Vitreous floaters can be a frustrating and even a debilitating condition for many people. However, complaints of vitreous floaters were often passed over or dismissed by practitioners. In the past, procedures to alleviate the floaters had relatively high rates of complications, and it took a significant time to recover. With the advent of new, small instrument surgery, treatment of vitreous floaters is now a more reasonable choice. Small instrument surgery allows an easier, quicker surgery as well as a more comfortable and quick recovery. Most importantly, the risk of complications is reduced.
What causes vitreous floaters?
Vitreous floaters are very common and for most people are nothing more than a nuisance. The most common cause of vitreous floaters is from a posterior vitreous detachment (PVD).
The vitreous (liquid and gel in the center of the eye) is mostly solid at age 10. It turns into liquid centrally as a person gets older. Eventually the vitreous collapses and peels away from the retina which is on the back wall of the eye. The patient may notice this as a large cobweb floater or multiple string-type floaters when it occurs. It is sometimes associated with some flashing lights. The vitreous gel usually then melts or liquefies over the next several weeks to months. The floaters often subside starting within a few days, and all but a few settle to the bottom of the eye and disappear within a 6-month period. Some residual floaters can be seen for life. The problem occurs when the floaters don’t become translucent and don’t settle. Sometimes the vitreous will only partially peel off the back wall of the eye (or retina), and floaters may get stuck in the visual axis or the center of the vision. These floaters can be quite bothersome because of the sharp shadows they cast on the retina. Bleeding may occur when the vitreous peels off the optic nerve or causes a retinal tear. Even if the retinal tear is repaired, the blood left in the eye can stain the translucent vitreous floaters and make them more opaque which makes them more bothersome. Of course, the main concern when new vitreous floaters develop is that it might be associated with a new retinal tear, and, hence, a possible subsequent retinal detachment.