Mostly it is aging. Aging doesn’t explain all circumstances as I do have many younger patients also suffering from eye floaters.
The reality is that it is not a well-studied topic as mostly the standard-of-care expectation for doctors is simply to check the retina and reassure the floater-sufferer that everything is OK. The vast majority of my patients are over the age of 45-50 and are otherwise healthy. Some have had previous eye procedures such as refractive surgery or cataract surgery, but many have not. I have not made the connection or have correlated any previous or concurrent behaviours, diets, activities, medications, family history, or diets that might be associated with the onset of floaters.
My personal and professional opinion is that floaters just happen. They may be more likely to happen if you are very nearsighted, or suffered some injury or trauma to the eye, but again, many if not most of my patients do not have any remarkable eye history or extreme behaviors that may explain the floaters.
OK, I know what you’re thinking. You were doing something different or unusual and that ‘must’ have caused your floaters. Some of my patients swear it was being at high altitude, another says it was scuba diving, and a young guy from Algeria absolutely believes it was excessive masturbation. I can’t really prove you wrong if you believe that, but a single anecdote doesn’t make the case. In science and medicine we say ‘correlation does not prove causation’. Unless I see a bunch or scuba divers in my office, or many people on a certain medication or extreme diet or lifestyle, these theories will remain correlations.
Really it may just be nature trying to break us back down to dust. There are no strong evolutionary pressures to keep perfectly clear vitreous. Fortunately, I don’t really need to have all the answers to these interesting and esoteric floater questions. I don’t need to answer all the ‘whys’, I need to be able to responsibly answer ‘how’.