Why do I see floating black dots

The vision of floating black spots or floaters is relatively common in the population. Our specialist in Ophthalmology, Dr. Pedro Amat, explains how they affect the elderly. It is due to the fact that the eye is filled with a transparent gel (vitreous gel) that allows it to maintain its spherical shape and thus the correct physical properties for vision. This gel is composed of collagen fibers and contains phagocytic cells that help remove debris in order to maintain the transparency of this cavity. If the debris passes through the visual axis we see the floaters and the medical term used to name them is myodesopsias.

Normally the vision of hoverflies is variable. They can be perceived more on light and bright backgrounds, white walls or blue skies; moreover, it is accentuated with age. The sensations they produce do not affect all patients equally, they are perceived individually and subjectively.

But there are cases in which urgent attention should be sought, for example, if floaters increase or appear suddenly. These symptoms may be associated with retinal breaks, with or without detachment, which, if not treated in time, may lead to irreversible loss of vision.

Causes of floaters

We have already seen that floaters can appear with the passage of time simply due to the natural processes that occur in the eye. They are age-related eye changes that affect the quality of vision.

But there are other ways of appearance, when we suddenly observe flies in the form of a circle floating in the field of vision, this is usually due to the vitreous gel detaching from the back of the retina and adopting annular shapes. Although generally unimportant, they should be seen by the ophthalmologist. This phenomenon is called posterior vitreous detachment.

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Uveitis, an ocular pathology consisting of inflammation of one or more internal parts of the eye, can also trigger the appearance of floaters, especially when the uveitis appears in the posterior part of the eye, as the inflammatory cells floating in the transparent vitreous produce this effect.

The vitreous gel is attached in some areas to the retina. Sometimes this bonding is too strong and can cause the retina to tear on certain occasions, resulting in a tear. Normally the patient who is suffering from this process will suddenly present the vision of flying flies and the vision of lights. If it is not treated in a short period of time by means of laser application, it may lead to the appearance of retinal detachment, a much more serious pathology that requires surgery by means of vitrectomy.

Diabetic patients who have had the disease for many years generally present diabetic retinopathy. When it is advanced, bleeding into the vitreous cavity may be favored. If the hemorrhage is mild, floaters will be seen. Such bleeding may also occur when the retina breaks.

The main risk factors are age, myopia, ocular trauma and even cataract surgery or diabetic retinopathy among others.

Treatment for floaters

It is important to consult a specialist in Ophthalmology in order to rule out serious diseases that should be treated.

If there is no serious disease, this pathology does not require specific treatment, except in cases where myodesopsia vision affects the quality of life of patients. In these cases, vitrectomy, which consists of replacing the vitreous humor of the eye with a solution prepared to maintain the consistency of the eye, may be considered. It is generally reserved for extreme cases of complete intolerance to the sight of these floating spots. Although thanks to technological advances and increased specialization, vitrectomy is very safe, it must always be understood that zero risk does not exist, therefore, it is recommended that the patient understands the options and alternatives very well.

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The main objective is not to eliminate myodesopsias, the important thing is to rule out serious pathologies that cause them and to carry out an adequate treatment in each case, always by a professional and according to the characteristics of each eye.