FLOATERS

What are eye floaters?
Eye floaters are usually seen when looking at a bright background, such as blue sky, snow or a computer screen. They may be of different shapes and colour and often shift downwards as the eyes get fixated on an object. Floaters are debris that form due to the natural ageing process of the vitreous (the jelly like structure that fills the inside of the eye).

Can floaters be harmful or a sign of a serious condition?
In the majority of cases floaters are benign and apart from causing visual disturbance to the patient they are harmless. However, there are a few occasions where floaters can be a sign of a serious condition. This includes conditions such as posterior vitreous detachment complicated with a retinal tear or a retinal detachment when floaters come on suddenly and therefore an urgent assessment by an ophthalmologist is required. Sometimes, inflammation (a condition known as uveitis) or an infection in the eye can cause the appearance of floaters. These will also require an assessment by an ophthalmologist.

Is there any treatment for floaters?
Majority of patients that have floaters get accustomed to them and can continue to lead a normal life style. Some patients however can never get used to them, and in a small subset of patients the floaters significantly affect their quality of life. In these cases, surgical treatment can be undertaken. The operation is called pars plana vitrectomy. It is similar to key hole surgery, and involves removal of the vitreous (jelly of the eye) where the floaters are present. With the advancement of technology this is done through very small incisions (up to 27G or 0.36mm) and normally do not require any sutures.

Can floaters be treated with other methods apart from surgery?
Laser treatment can be attempted for small floaters that are situated at the front part of the vitreous, gel, of the eye. However, this treatment is not always successful since it works by disruption of the floater into smaller pieces. The laser can cause some damage to the lens and to the retina. Due to its limited efficiency and risks associated this technique is not very commonly performed in the UK.

What are the risks of surgery?
As with any surgical procedure, the pars plana vitrectomy for floaters has a few risks. The very serious risk of severe infection or bleeding inside the eye is extremely rare (less than 1 in 2000). Some patients might develop retinal detachment following this procedure and would require further surgery. More common risk is the formation of a cataract, and therefore sometimes the procedure can be combined with a cataract surgery where the cataract is removed at the same time as the vitreous. All the potential risks and benefits of the operation should be discussed individually depending on the individual circumstances.

Anaesthesia for your operation.
The surgical procedure is usually performed under local anaesthetic as a day case, which means that the patient is fully awake during the surgery and can go home afterwards. A local anaesthetic is injected around the eye and for the duration of the surgery the patient is asked to keep still and lie on his/her back. The average time of the procedure is around 30-45 minutes. Alternatively, the surgery can be performed under general anaesthesia (the patient is asleep); however, that might require further investigations to assess the patients’ general health.