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Medical Author:

John D. Sheppard, MD, MMSc

Coauthor:

David M. Salib, MD

Medical Editor:

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.

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Patients may describe a wide variety of symptoms, including spiders or insects darting across their vision, cobwebs, dirt on the windshield, spots, strands, black spots in their vision, squiggly lines, and of course floaters. There is a wide variety of presentations. Floaters are generally more noticeable to patients in bright lighting conditions such as outdoor activity or brightly illuminated computer screens, binoculars, or microscopes. This is because the bright illumination increases the contrast between the darkness of the floater and the surrounding light, making the floaters more apparent. Floaters generally jiggle or move when the eye moves. This is because the vitreous gel is a dynamic structure and compresses slightly with eye movements. Thus, when the patient looks to the right for example, the floater may first dart to the right and then re-center as the vitreous gel returns to its normal resting position.

Patients with other conditions causing some loss of vision, such as cataract or macular degeneration, may not notice their floaters as much. Some patients with large or numerous floaters upon examination may have few complaints and minimize their symptoms. One fascinating condition known as asteroid hyalosis is characterized by dozens or even hundreds of small yellowish floaters throughout the vitreous cavity in one or both eyes. Patients with asteroid hyalosis are often remarkably unaware or unperturbed by their vitreous opacities. Other patients with demanding jobs or hobbies, such as professional truck drivers or outdoor athletes, may have more complaints and the presence of floaters may have a more profound impact upon their daily living.

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