Almost all of us will have floaters at some point in our life. For most, it happens later in life, but for people that are very nearsighted, had surgery or trauma, and sometimes for no reason at all, we see floaters that move in and out of our vision.
Floaters are caused by capacities in the vitreous jelly that cast a shadow over the retina. The eye is filled with this jelly called the vitreous. The vitreous is clear and fills the eye. As we get older, it shrinks just like older jello might shrink in a bowl it’s made in. In the eye, it pulls away from the sides of the eye. The solid jelly is then floating around in liquid jelly and sometimes the edges of the jelly are seen as a shadow. New floaters are a good reason to get your eyes checked. An ophthalmologist should make sure there are no retinal tears, macular holes, or vitreous hemorrhages. Those could be signs of a potential problem. Most people won’t have something needing treatment. However, but it’s impossible to find the ones that do without doing an exam.
What Can Be Done About Chronic Floaters? Laser vs. Surgery
The good news is for most people with floaters, the floaters get usually better over a period of four months. Almost 98 percent of patients with floaters are not bothered by them in four months. Most of them aren’t bothered after two months. When I was in training, we told people that if they had floaters that bothered them, there wasn’t much that we could do. Now there are two things that can be done.
Now there are two things that can be done.
Vitrectomy: Vitrectomy is a surgery that removes the jelly from the eye along with all of the things that cloud it.
It’s generally not recommended for young people because cataracts almost always form afterwards; and although the risks of other problems are small, they can be severe. For people that have already had cataract surgery, pars plana vitrectomy is a really safe option for removing the vitreous clouding. I believe the safest way is just to get in and out and remove the jelly if there is no other retinal pathology. Unfortunately, many retina surgeons do a preoperative evaluation that only finds floaters, but the surgery has many other procedures tacked on like epiretinal membrane peel, capsulotomies, vitreous biopsies, retinal biopsies, lasers, that don’t always relate to the problem at hand. The more you do, the more risk there is, so I usually only refer to retina specialists who have a history of getting in and out quickly, without adding all of these unnecessary procedures.
The next option is laser vitreolysis.
This is a procedure where the laser is used to vaporize, not break apart, the jelly in the eye. It’s remarkably safe with minimal serious side effects. It is very effective with almost 60% of people happy after only one treatment. It may take more treatments, though rarely more than two, in my experience, to get patients a happy end-point. It’s important to note that you don’t have to get every single floater to make someone happy; you just have to reduce it by 80% to 90%, or take away the floaters that are in the main line of sight. Its biggest downfall is that it’s best for distinct vitreous opacities that are few in number. It’s not great, or not practical, for large cloud or cotton candy type floaters with lots and lots of debris.
At The Eye Clinic of Florida, we do both procedures. We’ve had 14 years of experience with laser vitreolysis and currently, we use the Ellex Ultra Q laser, a laser that’s designed for laser vitreolysis. Read some of our reviews here. We do pars plana vitrectomies for patients that have had cataract surgery and have floaters that are very bothersome and have lasted for more than four months. We refer to our favorite retina specialists if patients have not had lens surgery or have other retinal pathology.
For anyone who may have eye surgery, we recommend taking Lutein 20mg a day long before any surgery. It seems to speed recovery and reduce the number of annoying complications.
Real Patient Review: Dr. Mahootchi’s Laser Floater Surgery reviewed by patient on Google May, 2017.
I had a visually debilitating symptomatic floater in my right eye. It was the cause of a car accident. The floater was so aggravating it negatively effected all my daily duties. It was as if there was a smudge or scratch on my glasses in direct line of my central vision. It was worse than a toothache, backache or any other chronic condition. I am an eye surgeon and I specialize in vitreo-retinal surgery. The vitreolysis procedure performed on me by Dr. Mahootchi has changed my life. One treatment, within a few hours I was able to resume my normal duties without any eye complaints whatsoever. The symptomatic floater is gone and I am happy. It was a painless, pleasant procedure and I would recommend Dr. Mahootchi to eveyone. The laser procedure was a breeze and beats the alternative of a serious surgical Vitrectomy. It has impacted my life so much that I will add this procedure to my repertoire for treating symptomatic floaters. I want to thank Dr. Mahootchi and his excellent staff.
– Warmest regards, Dr. Powers.