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Even men need to be aware of eye shadow

October 2012

Even men need to know about eye shadows!

Floaters in the eyeOur eyes are so precious and anything that interferes with our vision needs to be taken seriously.

Hopefully anyone who suddenly suffers from a dark shadow in their field of vision will think detached retina and seek urgent medical help.

However, there are less dramatic shadows and spots that can come into view that may also need investigating.

Floaters are small shapes that some of us can see wandering across our field of vision. They can appear as tiny shadowy dots, or long narrow threads or even as fragmented cobwebs, and can be definite or just noticeable as a vague shadow. As you move your eyes, the floaters usually move too, and they can move even when you are staring straight ahead, floating gently across your field of vision in any direction. There is also a tendency for floaters to sink downwards when you keep your eyes still.

The floaters are usually caused by tiny structures of proteins or other cell debris that have somehow become entangled in the vitreous jelly of the eye. When we are born, the vitreous is perfectly transparent but as we age, various imperfections and damage can occur.

They can also occur more in people with short sight, and after eye operations such as cataract removal.

Some floaters are so minor that you only rarely spot them; the brain can actually get used to having floaters within its vision and adapt accordingly, making them less intrusive. At the other end of the scale floaters can become a very annoying problem and affect vision. However, they don’t cause pain, will not harm the eye and generally do not indicate a serious change in your eyesight.

However, if floaters occur suddenly, or become more significant or intrusive, then they could be indicating a PVD, or a posterior vitreous detachment. This is more common than a retinal detachment and can be due to ageing. As we get older, the structures within our eyes change and this includes a change in the vitreous jelly. Initially our vitreous is made up mainly of water and collagen and is, as in its name, like a jelly. However, as we age this jelly can become more watery and begins to flow more readily and lose its shape. As a result, it stops clinging so tightly to the retina at the back of the eye and this change can be indicated by floaters that move more freely in its more liquefied state.

However, if you suddenly develop floaters along with perhaps the occasional flash of light in your sight, this can indicate that the vitreous is pulling at the retina as it moves away. The retina reacts to the tug by sending a small electrical charge to the brain which results in a short, small flash of light.

The problem here is that it can be difficult to know if floaters and flashes are being caused by PVD or a sign of a tear in the retina and urgent specialist examination is needed - in the case of a torn retina time is crucial so that treatment can be given as quickly as possible to save vision.

If the problems are being caused by PVD, then it unlikely you will be offered any treatment. Occasionally laser treatment has been suggested for floaters but this is not recognised as a standard treatment and some results have indicated that this only partially helps reduce floaters in only a third of cases. There is also a surgical procedure known as a vitrectomy which removes the vitreous jelly but this is a major operation with understandable risks, so again is not a normally offered treatment.

Some people do find floaters difficult to live with as they can get in the way of some activities such as reading. There are various techniques that can be followed to help. For instance, gently moving your eyes around in a circular motion will create currents in the vitreous in the eyes which can help to move large floaters away from the direct field of vision.

The good news is that normal day to day activities or even extreme sports do not make PVD any worse and there is no need to avoid heavy lifting for example.

As always, with any concern about your eyes, seek an appointment with a qualified ophthalmologist as quickly as possible.

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