Several treatments for floaters have been suggested. It is reasonable to say that time is a sensible treatment since in many cases of recent onset floaters the symptoms will dissipate over weeks to months. That is, however, on the assumption that a serious cause has been ruled out. If floaters persist and are causing visual problems with day to day life and activities, then it is not unreasonable to consider treatment.

Two treatments are currently in use.

The first is laser vitreolysis.
This involves focusing infrared light energy into the vitreous jelly with the aim of disrupting or blasting apart the collagen clumps which are causing the floater. In theory this is a good idea. In practice, however, it rarely works to significantly reduce either the number or severity of floaters which are present. Many individuals find that they have swopped large clumps for lots of little black dots.

The second option is to perform a vitrectomy.
This is an operation which involves going inside the eye and surgically removing the vitreous jelly and with it the vitreous floaters. The jelly is 99% salty water and that is what is left behind and the eye continues to replace it. Adults do not require their vitreous so the removal of the jelly is in itself not harmful.

There are, of course, some risks to a vitrectomy. The first is infection which might be expected to occur in 1 in 300 people. Infection is usually treatable if caught early enough but can occasionally be devastating. The second is retinal detachment.

This might be expected to occur in about 1 in 50 people undergoing a vitrectomy for floaters. Retinal detachment is a potentially blinding condition but in 95% of cases can be successfully treated. The treatment involves a further operation. Retinal detachments can frequently be repaired with no long term compromise to the eye.

It should, however, be noted that not all detachments can be repaired and that a reasonable proportion of people in whom a retinal detachment has successfully been repaired will suffer some degree of sight loss.

The third and by far commonest complication of a vitrectomy in an operation is cataract.




Pic : A cataract in patient who has undergone a vitrectomy.


The risk of this is largely dependent on the age of the person. In individuals aged more than 50 it is likely that a cataract will occur after a vitrectomy and once one is 60 to 65 years of age this is almost a certainty. The cataract tends to develop over a period of 1 to 2 years if left untreated and results in increasing shortsightedness, haziness and glare.

In people of more than 50 years of age the likelihood of cataract is so great that I now routinely combine vitrectomy and cataract surgery in order to prevent this complication. This does not appear to increase the problems with the operation and allows very good and stable sight to be regained quickly after the operation.