Vitreous Floaters and Laser Treatment

What are Vitreous Floaters, and how does Laser Treatment work?

Floaters are small dots, lines or shadows in your vision that dart away (or float) when you try to focus on them – they are very common. These tiny specks are often most noticeable against a light-coloured background, and may appear as scattered dots, comma-shaped smudges, little lines or small cobwebs. In most cases they are not serious and are caused by changes in the vitreous (the jelly-like substance inside the eye). Sometimes they can appear as tiny flashes of light. Floaters that have been present for a long time and do not change in size or appearance are generally nothing to worry about. There are situations, however, where the sudden appearance of floaters, or a change in them, can be a symptom of something more serious, such as retinal detachment. In that case, you should contact your ophthalmologist urgently for an examination.

Before laser treatment for floaters

You see small dots or lines, and flashes of light.

After laser treatment for floaters

The frequent floating dots and flashes are gone, and vision returns to normal.

How do I know if I need a specialist ophthalmologist for floaters and vitreous detachment?

If your floaters suddenly increase in number or severity, or do so over a short period of time, you should see a specialist ophthalmologist straight away. This is because it can be a sign of a serious underlying condition, such as a retinal tear. 

For many people, floaters cause no problems at all. In time we usually get used to them and barely notice they are there. For others, though, they can become more than a mere irritation – some people even give up activities because their floaters become so intrusive. Working at computer screens is a frequently cited reason for wanting floaters removed, even among younger people.

Floaters are often age-related. As we get older the vitreous shrinks, pulling small amounts of collagen fibre away from the retina with it. These cast shadows inside the eye, which we see as floaters. Although benign, floaters can reduce your quality of life, and you may wish to consider having them removed. This is a treatment performed by a specialist ophthalmologist experienced in treating vitreous detachment, who will examine your eyes and determine whether you are suitable for treatment.

Treatment options

There are two ways of treating floaters:

• Vitrectomy: this involves removing the natural vitreous from the eye and replacing it with an artificial saline solution.

This is an invasive surgical procedure performed under general anaesthesia. It is extremely successful, but carries certain associated risks, such as cataract formation and retinal tear or detachment. Your vitreous detachment specialist will determine whether such a procedure is appropriate.

In most cases, laser floater removal is likely to be the appropriate choice. This is also known as YAG laser vitreolysis.

• YAG laser vitreolysis: this uses a non-invasive laser to target the clumps within the vitreous that are responsible for the floaters. Up to 3 sessions are performed at intervals of 4-6 weeks, with an average success rate of over 90%. The procedure should only be performed by an experienced ophthalmologist.