Probably the most common question I have in clinic is about floaters in the vision. But what exactly are they? I thought I’d write about this in the blog this month as last week I had a sudden, new, very large floater and it needed assessment. More about that later…

To understand floaters first you need to appreciate the anatomy of the eye:

The eye is bit like a ping pong ball – but the inside of the eye is filled with a jelly like substance called vitreous. Just like the air in ping pong ball the jelly cannot escape from the eye. When floaters occur, they are due to a change in this vitreous jelly. The vitreous can change for several reasons – the most serious is retinal tear or detachment. More usually the vitreous changes due to it becoming more liquid and it shifts about. The floaters cast little shadows on the retina that move with your vision. They can be extremely irritating, but the brain is pretty good as blocking them out over time.

The most important thing is getting any new floaters assessed. This is to rule out a retinal tear or detachment which is sight threatening. Other signs of retinal detachment can be loss of vision, shadows across vision and/or flashes of light. If you are in any doubt, please contact the clinic.

After my sudden new floater, I had an Optomap scan and this showed a large floater near the optic nerve – a retinal detachment was ruled out. Here’s my scan with the vitreous floater highlighted:

So, what can be done about floaters?
If your vitreous floaters get in the way of your vision, which happens rarely, you and may consider treatment. Options may include surgery to remove the vitreous or a laser to disrupt the floaters, although both procedures are rarely done. The NHS will not routinely fund this treatment so usually has to be performed at a private eye hospital by a vitreo-retinal surgeon.

• Surgery to remove the vitreous: An ophthalmologist who is a specialist in retina and vitreous surgery removes the vitreous through a small incision (vitrectomy). The vitreous is replaced with a solution to help your eye maintain its shape. Surgery may not remove all the floaters, and new floaters can develop after surgery. Risks of a vitrectomy include infection, bleeding and retinal tears.

• Using a laser to disrupt the floaters: An ophthalmologist aims a special laser at the floaters in the vitreous (vitreolysis). This may break up the floaters and make them less noticeable. Some people who have this treatment report improved vision; others notice little or no difference. Risks of laser therapy include damage to your retina if the laser is aimed incorrectly.

If you’d like to know more about floaters please follow this link. Advice taken from literature provided by The Association of Optometrists.

I look forward to welcoming you in practice again soon.

Lucinda

*The information presented here reflects general information about floaters but of course is not exhaustive

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