What are Treatment Options?
There are some floaters that are caused by pathological conditions such as autoimmune disorders, infections, diabetes, and hemorrhage. The treatment for these floaters is directed at the underlying disease or disorder and not within the scope of this practice or website. The remainder of floaters are generally benign. They are benign in the anatomical and “health” aspect, but not so benign when you consider the psychological effect floaters can have on the floater sufferer. They are not so benign when you factor in the sometimes devastating effect on the quality of vision and quality of life.
If we then consider the ‘non-pathological’ vitreous floaters, there are essentially 3 viable options available + 2 other options we will mention to complete the discussion:
OPTION 1: DO NOTHING
This is the most common recommendation to people suffering floaters. As long as the floaters are not pathological in origin, the presence of floaters is not considered to an eye health issue. They can stay in there forever. For some people who are not candidates for the laser treatment, and for which the invasive surgery (below) is not indicated, this may be their only choice.
OPTION 2: YAG LASER VITREOLYSIS:
YAG Laser treatment has been around for about 20 years. Even after 2 decades, there are just a few ophthalmologists with any significant experience treating floaters. It is technically a very difficult procedure to perform. Not all floaters can be treated and the indication and ability to treat depends primarily on the location of the floaters as well as other optical characteristics of the eye. This is the procedure offered at our office and our area of particular expertise and interest.
OPTION 3: FLOATER-ONLY VITRECTOMY (FOV):A surgical vitrectomy involves general anesthesia or deep monitored sedation in a surgical center or hospital. A retinal surgeon will place three incisions into the whites of the eye and insert three instruments to remove all or much of the vitreous material. The removed vitreous is replaced with a saline water solution. The vitrectomy enjoys a higher expectation of removing most if not all of the floaters, but with greater relative risk. The commonly noted risks of vitrectomy are cataract formation within the first year. This is often quoted in a range of 50-100%. In addition there are more rare incidences of retinal detachment, eye pressure fluctuations, chronic retinal edema amongst others. Because of these risks the retina specialists who perform the procedure are generally reluctant to perform a vitrectomy “just” for floaters even if the patient desires one. This treatment may be a theoretical option rather than a realistic or practical option because of the general lack of availability in finding doctors willing to perform the procedure.
Surgeon's view of vitrectomy
OPTION 4: MEDICAL, INJECTION, OR ENZYMATIC TREATMENT
Occasionally I am asked about an injectable enzyme, Ocriplasmin which is a form of collagen breakdown enzyme. There is a specific use to assist in completing a posterior vitreous detachment that has not completed on its own. This and other similar enzyme have been tried, but their non-specific targeting of all collagen in the vitreous leads to a big disorganized mess and will likely be much worse than the original problem.
OPTION 5: NATURAL, ALTERNATIVE OR SUPPLEMENT THERAPY
In short, they do not work.
Suggested next topic