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Steps to take if you notice a floater in your eye

If you have a floater in your vision that you have never seen before and it is constantly there with a flashing light, you should seek an urgent ophthalmic assessment and opinion. The reason being is that your floater could represent a tiny bit of the retina which has come adrift leaving a small hole behind under which fluid may enter and lift off the retina causing a retinal detachment.
Some people are more prone to the development of floater and retinal detachment than others. If you have had trauma to your eye, you are highly short-sighted (myopic), or you have had a previous history of floaters, there is a small chance that your floater may be a more serious, and not just degeneration in the vitreous gel. We are all familiar with the occasional cobweb that we see a few days a year on a bright sunny day. This is usually a posterior vitreous detachment where the gel filling the eye is degenerating naturally. If there is a sudden new floater, shower of floaters or flashing lights, this may indicate that there is a retinal problem.
You can call for Urgent eye care at Clinica London on 0207 935 7990 if you have a floater, and we will make arrangements to see you within a short period to check that your floater is innocent and does not represent a more serious problem.
At the consultation, the nurse will first take a basic history about your eye symptoms, your general medical health, and ask whether you have had any previous eye surgery or eye trauma. She will check your vision and measure the strength of your glasses, so she knows whether you are short sighted (myopic), long sighted (hypermetropic) or have no need for glasses. She will dilate your pupils and take you through and see the consultant specialist.
The consultant specialist will go over the history with you, ask a few more pertinent questions and then examine the eyes. The examination will involve first of all you sitting at the slit lamp, measuring intraocular pressure, and an examination of the anterior chamber lens, the vitreous and retina.
If a retinal tear has gone through a very small retinal blood vessel, this releases red blood cells into the vitreous which are seen as a shower of floaters. These can be recognised on the slip lamp examination by the ophthalmologist looking at the anterior vitreous behind the lens to see whether there is any tell-tale sign of the blood which is often described as looking like “tobacco dust”. They will then use a series of special lenses in which they can view your retina binocularly i.e. in three dimensions, both at the posterior part of the retina, meaning the part immediately straight ahead when they look in and looking more peripherally towards the equator and the far edge of the retina.
They will subsequently probably put on a “hatti” which is an indirect ophthalmoscope and then using a large lens with which they can view the back of the eye with a much broader field and look right out at the periphery to see whether there are any retinal tears or even an early retinal detachment. They will look 360 degrees around the retina. They will have looked at the vitreous to see whether there is a posterior vitreous detachment where it has come away from around the optic disc. That type of floater often has a small ring to it called a Vossius ring, where the transparent vitreous gel was attached around the optic disc, and does not cause a retinal detachment. If they find any pathology in the retina, they will advise you what is going to happen next.
In my next blog, I need to talk a little bit more about urgent problems with the retina.


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