Vitreous floaters are caused by condensation in the vitreous. As a result, the light entering the eye is absorbed at this point and throws a shadow on the retina, so to speak, which is then perceived as a floaters. As the vitreous body is not completely homogeneous at a young age, floaters can already occur in very young people. Most people have floaters, but they are not perceived or only perceived in certain situations, for example when looking into a homogeneous bright environment (snow field, blue sky). The brain also fades out these phenomena (like the blind spot, which is also not perceived as disturbing). Small floaters occur in the normal aging process. Larger, sometimes highly disturbing occur in the context of vitreous shrinkage (also called syneresis), which usually leads to a posterior vitreous detachment. This leads in part to dense vitreous condensations, which are then perceived as black spots or rings. If these are located in the central visual axis, they can cause considerable discomfort. Since the posterior vitreous detachment occasionally leads to a tear in the retina and thus to a retinal detachment, a retinal examination should be carried out by the ophthalmologist in case of sudden and large new floater(s). Usually these floaters disappear with time. However, this can take months to years. If floater(s) lies in the central visual axis and leads to restrictions in daily life (reading, driving, etc) for more than 6 months and shows no tendency to improve, surgical removal can be discussed. In laser treatment, the condensations are shot up with a laser, but often residual floaters remain and the success rate is far from as high as in vitrectomy. The most efficient method is the so-called vitrectomy, where the vitreous body is removed with the floaters. Although this procedure is associated with relatively few complications, it is not without risk and should therefore only be performed after thorough clarification of the patient's symptoms and information about possible complications. The procedure can be performed under regional anesthesia and takes about 30 minutes.
In most people, a shrinking of the vitreous body (in technical jargon, a "posterior vitreous detachment") occurs with increasing age. In most cases this is without consequences, but it can sometimes lead to a tear in the retina and rarely to a retinal detachment. Therefore a thorough ophthalmoscopy (https://de.wikipedia.org/wiki/Ophthalmoskopie) is advisable in these cases. Untreated, a retinal tear can develop into a retinal detachment. If the retinal tear is detected early, treatment with laser or cold pencil (cryotherapy, for peripheral tears) can prevent a retinal detachment. At the University Clinic for Ophthalmology of the Inselspital, state-of-the-art laser equipment (http://www.ellex.com/physicians/product-portfolio/photocoagulation/integre-pro/overview/) is available to perform this treatment. In the case of larger or peripheral tears, "freezing" of the tears can be carried out using a cold pencil (cryocoagulation). As a rule, it takes about a week for the treatment to close the crack and regular checks are therefore necessary.