Understanding floater surgery

What are floaters?
What causes floaters?
How do floaters affect your sight?
When should you have surgery for floaters?

 

What are floaters?

Floaters are opacities in the vitreous jelly of the eye. They cast a shadow on the retina and generally take the form of small dots, irregular rings and general cloudiness. The key to diagnosing floaters is that they move independently of the eye, continuing to drift even when the eye is still.

It is helpful to know a little about the eye and how it works in order to understand the effect floaters have on your vision, and how they can be treated.

Anatomy of a normal eye

The wall of the eye is formed by three layers, the retina, the choroid and the sclera.

The retina is the light-sensitive nerve tissue that lines the inner wall of the eye. Rays of light enter the eye, passing through the cornea, pupil and lens before focusing on to the retina. The retina contains photoreceptors which convert light into electrical impulses.

In the healthy eye these impulses are sent via the optic nerve to the brain where sight is interpreted as clear, bright, colourful images. The retina can be likened to photographic film in a camera.

The macula is a small area at the centre of the retina. It is very important as it is responsible for our central vision. It allows us to see fine detail for activities such as reading, recognising faces, watching television, and driving. It also enables us to see colour.

The choroid is the underlying vascular (blood vessel) layer of the eye from which the retina receives oxygen and nutrients.

The vitreous is the clear jelly-like substance which fills the hollow space behind the lens. As we age the vitreous gel opacifies and eventually may shrink away from the retina. This is very common, occurring in about seventy-five per cent of people over the age of sixty-five.

Although floaters can occur when the gel is still attached, they are much more common when separation of the vitreous gel from the retina occurs. This is known as posterior vitreous detachment or “PVD”. It does not itself cause any permanent loss of vision, although very occasionally PVD results in tearing of the retina, with the risk of retinal detachment.

The appearance of floaters is also more common following cataract surgery.

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What causes floaters?

In childhood the vitreous jelly is anchored to the retina and is essentially a clear structure. As we age the vitreous breaks down, with solid components separating from the salty water. It is normal for a few floaters to appear over the years, but at some stage a sudden shrinkage or collapse of the jelly results in posterior vitreous detachment. This is an acute event, usually perceived as a sudden shower of floaters or awareness of a marked increase in floaters.

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How do floaters affect your sight?

Common symptoms of floaters are:

  • small spots or “cobwebs” which flick across the field of vision on eye movement;

  • a generalised mistiness of vision, often described as “frogspawn”.

  • glare and increased difficulty in bright light.

Comparison of normal vision and vision with floaters

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When should you have surgery for floaters?

Floaters do not cause damage and the need for surgery is based entirely on your symptoms and the impact they have on your daily activities.

We will help you decide if an operation to remove your floaters is appropriate for you.

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