Hello and welcome to Case of the Day. I’m Dr. Croley and today we’re gonna discuss an interesting case. We had a lady that came in today complaining of floaters. That’s a very common complaint and we get that all the time. Probably on an average day we see two to three patients a day that come in complaining of floaters in their eye.
So, what are floaters? Floaters are little specks of material that are inside the vitreous or jelly in the back of your eye. So if we look at a diagram of your eye, the back behind your lens, back of eye, are filled out with a Jell-O-like substance called the vitreous humor is mostly made up of water with some small amount of fibers and stuff they run through to the vitreous. So what happens as we age this vitreous, tends to shrink and then pulls loose from the retina where it’s attached. And so when it pulls loose, you see that attachments are floating around in the jelly and so when light comes in and hits that piece of object floating in your vitreous, then it casts a shadow on to your retina. That’s what you see.
People describe these floaters as spots, dots, cobwebs, flails, curtains, bugs, nets, chinese letters; they can look like pretty much anything. When it first happens, you need to have a thorough dilated eye exam because on a rare occasion when that vitreous pulls loose from your retina, it could tear your retina which will then create that opening where fluid can gather underneath the retina and cause a retinal detachment. If it’s caught when it’s just a tear, it’s very easy to treat with either laser treatment or a freezing probe that would seal the tear up and so therefore fluid cannot get underneath the retina and then you would not get a retinal detachment.
The treatment for the tear is very easy, the treatment for the retinal detachment can be in some cases, not even fixable where you would lose the sight of that eye. So it’s important that if you have a floater you get your eyes checked as soon as you can easily do so.
Why does this happen? So what happens is, the vitreous shrinks, the fiber sort of get loose and so it shifts and it moves around. So when you see a floater and you move your eye back and forth you can see it fly across and back and forth. Typically you’re not gonna do anything about a floater other then we’re gonna watch. So you do an eye dilated exam and then usually a second exam then two to three weeks after the first exam to make sure everything is stable.
If they really come persistent, that they are right at the middle of your vision and they are large and they are stretching your vision, then some people choose to have those removed. And there’s two ways you can do that. One, there are very few people around the country that would actually try to laser those floaters, or break them apart and try to get rid of them that way. And that has some success. Sometimes it takes two to three treatments to break them up and after that you’re happy. Sometimes by breaking it up you can actually move things up and create a new floater, but it’s a fairly safe procedure to do.
And then sort of the other treatment that is more aggressive but then really does relieve the problem is to actually do what is called the Vitrectomy. And so Vitrectomy is a tiny probe that goes inside the back of the eye and sort of removes and chops up all the vitreous out of the back of the eye and replaces that with fluid and therefore all that material is gone. But then you have side effects and complications related to having that surgery done and so you would have to make that decision on how bad the vision difficulties were whether you take the risk of having a laser treatment done and or surgery to remove them. So most of the time 98, 99 percent of the time where people have floaters, there’s no damage to the retina, and they are okay. They just need to follow it.
If you have any other questions about floaters because they are very common. You can always contact us to the website or if not then you can ask any other questions like as well. If you’d like some kind of answer to some questions we’d be happy to do that. And may God bless you with healthy eyes and great vision.