Eye Floaters: Is it Simple Aging or a Warning Sign of Retinal Detachment?

Many people feel anxious when they experience symptoms such as flies, black dots, or thread-like objects floating in front of their eyes. These symptoms are commonly called 'eye floaters' and frequently appear in middle-aged and elderly people, but it is more important than anything to distinguish whether it is a simple aging phenomenon or a precursor to retinal diseases that threaten vision.

According to a video from Uihak Channel Biondwi, eye floaters are closer to a 'symptom' indicating the condition inside the eye rather than being a disease in themselves. The discomfort felt subjectively by a patient is a 'symptom,' while things like vitreous opacity or bleeding that a doctor confirms through examination can be distinguished as 'signs.' Eye floaters appear as changes occur in the 'vitreous,' the jelly-like substance that fills the inside of the eye. Jang In-beom, director of Seoul On Eye Clinic, advises that if eye floaters appear due to physiological aging rather than a pathological problem, it is important to steady one's mind and adapt rather than worrying too much about it.

Physiological Eye Floaters due to Vitreous Aging and 'Posterior Vitreous Detachment'

The inner space of our eye is filled with a substance called the vitreous. When young, the vitreous maintains a firm volume and stays attached to the retina, but as one ages, water content decreases, and the vitreous undergoes liquefaction or shrinkage. This is called 'vitreous degeneration,' and the process where the vitreous detaches from the retina is called 'posterior vitreous detachment.'

Statistically, about 80% of the causes of eye floaters are physiological changes caused by this posterior vitreous detachment. The traces created as the vitreous shrinks appear as black dots or worm-like shapes in front of the eyes. In particular, people with severe myopia have longer axial lengths of the eyeball, so posterior vitreous detachment can occur even at a young age. Most of these physiological floaters can persist for a lifetime, but over time, many cases involve the vitreous debris moving away from the center of the field of vision or the brain adapting to the symptoms so that they are no longer felt. The video explains that if a patient tries too hard to focus on a specific spot, the symptoms may actually be felt more clearly, so if it is not a pathological problem, staying comfortable is helpful.

Retinal Hole and Retinal Detachment: Emergency Situations Requiring Immediate Treatment

Unlike simple aging, cases requiring caution occur when physical damage happens to the retina. The retina is a thin neural layer that acts like the film of a camera, and in the process of the vitreous separating from the retina, it can pull on weak parts of the retina and create a hole. This is called a 'retinal hole.' 'Lattice degeneration,' a degenerative area of the retina, is a part where the color looks different in the periphery of the retina, and this is a vulnerable spot where retinal holes easily form.

If a hole occurs in a state of 'lattice degeneration' and the vitreous penetrates under the retina through this hole, it leads to 'retinal detachment,' where the retina lifts off like wallpaper. The video explains that if retinal detachment occurs, symptoms such as part of the field of vision appearing as if covered by a curtain or a sudden, rapid increase in floating objects may appear. Additionally, 'photopsia,' a feeling of flashing lights even when there is no light, may accompany it. Photopsia is one of the symptoms that can appear as a type of eye floater. Since these symptoms signify serious damage to the retina, one should not wait for a broadcast and must receive immediate ophthalmic treatment.

Laser Treatment and Preventive Measures to Prevent Retinal Damage

If a retinal hole, where a hole forms in the retina, is discovered, there is a high risk of it progressing to retinal detachment if left untreated. To prevent this, treatment using 'argon laser' can be performed. Laser treatment works by irradiating the area around the hole to hold the retina in place so it does not detach again. According to the video, it is known that laser treatment can prevent the progression of retinal detachment or holes by more than 90%. Laser treatment is performed on a preventive basis to strengthen the cohesion of the retina before a hole is fully formed.

In conclusion, when eye floaters appear, if they are physiological changes due to simple aging, a process of staying calm and adapting is required. However, if vision obscuration, rapid worsening of symptoms, or flashing lights are accompanied, it is highly likely to be a structural defect of the retina, so the condition of the retina must be checked through a fundus examination. In particular, in the case of vitrectomy, it is necessary to understand that it is not simply sucking out the vitreous, but a process of breaking down and removing the sticky vitreous into small pieces.