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Younger Patients: Managing Eye Floaters <35 Yrs

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Younger floater-sufferers are less likely to be good candidates for treatment with the YAG-laser due to the typical location being very close to the retina.

The best predictor of the ability to offer safe and successful laser treatment to floaters is the patient's age. Period. Younger patients have been consistently such a disappointment in the practice, we have (with very few exceptions) continue to be rather pessimistic when communicating with younger patients regarding their potential candidacy for treatment with the laser. The disappointments are twofold: Most of the younger patients are simply not candidates for treatment as their floaters are too close to the retina, and the others have some floaters that may be deemed treatable, but these end up NOT being the actual culprit floaters responsible for the patient's main complaint. 

Generally, I divide floater sufferers into 3 different age groups:

  1. Younger than 35yrs,

  2. 30-45 yrs, and

  3. 45-50 and older.

Most of the patients that I am able to treat safely are in that third, older age group. Although in all age groups, the basic entities are the same: aggregations and clumps of collagen proteins casting a shadow onto the retina, the size, amount, densities, and most important, location differ quite a lot between the different age groups. 


Floater appearance typical for younger patients. Small semi-transparent threads and filaments with, what I refer to as "Detail withing detail".

In the younger groups, the floaters are usually microscopic filaments and strands located within 1-2mm of the retina. They move, as all floaters do, but they 'slide' along the retina but do not move away from the retina. And the challenge to the surgeon is that the laser needs to always be focused safely away from the critical structures in the eye, namely the lens and retina. 

Here are Frequent Asked Questions for younger people with floaters

  • The floaters that young people have are not the same as the floaters that older people have. The floaters that young people have do not “age” and become the floaters that older people have. If you are 30 years old there is no reason to believe that in 10 years time your floaters will then become treatable with the YAG laser.

  • There are no scientific studies or publish articles that address this problem of floaters in younger patients adequately. All of my comments or recommendations are based on my understanding of the anatomy of the eye, and my observation and examination of people in all age groups.

  • I have not found it helpful to review the medical charts provided by other doctor’s offices. I have not found them to be helpful in the context of determining whether somebody is a candidate for treatment or not with my laser.

  • Simply put, a floater is caused by condensation or clumping of the (usually individual ) protein strands interspersed throughout the vitreous fluid. The collagen that makes up these floaters is “sticky” in its natural state. The stickiness is probably due to intermolecular attraction. When these protein strands have stuck together, they are very difficult to separate.

  • Collagen proteins that make up your eye floaters have been in your eye your entire life. There is no natural turn-over of vitreous material or filtration system that would normally clear that material out

  • Tiny little microscopic floaters are suspended in place by a complex system of elastic fibers. They are neutrally buoyant. They do not sink from gravity. There is no reason to believe that in a young person, your floaters will sink to the bottom of your eye and out of your visual field.

  • Based on my experience with examining younger patients with floaters, the floaters typically reside less than 2 mm away from the retina and often quite a bit closer than that. Although it may appear to be floater sufferer that the floaters are moving quite a bit, the actual movement within the eye may be just a couple of millimeters and typically they remain about the same distance away from the retina and do not move far enough away to allow for treatment with the laser. It is not safe to discharge the laser that close to the retina. This is the primary reason why I cannot treat most younger people with eye floaters.

  • Posterior vitreous detachments are very rare in younger patients. I have found that some doctors use that term as a generic description of floaters.

  • Just because your doctor actually does see some vitreous irregularities does not guarantee that what they are seeing is responsible for your symptoms. 

  • No one can predict if your floaters will get better, worse, or remain stable with time.

  • I can not recommend taking any supplements or eye drops to improve your condition

  • If you are considering a surgical vitrectomy or floater-only vitrectomy (FOV) as it is sometimes referred to, there are a few things you should know. After surgery, there is a high incidence of  lens cataract which may require more surgery. If a cataract surgery is necessary, you will lose the normal focusing and accommodating behavior of the eye. In addition, because most younger people have not had a posterior vitreous detachment, vitrectomy may put that patient at higher risk of retinal detachment. So although the surgical vitrectomy is a theoretical option, you would be very hard-pressed to find somebody willing to perform that procedure on you even if you were directly asking for it.

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