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Surgical Retina

Floaters

A jelly-like substance called the vitreous fills the eye. The vitreous is a gel that maintains the shape of the eye, supplies it with nutrition and helps with the focusing of light.

The retina is a thin membrane located in the inside of the eye, adhered to the wall of the eye like "wallpaper" and that acts like the film of a camera, capturing the image that will be transmitted to the brain through the optic nerve. The macula is the central area of the retina. We use the macula to see details, colours, read small print and discriminate faces amongst others.

The younger we are, the more strongly the vitreous is attached to the retina. As we get older, and as part of the normal ageing of the eye, the vitreous starts liquifying (syneresis) and developing pockets of fluid (lacunae). The lacunae later coalesce and the vitreous body starts to collapse. At the time the vitreous body collapses it starts detaching from the retina; first partially and then totally. This is known as Partial or Total Posterior Vitreous Detachment (PVD).

The PVD process can take varying lengths of time: from hours to months. It is believed by some to take place within 4-6 weeks.

For some patients the PVD process can be symptomatic and some patients experience flashing lights (photopsia). Flashing lights can be attributed to the vitreous pulling from the retina as it detaches from it.

Other patients experience floaters or a cloud-like image like a lace curtain that moves around with the eye movements, sometimes in combination with flashing lights.

Floaters (myodesopsiae) can be perceived in different colours or shapes: spots, thread-like strands, tadpole or cobweb-like.


Should I pay attention to these symptoms?

Yes. It is important to have the eyes checked by a Vitreoretinal Surgeon at the earliest.

Occasionally while the PVD is taking place, breaks or tears develop in the retina as a consequence of the vitreous pulling from it while trying to detach. For this reason it is important to have both eyes checked as retinal tears can usually be treated with laser photocoagulation as an out-patient procedure.

Untreated retinal tears can lead to the development of a Retinal Detachment, a potentially blinding condition that requires surgery.

The ocular examination to rule out retinal tears should be preferentially carried out by a Vitreoretinal Surgeon through a fully dilated pupil and usually with the patient lying on their back. An examination technique called Indirect Ophthalmoscopy with 360° Scleral Indentation is carried out. During this procedure gentle pressure is applied on the lids to shallowly indent the wall of the eye and therefore move the peripheral retina into view (the area of the retina otherwise inaccessible).

Some patients, especially myopes, can suffer from floaters for years and they can find it difficult to know when to consult the specialist. The logical advice is to always contact when in doubt or certainly if you develop new floaters, old floaters become more intrusive or are accompanied by flashing lights. Patients experiencing flashing lights without floaters should also seek prompt consultation. If in doubt, do not hesitate to contact Professor Stanga.


Can I get rid of my floaters?

Yes, through a surgery called vitrectomy.

Floaters can be very intrusive and annoying but are generally harmless. The brain can get used to them after a while. They are usually more evident the more we look for them and especially against a clear background.

Floaters tend to settle over time once the PVD has completed.

Professor Stanga can discuss fully with you the risks and benefits of this procedure with you during a consultation.


Retinal Detachment

Retinal Detachment is a potentially blinding condition that is treated with surgery that usually needs to be carried out as an emergency if the macula is still attached (central vision has been maintained) or within seven to ten days for best results if the macula is already off. Macula-on detachments can sometimes be delayed with appropriate posturing of the patient.

The most commonly used surgical techniques to repair a Retinal Detachment are scleral buckling or external procedure and Pars Plana vitrectomy or internal procedure.

Both approaches have different risks and benefits. Professor Stanga will tell you which is the best approach for your eye condition, risks and benefits and what to expect postoperatively.
If you experience any of these symptoms you can contact Professor Stanga or his team on the above numbers. Urgent treatment is essential to preserve your vision.

Please remember that each patient is different and the information here provided is only a general guide.

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