Eye Floaters and Bright Spots: What You Need to Know

Eye highlights

Hello Doctor, I started noticing transparent floaters in my eyes around the age of 16, but recently I feel that the floaters have increased, and there are also persistent bright spots (similar to floaters but bright white).
Previously, these bright spots would only appear during intense head movements, but now they float around just like the transparent floaters and do not disappear.
I searched online about this issue, and many sources suggest that it could be cataracts, which typically occur in individuals in their 40s or 50s (and at that age, cataracts are considered relatively young).
However, I am only 18 years old.
I have visited an ophthalmologist, but they only mentioned that it is debris falling onto the retina without clearly stating what it is.
I have seen three different doctors, and they all told me to coexist peacefully with it, but this is very distressing for me...

dan, 10~19 year old female. Ask Date: 2011/11/11

Dr. Gao Pilin reply Ophthalmology

Hello, the situation you described is likely floaters, not cataracts.
The bright spots are also a type of floaters.
The causes of floaters can be categorized into three types.
The first type 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 dots in their vision.
The second type is degenerative, making up 75%, which signifies the degeneration of the vitreous body, causing it to separate from the retina.
Patients in this group are typically over 40 years old and usually see only a single floater.
The third type is pathological, which, although it only accounts for 5%, can affect vision and sometimes even lead to blindness.
This type of pathological floaters has various causes, such as vitreous hemorrhage (e.g., from diabetes, hypertension, or retinal vascular occlusion), retinal tears, retinal detachment, vitreitis, and degenerative changes in the vitreous.
We recommend that floaters be examined to identify any of these pathological changes.
If the examination results indicate only physiological or degenerative floaters, they can coexist without issue and do not require treatment.
However, if they are pathological, laser treatment may be necessary, and in more severe cases, surgery may be required.
Therefore, it is best to adapt to them; hopefully, you will get used to them and eventually not notice them!

Reply Date: 2011/11/11

More Info

Hello! Thank you for reaching out with your concerns about eye floaters and bright spots. It's understandable to feel anxious when experiencing changes in your vision, especially at a young age. Let's break down your symptoms and provide some clarity.

Understanding Eye Floaters
Eye floaters are small specks or strands that drift through your field of vision. They are typically caused by changes in the vitreous humor, the gel-like substance that fills the eye. As we age, the vitreous can become more liquid and may pull away from the retina, leading to the perception of floaters. While floaters are common and often harmless, they can be more noticeable against bright backgrounds, such as a clear sky or a white wall.

Bright Spots and Their Implications
The bright white spots you're experiencing could be a form of visual phenomenon known as "photopsia." This can occur due to various reasons, including:
1. Vitreous Detachment: As mentioned, the vitreous can pull away from the retina, leading to floaters and sometimes flashes of light or bright spots.

2. Retinal Issues: Although less common in younger individuals, conditions like retinal tears or detachment can cause similar symptoms. It's crucial to monitor for any sudden changes in vision, such as an increase in floaters or flashes, which would warrant immediate medical attention.

3. Migraine Aura: Some individuals experience visual disturbances, including bright spots or zigzag patterns, as part of a migraine aura, even without a headache.

4. Other Causes: Conditions like inflammation in the eye (uveitis) or even certain neurological issues can lead to visual disturbances.

Age and Eye Conditions
While cataracts are more common in older adults, they can occur in younger individuals, especially if there are risk factors such as a family history, previous eye injuries, or certain medical conditions. However, at 18, it is relatively rare. Your eye care professionals may have ruled this out based on your examinations.

Recommendations
1. Regular Eye Exams: Continue to have regular check-ups with an eye care professional. If your symptoms change or worsen, seek immediate evaluation, especially if you notice a sudden increase in floaters, flashes of light, or any loss of peripheral vision.

2. Document Symptoms: Keep a record of when you notice the bright spots or floaters, any accompanying symptoms, and any activities that seem to trigger them. This information can be helpful for your eye doctor.

3. Lifestyle Adjustments: Ensure you are protecting your eyes from excessive strain. Take regular breaks when using screens, maintain good lighting, and consider wearing sunglasses in bright sunlight.

4. Seek a Second Opinion: If you feel your concerns are not being adequately addressed, it may be beneficial to seek a second opinion from another eye specialist, particularly one who specializes in retinal issues.

Conclusion
While eye floaters and bright spots can be concerning, they are often benign, especially if they have been evaluated by professionals and no serious conditions have been identified. However, staying vigilant about your eye health is essential. If you experience any new symptoms or changes, don’t hesitate to seek further evaluation. Your vision is important, and understanding your symptoms is the first step toward peace of mind.

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