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Floaters

What are eye floaters?

Floaters are small shapes that some patients experience floating in or moving across their field of vision. They can take on different forms that can include spots, rings, or long narrow strands.

These shapes float across your vision as you move your eye around. If you try to look at the floater(s) it may seem like they are darting away. Many people can ignore them but for some, they can become very frustrating.

Some persons may not even notice they have them until they become more prominent or numerous.

What causes eye floaters?

The vitreous (a clear and gel-like transparent structure that fills the space in the middle of the eye) liquefies as we get older and the collagen fibres that form it tend to clump together and float in the resulting fluid. These clusters of fibres can cast shadows on your retina which you see as floaters.

In most cases, floaters do not require treatment. However, in some cases and especially in cases of sudden onset, they may be a sign of Posterior Vitreous Detachment or PVD.

PVD becomes more common as we age or can appear at an earlier age in short-sighted people or after cataract surgery or trauma.

Any patient who experiences a sudden onset of floaters (or they become more numerous or intrusive), flashes of light or a shadow in their visual field should be examined as soon as possible by an Ophthalmologist, ideally a Vitreoretinal Surgeon.

Patients need to undergo a full retinal examination through dilated pupils that includes Biomicroscopy and Indirect Ophthalmoscopy with scleral indentation to rule out retinal tears or retinal detachment and the need of treatment (retinal laser retinopexy for tears or laser or surgery for retinal detachment depending, amongst others, on symptoms, surface area and location) and prevent loss of vision or blindness.

Possible treatment options

When you notice floaters in your vision, you have a few options depending on the severity:

Do nothing: many people find that some floaters can be easily ignored and go away gradually over time.

See a Vitreoretinal Surgeon and undergo: Vitreolysis YAG laser or vitrectomy surgery

What is YAG LASER VITREOLYSIS for LASER FLOATER TREATMENT (LFT)?

Also known as YAG laser vitreolysis, LFT is a painless procedure that can reduce and sometimes eliminate the visual disturbance caused by floaters.

The aim of the treatment is to achieve a ‘functional improvement’ and to allow the patient to return to ‘normal’ day-to-day activities without the hindrance of floaters.

What are my other treatment options?

Clinical studies have shown LFT to be effective in the majority of patients. However, if floaters persist, following a thorough examination, Prof. Stanga may recommend vitrectomy surgery.

How does LFT work?

LFT involves the application of incredibly fast nanosecond pulses of laser light to vaporise the vitreous cloudiness (the floater) and to cut the vitreous strands to which they are attached and suspended.

During this process, the floater’s collagen and hyaluronic molecules are converted into a gas.

The end result is that the floater is removed, reduced in size, or allowed to displace from the central vision.

What happens during the procedure?

LFT is performed by Prof. Stanga using the latest ELLEX Reflex Technology TM. Immediately prior to your treatment, eye drops will be given to dilate your pupils and to numb the eye which will be treated. A contact lens will then be placed on your eye, with the laser light delivered through a specially designed microscope.

During the treatment, you may see small, dark shadows – these are the floaters being evaporated into small gas bubbles. These gas bubbles quickly dissolve and resorb into the vitreous.

Each treatment session lasts between 20-60 minutes and most patients need to have between two to three treatment sessions per eye. The number of sessions needed is determined by the type of floaters to be treated: less for small and well-defined floaters and more for large and woolly ones.

What can I expect after treatment?

Initially, you will be dazzled in the treated eye and may subsequently observe small, dark blots in your lower field of vision immediately following treatment. However, these small gas bubbles will quickly dissolve and should not affect your vision.

Some patients may experience mild discomfort, redness or temporarily blurred vision directly following treatment and that usually resolves within hours.

Complications and side effects

Like with all medical treatments, complications can take place though reported side effects and complications associated with LFT are rare. Side effects may include cataract and intraocular pressure (IOP) spike. Prof. Stanga will discuss with you at length risk as well as benefits of the treatment as part of your initial consultation and prior to you signing a full- informed consent form.