Managing eye floaters and navigating the latest research

Don't let eye floaters get the best of you - discover the latest advancements in managing this condition, from surgical treatments to home remedies.

A few years ago, my mother started to experience eye problems and was later diagnosed with cataracts. However, after undergoing a successful surgery, she started to notice dark spots that appeared like flies or bugs and would come and go. These spots were eye floaters.

In an effort to find if there was anything that could help with the eye floaters, I researched the topic to see what the latest understanding and treatment options were. In this blog post, I will share the information I gathered about eye floaters, including their causes, symptoms, and potential treatments. I will also discuss several studies on non-surgical alternative remedies I have come across. And lastly, my thoughts on what this information means for my mother’s eye conditions.

Causes of eye floaters 

Eye floaters are spots in your field of vision that appear as black or gray specks, strings, or cobwebs. They may drift about as you move your eyes and appear to dart away when you try to look at them directly. Eye floaters are commonly associated with aging, and middle to late-aged adults are more likely to experience them as the vitreous gel in the eye changes and becomes more liquid or shrinks. This change in the vitreous causes small particles to float down through the fluid, creating the appearance of floaters. They eventually settle toward the bottom of your eye, where you won't notice them anymore.

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In addition to aging, other factors that can increase the risk of developing eye floaters include nearsightedness, ocular inflammation, bleeding in the eye, a torn retina, eye injury, eye injections for macular degeneration, or cataract surgery. If you have any of these risk factors, it's important to closely monitor your vision and seek medical attention promptly if you notice any changes.

Eye floater symptoms and when to see a doctor

Eye floater symptoms may include small shapes in your vision appearing as dark specks or transparent strings that move when you move your eyes and are most noticeable when looking at a plain, bright background. These small shapes or strings eventually settle and drift out of the line of vision.

Eye floaters, while commonly harmless, can sometimes indicate more serious underlying eye conditions, such as retinal detachment, retinal tear, or macular degeneration. If you notice an increase in the number of floaters, a sudden appearance of new floaters, flashes of light in one eye, a gray curtain or blurriness that obstructs part of your vision, or darkness in the peripheral vision, it is essential to see an eye specialist right away. These painless symptoms could indicate a retinal tear or detachment, which is a severe and sight-threatening condition that requires immediate medical attention. Do not wait to seek help if you experience any of these symptoms.

Eye floater treatments

Eye floaters are a common condition that can be frustrating and take time to adjust to, but most of the time, they do not require treatment. However, in rare cases, when they get in the way of your vision, you and your eye care specialist may consider treatment options. There are two main treatments for eye floaters: vitrectomy surgery and laser vitreolysis.

Vitrectomy Surgery: This is a surgical procedure to remove the vitreous gel through a small incision and then replace it with a solution that mimics the vitreous to help the eye maintain its shape. The procedure is performed by an ophthalmologist who specializes in retina and vitreous surgery. While this surgery can remove some of the eye floaters, it may not remove all of them and new floaters can still develop after surgery. Additionally, there are several risks associated with this procedure, including infection, bleeding, retinal detachment, retinal tears, and cataracts.

Laser Vitreolysis: This is a minimally invasive procedure that aims to eliminate the visual disturbance caused by eye floaters. An ophthalmologist uses a special laser to break up the floaters, making them less noticeable. The goal of this treatment is to achieve a "functional improvement," allowing you to return to your normal day-to-day activities without the hindrance of floaters. Some people report improved vision after the treatment, while others notice little to no difference. However, there is a risk of damaging the retina if the laser is aimed incorrectly.

In my mother's case, in addition to having eye floaters, she was also diagnosed with macular pucker. If either condition worsens to the point where it significantly affects her vision and daily activities, we would consider vitrectomy surgery to treat both the macular pucker and eye floaters.

Eye floater relief or remedies

During my research, I found some small studies exploring alternative treatments for eye floaters. 

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Pineapple (bromelain): A pilot study published in the American Science journal in 2019 showed that consuming pineapples could reduce the persistence of floaters. The study involved 388 participants, who consumed 100 to 300 g of pineapple daily for three months. Results showed that the percentage decrease of floaters ranged from 30% to 45%, depending on the amount of pineapple consumed. The researchers also suggested that the special chemicals in pineapples, called bromelain, might help break down substances that create tiny fibers or the eye floaters, and get rid of harmful particles called free radicals. 

Bromelain based supplement: Another study published in 2020 involved 280 participants who took a supplement containing bromelain, papain, and ficin. The study found that 70% to 72% of participants reported a reduction in their eye floaters. The authors believed that the supplement works by breaking down the substances that cause floaters and removing harmful particles in the eye, similar to the pineapple study.

L-lysine based supplement: A study published in 2021 looked at the effects of a supplement containing L-lysine, grape seed extract, vitamin C, zinc, and citrus fruit extract on eye floater patients. Out of 61 participants, 77% reported a reduction in their floaters after taking the supplement daily for six months. However, it's worth noting that 29% of the participants in the placebo group also reported improvement. (Note: The authors of the study have a patent on the formula and funded the research.)

Atropine eye drops: During my research, I also came across research indicating that atropine eye drops may help relief symptoms of eye floaters. Atropine is more commonly known as an eye dilution eye drop used during eye exams or treatment to prevent myopia progression in children. For eye floaters, an abstract of a study submitted by Dr. Kaymak from Germany to the European Society of Cataract and Refractive Surgery in 2017 indicated that atropine improved floater symptoms when used in diluted concentrations of 0.01% or 0.005%. However, this study was not published and is no longer available on the society's website. 

Before finishing, it is important to note that the current standard of care for eye floaters is vitrectomy or laser vitreolysis. The alternative treatments discussed were based on small studies and didn’t work for everyone. And the use of atropine for eye floaters relief was not widely studied and not approved by the FDA.

Additionally, nutritional supplements may interact with medications or have potential side effects that may impact your health. Therefore, always consult with your eye care specialist before trying any new remedies or treatments for your eye floaters.

Our plan forward

Macula pucker and eye floaters are conditions that can develop with age. Although my mother experienced some symptoms of eye floaters and was diagnosed with macula pucker, these conditions do not significantly impact her vision or daily life now. As surgery comes with potential risks and complications, we have decided to treat these conditions if they worsen.

However, we will remain proactive and schedule regular check-ups with her eye doctor to monitor both of her conditions. If one of the conditions progresses and starts to significantly affect her vision and daily life, we will consider the surgical option, such as a vitrectomy.

In the meantime, we plan to add pineapple to the grocery list. Despite our skepticism about its potential benefits for eye floaters, it is convenient and one of my father’s favorite fruits. We are also considering supplements and atropine eye drops, but will consult with here eye doctor first.

And if atropine is appropriate, I can imagine a future scenario where my ten-year-old son asks his grandmother if her myopia is worsening too and that they can be myopia control buddies.

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