What causes floaters in the eye, and how effective is laser treatment for floaters?

Our eyes are divided into 2 main compartments, a smaller one in front, and a larger one behind, separated by the lens. Any particle/ opacity in the rear compartment will cause a shadow to be cast on the retina, resulting in the visual perception of floaters.

The rear compartment is filled with a firm gel (vitreous) which is normally transparent. As we age, the gel degenerates and liquefies, and some undissolved gel particles may remain within the cavity. As light enters the eye, these particles cast shadows on the retina, resulting in floaters. This can happen spontaneously, or after vigorous rubbing of your eye, being hit in the eye etc. This is by far the most common cause of floaters, and is termed posterior vitreous detachment (or PVD).

Occasionally, floaters can be due to other particles in the cavity such as pigment cells, red blood cells, or white blood cells. Conditions such as a retinal tear, bleeding (from abnormal blood vessels) or infections and inflammatory conditions can also lead to floaters.

It is important therefore for your mother to be seen by an Ophthalmologist to determine the cause of the floaters. Retinal tears may require laser treatment to prevent a more serious condition known as retinal detachment from happening. A PVD is usually left untreated as it is harmless. Although visually irritating, most people get used to the presence of floaters after a period. The floaters will usually get less obvious with time, but may not completely disappear.

More importantly, after the initial visit to determine the cause of the floaters, your mother should seek prompt attention by an Ophthalmologist should she suddenly experience a dramatic increase in the number of floaters. This may be a symptom of a new problem (such as a retinal tear or bleeding) happening.

I hope your mum is feeling better!

Regards,

DQ

Floaters are due to translucent/opaque objects floating around in the vitreous cavity of the eyeball. When light shines into the eye, these objects cast shadows on the retina, causing the perception of floating objects in the visual field.

Most commonly, the floaters are bits of degenerated vitreous gel. They may also be caused rarely by things like blood or blood cells if there is inflammation in the eye.

If your mother suddenly got new floaters, she should make an appointment to see an eye doctor soon, preferably within a day or 2.

This is because the sudden onset of new floaters may be associated with a retinal tear/hole, which if present may lead to a retinal detachment and loss of vision.

Laser treatment for floaters themselves is generally not recommended. However, if a retinal tear is found on examination, that retinal tear needs to be sealed as soon as possible with a special 'Argon' laser to prevent it from progressing to a retinal detachment. This 'Argon laser retinopexy' does not get rid of the floaters, it just seals the hole so fluid cannot get in.

There is a laser machine, ELLEX Laser, used to perform Laser Floater Vitreolysis which can treat troublesome floaters in the eye. This is available at limited eye centres.