Q: My mother complains of suddenly seeing large dark “cobwebs” in one of her eyes. Is this something serious?

A: Sudden changes in vision, including “floaters”, can be serious and should absolutely be examined by dilation as soon as possible. This is especially true if the floaters are accompanied by the appearance of “flashing lights”. There is a normal aging change called “posterior vitreous detachment” (PVD) which normally resolves over a period of weeks to months. This consists of sudden floaters in one eye, often with episodes of flashing lights similar to sparklers. While PVD usually resolves without future problems, it occasionally results in a very serious retinal detachment that can cause blindness. How do you tell the difference? You can’t. It takes a very thorough, dilated eye examination to be certain.

If you have a sudden onset of floaters, see an eye doctor as soon as possible.

Q: I have a persistent “floater” in my eye that is very irritating. Is there a treatment for floaters or does laser surgery cure it?

A: Floaters are strands of material normally found inside the eye but which have moved into an abnormal position and interfere with vision. They frequently look like a dark spot or glob, often with a “tail”. Floaters are often present to a mild degree throughout life, but as we age we are more prone to have a sudden onset of dark floaters known as a “posterior vitreous detachment” or PVD. This condition usually subsides on its own, but in a small number of cases the floaters become persistent or even cause a tear in the retina. Because retinal tears are so serious, you should always contact your eye doctor when you first notice a PVD. This is especially true if it is accompanied by what appears to be flashing lights. The good news is that for most patients the condition resolves on its own. The bad news is that for persistent floaters there is no good treatment, including laser surgery. The only way to eliminate the floater is to surgically remove all the contents of the inside of the eye and let the natural fluid rebuild without the strands. This surgery is called a vitrectomy, and is very risky. It is used by retinal specialists to repair bleeding into the eye by diseases such as diabetes, but not for floaters.

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