Many people have asked me about floaters and whether there is any treatment for it. First of all, let us understand that floaters are very common. Almost 70-80% of individuals will experience floaters at some point in their lives. Does this mean that everyone with floaters needs to have their floaters treated? The answer to that is NO. The majority of floaters are left alone and require no treatment at all.
What are eye floaters?
Floaters are the little black, grey or translucent dots that we occasionally see floating in our vision. We think it’s a fly, but no, it’s not! The floater sits within our eyeball and is a shadow cast by the condensed vitreous gel as it moves in our eye.
90% of all floaters are benign, which means they are part and parcel of our normal ageing process. They are harmless and will not cause any sight-threatening problems. Only about 10% of floaters require some medical attention because they could signify a retinal tear, hole, or bleeding. That is why all new floater occurrences should be screened by the eye doctor so that retinal issues can be treated as early as possible. It cannot be stressed enough that when we see floaters, we need to make sure there is no underlying condition such as a retinal disorder that requires urgent treatment.
When we refer to benign floaters, the ones that we were told to ignore or live with, we assume that your good eye doctor has already excluded all other harmful retinal diseases. Do we really have to live with these floaters forever? Traditionally, that was what we were told because it’s true that they don’t actually harm our vision. Back when technology was nowhere near as advanced as today, having an invasive procedure to remove it back in those days would probably lead to more harm than help.
Now, there are many differing opinions on this matter. Many eye doctors still maintain that benign floaters should not and cannot be treated. This is because, in their opinion, the risks of any procedure far outweigh the benefits, considering these floaters are harmless, after all.
My professional opinion is that technology has advanced to the point that we are now able to give patients the option of relieving troubling floaters. While we do not take the risks of any procedures lightly, we can discuss the available options with our patients and advise them on the best course of treatment based on their symptoms. Given these options, treatment for those who suffer from severely obstructive floaters is a real possibility. Of course, not all floaters are the same, so it really does depend on the size, number, and how severely the floaters are affecting the individual’s quality of life.
How are eye floaters treated?
Laser Vitreolysis is a non-invasive laser that acts to disperse the floater particle and break it into multiple pieces. In doing so, it renders the floater less obvious and less obstructive. This is a painless, clinic procedure performed on a specialized laser machine that can only be found in specialized retinal clinics. Sometimes multiple sessions may be needed to disperse the floater completely. They are little to no side-effects to this procedure. Most of my patients who have had this laser treatment are happy with the outcome and stop experiencing their floaters like before.
Surgical Removal of Floaters can also be done in this age of micro incisional surgery. In the past, when incisional wound sizes were larger, the risks of surgery and retinal detachment were higher. Currently, incisional wound sizes are less than 0.5mm, self-sealing, and require no sutures. This means that the risks of adverse events or retinal detachment are considerably smaller.
Having said that, I strictly reserve surgical removal of floaters to patients who experience a significant decrease in quality of life, impairs their ability to function normally in daily activities and are handicapped by their floaters. The surgical option is also particularly appropriate for patients who have a pre-existing cataract and are opting to go for surgery to remove their cataract. Combined cataract surgery and vitrectomy to remove their floaters can be performed at the same time if the patient wishes to be floater-free. Many of my patients jump at the opportunity to be relieved of their annoying floaters since the procedure can be done at the same time.
No, you do not need to live with your floaters forever. There are various options that you can consider if your floaters are very troubling. Get an easy eye assessment to determine if you can free yourself from your floaters finally.
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- Hollands H et al. Acute-onset floaters and flashes: is this patient at risk for retinal detachment? JAMA 2009. Hov 25;302(20):2243-9.
- Kim YK et al. Psychological Distress in Patients with Symptomatic Vitreous Floaters. J Ophthalmol. 2017;2017:3191576.