Vitreous Floaters: How Our Optometry Practice Can Offer Non-Surgical Treatment Options

What are vitreous floaters?

Have you ever noticed small spots, strings, cobwebs, or shadows drifting across your vision? These are commonly known as vitreous floaters. Vitreous floaters are opacities within the vitreous that cast shadows onto the retina. Common causes are age-related vitreous changes, a posterior vitreous detachment, myopia, inflammation, trauma, and previous surgery. For many people, floaters are harmless and become less noticeable over time. However, when floaters are persistent and interfere with everyday activities, they can become a significant visual concern. Advances in eye care have created non-surgical treatment options for certain patients with visually significant floaters.

When are floaters more than a nuisance?

When persistent, visually significant floaters interfere with:

• Reading and computer work

• Driving

• Detailed visual tasks

• Working in bright environments

• Photography or other visually demanding hobbies

• Enjoyment of outdoor activities

• Quality of life

New or a sudden increase in floaters should always be evaluated by an eye care professional, particularly if they occur with flashes of light, a sudden increase in floaters, or a dark curtain or shadow moving across your vision. These symptoms can sometimes be associated with a retinal tear or retinal detachment, which requires urgent evaluation.

The traditional treatment approach: observation

Many floaters don't require intervention. The brain can adapt to them, and many become less noticeable over time.

Non-surgical treatment option: vitamin therapy

Our eyes rely heavily on overall good nutrition in the body. There is a specific eye floater vitamin formula that contains antioxidant and anti-glycative nutrients and has been very effective in reducing the size and density of symptomatic floaters. The Floater Intervention Study (FLIES) evaluated a targeted micronutrient supplement and found it significantly reduced visual discomfort and opacity size from eye floaters.

Non-surgical treatment option: laser vitreolysis

Laser vitreolysis uses laser energy to disrupt, vaporize, or reposition portions of the floater so that the floater become less visually bothersome. The goal is to reduce the opacity or move it away from the patient's primary visual axis so that it becomes less noticeable. Unlike a vitrectomy, laser vitreolysis does not involve surgically removing the vitreous gel from the eye.

Not every floater is a good laser target

At the retinal examination, the following will be evaluated:

• Location of the floater within the vitreous

• Size and density of the floater

• Distance of the floater from the retina and crystalline lens

• Overall health status of the Vitreous

• Presence of any retinal pathology

• Patient symptoms and expectations.

• During your floater evaluation

A floater consultation begins with understanding what you are experiencing and how your symptoms affect your daily life. Our optometrists will perform a comprehensive ocular examination, including a careful evaluation of the retina and vitreous and imaging of the retina and vitreous with our OCT technology. The purpose of the examination is not simply to determine whether a floater is present, but also to make sure that there is no underlying retinal or ocular condition that requires a different form of treatment.
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Once the evaluation is complete, our optometrists can discuss whether observation, vitamin therapy, laser vitreolysis, referral for surgical consultation, or another approach is most appropriate.

If floaters are interfering with your vision or quality of life, schedule a comprehensive eye examination to discuss your options. Symptomatic floaters deserve an individualized assessment. For select patients, non-surgical vitamin treatment or laser treatment may provide an alternative to simply living with persistent visual disturbances.