual function and related quality of life.
• Mixed fruit enzyme supplement: A 2022 clinical trial involving 224 patients with ocular floaters or vitreous hemorrhage-induced floaters assessed the effects of mixed fruit enzyme (MFE) supplementation. Some participants received a high-dose MFE supplement (190 milligrams bromelain, 95 milligrams papain, and 95 milligrams ficin) daily for three months. These fruit enzymes were extracted from pineapples, papayas, and figs, respectively. The results demonstrated that MFE supplementation significantly reduced vitreous opacities, including those caused by intraocular hemorrhage. Additionally, supplementation with MFEs improved corrected distance visual acuity and yielded high patient satisfaction, highlighting its effectiveness for managing floaters and related visual impairments.

2. Herbal Teas and Soup

Traditional Chinese medicine (TCM) has been used for thousands of years to treat various illnesses. In TCM, chrysanthemum tea, goji berries, and mulberry leaves are commonly used for eye care. Goji berries are one of the highest sources of zeaxanthin and lutein, carotenoids essential for eye health. While research on these remedies’ abilities to treat eye floaters specifically is lacking, many TCM practitioners recommend them for general eye health.

According to Taiwan-based TCM practitioner Yingta Lee, the following herbal teas and soup may help reduce floaters:

• Mulberry black bean soup
• Chrysanthemum tea
• “Three flowers” chrysanthemum tea

To learn more about how these remedies work, please consult a certified TCM practitioner.

3. Acupoint Massage

According to TCM practitioners, massaging specific acupoints may help improve eye floaters. However, it is essential first to undergo an ophthalmological examination, as massage is not recommended for individuals with retinal holes or detachments. Please do not perform acupoint massage without first consulting an eye doctor.

According to Lee, to massage around the eyes, lie down, close the eyes, and use the index finger to press and rotate the Cuanzhu acupoint (above the brow) 50 times. Then, massage the outer corners of the eyes inward and outward 50 times each. Follow this by massaging the eyeballs with the index and middle fingers in circular inward and outward motions 50 times each.

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The Cuanzhu acupoint. The Epoch Times

Targeting the Jingming acupoint (near the inner corner of the eye) may also be beneficial. Press it firmly nine times and then massage it inward in the direction of the nose another nine times. Repeat this two to three times daily.

Additionally, massaging the Fengchi acupoint at the back of the head may also help. This acupoint is located below the occipital bone in the depression next to the prominent neck tendon. Use your thumbs to press and massage the Fengchi acupoint firmly 50 times, keeping your fingers raised above your head (like you’re making bunny ears).

The Jingming and Fengchi acupoints. The Epoch Times

While research is lacking on whether these practices have an effect on floaters, TCM suggests applying these techniques regularly may reduce floaters by manipulating the body’s meridians, or energy channels.

How Can I Prevent Floaters?

Floaters cannot be prevented, as they are usually due to the normal aging process. Nevertheless, you can detect them early by getting a dilated eye exam every one to two years. Following a healthy lifestyle by eating a nutritiously balanced diet, getting regular exercise, avoiding smoking, and sleeping seven to eight hours every night may reduce your chances of developing floaters or slowing their onset.

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Also, consider getting a sufficient supply of the following nutrients, as they may protect against floaters by supporting general eye health:

• Vitamin C: Vitamin C plays a crucial role in protecting the vitreous by neutralizing reactive oxygen species, thus preventing oxidative damage.
• Lutein: Lutein is an essential nutrient for eye health, offering protection against the development of nearsightedness.
• Vitamin A: Vitamin A supports eye health, and its primary source, beta-carotene, acts as a precursor that the body converts into vitamin A.
• Vitamin E: Vitamin E is also a powerful antioxidant that helps protect eyes from damage caused by free radicals. Not getting enough vitamin E can lead to retinopathy, which affects the retina and can affect vision.
• Selenium and iodine: Selenium and iodine are trace elements in the vitreous and have antioxidant properties. Selenium supports antioxidant proteins, while iodine acts as a standalone antioxidant. Both help prevent oxidative damage to the vitreous.
• Omega-3 fatty acids: These are essential for eye health, contributing to cell membrane structure and supporting visual function. Their anti-inflammatory properties help relieve dry eye symptoms and lower the risk of age-related macular degeneration and glaucoma.