A: Floaters are little clumps of gel or cells floating through the thick transparent gel of the eyeball. They can appear as specks, strands, webs or other shapes, and may momentarily be confused with dust or tiny insects flying across the eye. Strictly speaking, what we are seeing are the shadows of these irregularities in the vitreous fluid that separates the lens and retina. This gel-like fluid maintains the eye’s shape, aids the transmission of light to the retina, absorbs shock and holds the retina in place.
Over the years, the vitreous fluid inevitably thickens, dries and shrinks, which is why floaters are more commonly seen in people over 40. If their onset is gradual, they are very likely harmless and require no treatment.
However, if there is a sudden appearance of multiple floaters, this may be a sign of posterior vitreous detachment (PVD), the separation of vitreous fluid away from the retina. By age 70, PVD has usually already taken place gradually. However, floaters as well as PVD occur more often – and earlier – in shortsighted people like yourself, in diabetics and in those who have undergone cataract surgery, or laser surgery for the eye or skin, and as a result of trauma (Graefes Arch Clin Exp Ophthalmol, 2005; 26 July: 1-5; Am Fam Physician, 2004; 69: 1691-8; Dermatol Surg, 2002; 28: 1088-91).
In addition, in about 25 per cent of cases, floaters indicate a sight-threatening condition such as tears or detachment of the retina, which is when any part of the retina gets pulled away from the back wall of the eye. If left untreated for several days, permanent vision loss or blindness will result.
So, if your floaters appeared suddenly and are accompanied by light flashes or loss of peripheral vision, it may be prudent to visit an eyecare specialist immediately. Posterior uveitis (chronic eye inflammation brought about by infectious disease or an autoimmune disorder) can also be sight-threatening. But, unlike PVD, posterior uveitis is associated with a gradual blurring of vision.
A surgical procedure called a ‘vitrectomy’ can remove floaters, but this should only be done if your vision is severely limited and any other possible causes – of which there are many – are ruled out. Indeed, the most common complication of vitrectomy is cataract, so you may well be trading a small problem for a more serious one (Br J Ophthalmol, 2001; 85: 546-8; Am J Ophthalmol, 1988; 105: 160-4).
Floaters have also been linked to candidiasis, an overgrowth of the yeast-like fungus Candida albicans, and may simply be a symptom of this system-wide problem (Postgrad Med J, 2001; 77: 119-20). Candidiasis can be controlled by eliminating sugar and yeast from the diet, which is certainly a safer and simpler solution than surgery.
According to traditional Chinese medicine (TCM), floaters are the result of a poor blood circulation that fails to nourish the optic nerve and surrounding muscles of the eye. In TCM terms, the cause of this weak circulation is congestion of the liver, kidneys and colon, so herbs that support these organs can improve vision, strengthen the retina and blood vessels, and keep the vitreous fluid free of debris. Although scientific studies are lacking, the anecdotal evidence points to the fruit of Lycium barbarum – or Chinese wolfberry (gou qi zi), a member of the nightshade family – as a popular TCM remedy that can nourish and support the liver and kidney, and treat a slew of eye problems (including floaters, excessive tearing and cloudy vision) while helping to prevent serious eye diseases.
While there is no proven or universal cure for floaters, the nature of the condition suggests that lifestyle changes, and a programme of supplements and herbs to feed, stimulate and hydrate the vitreous fluid, may well improve the condition. For example, the anthocyanosides (flavonoid compounds) found in bilberry (Vaccinium myrtillus) have been shown to improve circulation in the blood vessels of the eye, maintain the integrity of capillaries, stabilise collagen, and correct the signs of retinal damage (Biochem Pharmacol, 1983; 32: 53-8; Angiologica, 1972; 9: 355-74; Minerva Med, 1977; 68: 3565-81).
Ginkgo biloba, too, improves eye circulation by preventing clotting of blood platelets and causing blood vessels to dilate. Ginkgo works in synergy with bilberry, so taking this herbal combination is an excellent choice for improving overall eye health. In one German study, taking Ginkgo as a hard candy (160 mg/day for four weeks, then 120 mg/day) resulted in improved eyesight in patients with severe degenerative circulatory disturbances, visual-field defects and retinal problems (Klin Monatsbl Augenheilkd, 1980; 177: 577-83).
Finally, whereas most floaters are found in the vitreous fluid, it is important not to overlook another, simpler cause of the problem. You could be suffering from debris in the tear film. Many people, especially those prone to allergies, blepharitis (eyelid inflammation) or styes can accumulate makeup, mucus and other material within their tears. Floaters due to tear-film debris move when you blink, whereas vitreous floaters respond more to eye movements than to blinking.