Five days ago, 58-year-old Ms. Luo from Wuhan noticed small dark shadows drifting before her eyes, as if tiny mosquitoes were flying around. She went to the hospital for an examination and was diagnosed with floaters. The attending physician informed her that floaters are quite common and not a serious issue, advising only observation and follow-up visits before sending her home.After resting at home for four days, the "mosquitoes" in Ms. Luo's vision multiplied, even merging into patches at the edges of her field of vision. Her eyesight grew increasingly hazy, as if obscured by dark shadows, causing her growing distress. Noticing her mother's deteriorating vision, Ms. Luo's daughter became deeply concerned and insisted on taking her back to the hospital for further examination.This time, they visited the Retinal Diseases Department at Hanyang Aige Eye Hospital. Examinations revealed a retinal tear in Ms. Luo. The worsening floaters were caused by delayed treatment of vitreous opacities, leading to posterior vitreous detachment and subsequent retinal tearing.Director Peng Zhihua promptly administered laser treatment to reinforce the retina, successfully rescuing Ms. Luo from a potentially life-threatening retinal detachment at its earliest stage.
Before vitreous opacity treatment
The dark shadows are projections of vitreous debris onto the retina
Director Peng Zhihua stated: "Some floaters are merely vitreous cloudiness, while others may signal retinal detachment. Therefore, any floaters should prompt immediate examination and treatment at a specialized ophthalmology hospital."Ms. Luo was fortunate to recognize her eye condition and promptly sought examination at our Hanyang Eye Hospital. Through laser treatment, we successfully halted the progression of her retinal detachment. Had she delayed treatment, it could have advanced to full retinal detachment, requiring vitrectomy surgery to salvage whatever vision remained. The damage to vision caused during retinal detachment is irreversible."
After 3 weeks of vitreous opacity laser + medication (Voldin) treatment
Reduced shadows indicate opacity resolution
So, does all floaters require treatment? Can floaters be prevented? Below is Director Peng Zhihua's science corner—those troubled by floaters should pay close attention!
★ Classification of Floaters
Floaters are categorized into physiological and pathological types.
I. Physiological Floaters: These result from normal "aging" of the vitreous humor. Much like hair turning gray or skin developing wrinkles, this is a natural aging process. However, it progresses relatively slowly. Vitreous liquefaction typically begins around age 4 in healthy individuals. Without additional pathological factors, approximately 50% liquefaction occurs by age 80, so excessive concern is unnecessary.
For mild cases of physiological floaters that do not significantly impair visual quality, oral administration of Volitine tablets is recommended. Symptoms typically improve within several weeks, or patients may no longer perceive dark shadows moving in their field of vision. However, for cases with pronounced dark shadows, larger vitreous opacities, or poor drug absorption, vitreous laser ablation therapy may be employed.The majority of these opacities can be vaporized into water via laser treatment. For residual fine particles that remain after laser vaporization, oral treatment with Volitine tablets is often combined to promote complete absorption of the opacities. This restores the vitreous's optimal refractive state, reduces intraocular aberrations, and enhances visual quality.
Wolitin Lecithin-Iodine Complex Tablets
Wolitin is a natural soy lecithin iodide compound that delivers the benefits of iodine while avoiding the adverse reactions associated with traditional iodine preparations. Oral administration of Wolitin enhances retinal respiration, boosts retinal metabolism, and promotes the absorption of vitreous opacities.
Pathological Floaters: Beyond age-related floaters, floaters caused by ocular diseases—such as retinal tears/detachments, vitreous hemorrhage, or uveitis—are termed pathological floaters.
Types of Floaters by Cause
1. Floaters from Retinal Tears and Detachment
When vitreous liquefaction causes acute posterior detachment, it can pull on the retina and create tears. If liquefied vitreous fluid seeps into these tears, retinal detachment occurs.Therefore, the initial symptom of retinal detachment is a sudden increase in the number of "floaters" in the visual field. If such changes occur, prompt consultation with a specialist in fundus examination at a hospital is essential to avoid delayed treatment and more severe complications.
Generally, retinal tears can be treated with retinal laser therapy combined with oral Wolitin to promote rapid absorption of the opacity. If retinal detachment has already occurred, immediate hospitalization and surgical intervention are required.
Floaters Caused by Vitreous Hemorrhage
Diabetes, hypertension, and trauma can all trigger retinal hemorrhage. When blood enters the vitreous body, it suddenly causes floaters or a sensation of a red curtain unfolding before the eyes. Depending on the volume and location of the hemorrhage, varying degrees of vision loss may occur.In such cases, we often administer Warfarin tablets during the early bleeding phase instead of blood-activating and stasis-resolving medications. This is because the chelated iodine in early-stage Warfarin can rapidly facilitate blood absorption and metabolism. Administering blood-activating and stasis-resolving drugs may exacerbate bleeding and worsen the condition.3. Floaters Caused by Uveitis During uveitis, white blood cells and exudates may leak from blood vessels into the vitreous humor, producing floaters. As inflammation worsens, increased "floating particles" and vision loss may occur.Treatment typically involves managing the underlying uveitis with medication. Concurrently, Wolitin tablets are routinely prescribed. The chelated iodine in Wolitin activates thyroid function while directly penetrating cells to enhance cellular activity. This suppresses inflammatory factors and promotes vitreous metabolism, effectively shortening the disease course and accelerating visual recovery. Floaters Field of Vision★Preventing Floaters
The primary focus is preventing pathological floaters. Avoid excessive eye strain, strenuous exercise, and activities requiring breath-holding. Maintain a balanced diet to prevent hypertension and hyperglycemia. Individuals with high myopia, diabetes, or hypertension should undergo regular fundus examinations. Seek immediate professional ophthalmological care if experiencing sudden increases in floaters or abrupt vision loss.