Vitreous Degeneration and Floaters: Your Questions Answered - Ophthalmology

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Questions related to vitreous degeneration and floaters?


Hello, Doctor.
I am 19 years old, with my right eye having a myopia of -4.50 and my left eye -1.50.
I currently wear daily disposable contact lenses and glasses at home.
Last month, after staying up late and using my phone extensively without my glasses, I developed floaters.
The floaters appear in various forms, including many bubbles, irregular elongated shapes, nearly transparent black shadows, and large clumps resembling a beehive.
I have already visited a nearby clinic for a fundus examination, and the doctor confirmed that my retina is normal with no tears, prescribing some eye care medications and drops for me to take at home.
I have a few questions for you:
1.
Recently, I have noticed a wavy distortion when looking at the sky while riding a bike, driving, or even walking.
Does this indicate that my vitreous degeneration is worsening?
2.
How can I differentiate between physiological and degenerative floaters? Do both types occur, and which one do I belong to?
3.
Will the number of floaters increase in the short term?
4.
What is the relationship between intraocular pressure and eye strain?
5.
Does vitreous degeneration (floaters) affect the macula?
6.
In this situation, can I continue to engage in my favorite sports (swimming, badminton)?
7.
Could wearing contact lenses lead to excessive eye fatigue and indirectly worsen my floaters?
I apologize for having so many questions.
Each time I visit the clinic, there isn't enough time for me to ask everything, and this past month has been filled with anxiety due to the floaters, causing me to oscillate between feelings of depression and optimism.
I hope and greatly appreciate your patience in reading and answering my concerns!

Jake, 10~19 year old female. Ask Date: 2023/09/09

Dr. Gao Pilin reply Ophthalmology


Hello: 1.
The appearance of wavy vision may be caused by opacities in the vitreous body or floaters, but it does not necessarily indicate that vitreous degeneration is worsening.
It is recommended that you visit an ophthalmologist for an examination to assess and determine the cause.
2.
The first category is physiological, accounting for 20%, which indicates the presence of impurities in the eye.
Most patients in this category are under 40 years old and see only a few small black dots.
The second category is degenerative, accounting for 75%, which indicates vitreous degeneration leading to separation of the vitreous from the retina.
Most patients in this category are over 40 years old, and the floaters they see may appear as small circles.
The third category is pathological, which accounts for only 5%, but can affect vision and may even lead to blindness.
This type of pathological floaters has various causes, such as vitreous hemorrhage (e.g., diabetes, hypertension, retinal vascular occlusion); retinal tears, retinal detachment; vitreitis, and retinitis.
(The above text is from https://www.eye-clinic.com.tw/floaters.html) You may already belong to the degenerative type, but it is best confirmed by an ophthalmologist.
3.
Changes in floaters in the short term vary from person to person; they typically do not increase rapidly in a short time, but it is still advisable to monitor closely and regularly track your eye condition.
4.
Intraocular pressure is related to excessive eye use, but it does not necessarily lead to floaters.
High intraocular pressure may be associated with glaucoma, while floaters are primarily related to changes in the vitreous body.
5.
Floaters usually do not directly affect the macula.
However, if you are concerned about retinal health, it is recommended to have regular fundus examinations.
6.
Generally, you can continue to engage in your favorite sports, such as swimming and badminton.
Please ensure to protect your eyes during these activities by wearing appropriate goggles to reduce risk.
7.
Wearing contact lenses does not directly cause the worsening of floaters.
The most important thing is to regularly monitor your ophthalmic condition and follow the ophthalmologist's recommendations for treatment and care, which will help maintain your eye health.
If there are significant changes or worsening of symptoms, please seek professional help from an ophthalmologist immediately.
I hope your eye health improves and your worries decrease.

Reply Date: 2023/09/09

More Info


Understanding vitreous degeneration and floaters, especially at a young age, can be concerning. Let’s address your questions one by one, providing clarity on the nature of floaters, their implications, and how they relate to your overall eye health.

1. Wavy Vision: The appearance of wavy lines or distortions in your vision, especially when looking at the sky or bright backgrounds, can be a sign of changes in the vitreous gel within your eye. This phenomenon, known as visual distortion, may not necessarily indicate that your vitreous degeneration is worsening, but it is important to monitor these symptoms. If you experience persistent or worsening distortions, it’s advisable to consult an eye care professional for further evaluation.

2. Physiological vs. Degenerative Floaters: Physiological floaters are typically benign and occur as a natural part of the aging process of the vitreous. Degenerative floaters, on the other hand, may be associated with more significant changes in the vitreous, such as detachment or other pathological conditions. Given your age and the recent onset of symptoms, it’s likely that you are experiencing physiological floaters, but only a thorough examination by an ophthalmologist can provide a definitive diagnosis.

3. Increase in Floaters: It is common for floaters to become more noticeable, especially after prolonged periods of eye strain or changes in visual habits, such as excessive screen time. However, new floaters can also develop as the vitreous continues to change. If you notice a sudden increase in floaters, especially if accompanied by flashes of light or a shadow in your peripheral vision, seek immediate medical attention, as these could be signs of retinal detachment.

4. Eye Pressure and Overuse: Eye pressure can be influenced by various factors, including prolonged screen time, which can lead to digital eye strain. While this strain itself may not directly cause an increase in floaters, it can exacerbate your awareness of them. Maintaining good eye hygiene, taking regular breaks, and ensuring proper lighting can help mitigate eye strain.

5. Impact on the Macula: Vitreous degeneration and the presence of floaters generally do not directly affect the macula, which is responsible for central vision. However, if there are significant changes in the vitreous, such as a posterior vitreous detachment, there could be a risk of macular complications. Regular eye exams are crucial to monitor any potential changes.

6. Engaging in Sports: You can continue to participate in activities like swimming and badminton, but it’s essential to be cautious. If you experience any discomfort or visual disturbances during these activities, it’s best to stop and consult with your eye doctor. Staying hydrated and ensuring your eyes are well-rested can help.

7. Contact Lenses and Eye Fatigue: Wearing contact lenses, especially for extended periods, can contribute to eye fatigue, particularly if your eyes are already strained from screen time. Ensure that you follow proper hygiene practices with your lenses and consider giving your eyes a break by alternating with glasses, especially if you notice increased fatigue or discomfort.

In conclusion, while floaters and visual distortions can be alarming, they are often benign, especially in younger individuals. However, it’s crucial to maintain regular check-ups with your eye care provider to monitor your condition and ensure that any changes are addressed promptly. If you find that your symptoms are affecting your daily life or mental well-being, don’t hesitate to reach out for support, both from medical professionals and mental health resources. Your eye health is important, and taking proactive steps can help you manage your symptoms effectively.

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