From the Guidelines
Vision floaters are typically harmless and do not require treatment, but if you experience a sudden increase in floaters, especially accompanied by flashes of light or peripheral vision loss, seek immediate medical attention as this could indicate a retinal tear or detachment requiring urgent treatment. Most floaters result from age-related changes in the vitreous gel inside your eye and become less noticeable over time as your brain learns to ignore them 1. To manage mild floaters, try moving your eyes up and down or side to side to shift the floaters out of your central vision. The floaters occur when the vitreous gel shrinks and clumps, casting shadows on your retina.
Some key points to consider:
- Posterior vitreous detachment symptoms, such as flashes and floaters, usually diminish over time, sometimes requiring several months 1.
- Pars plana vitrectomy is an option if symptomatic floaters are still bothersome after several months, and it has been documented to improve contrast sensitivity function 1.
- Laser treatments and pharmacotherapies have been proposed to decrease these symptoms, but such therapies currently lack sufficient evidence to support their use 1.
- Regular eye exams can help monitor any changes in your eye health, and it is essential to seek immediate medical attention if you experience a sudden increase in floaters, especially accompanied by flashes of light or peripheral vision loss 1.
In terms of treatment, pars plana vitrectomy has been used for removal of floaters, and improvement in contrast sensitivity function has been documented 1. However, this treatment is rarely recommended due to risks that outweigh benefits for most people. As you age, the likelihood of developing floaters increases, with most people noticing them by their 60s or 70s. It is crucial to weigh the potential benefits and risks of any treatment and to seek medical attention if you experience any sudden changes in your vision.
From the Research
Vision Floaters
- Vision floaters are characterized by the perception of spots or shadows in the visual field, commonly resulting from posterior vitreous detachment 2.
- The diagnosis of posterior vitreous detachment is typically determined clinically and can sometimes be confirmed with optical coherence topography (OCT) 2.
- Symptoms of vitreous floaters may be mild or may significantly affect patient quality of life 2.
Management Options
- Observation is the most common management strategy for vitreous floaters 2.
- Procedural management options include pars plana vitrectomy (PPV) and neodymium-doped yttrium aluminium garnet (Nd:YAG) vitreolysis 2.
- PPV is considered the most definitive management option for vitreous floaters, but carries inherent risks such as infection, cataract formation, and retinal detachment 2, 3.
- Nd:YAG laser vitreolysis is a less invasive alternative with varied success rates 2, 3.
Efficacy and Safety
- Vitrectomy has been shown to normalize contrast sensitivity function in patients with vitreous floaters 3.
- The procedure also improves visual function and quality of life, as measured by the National Eye Institute Visual Function Questionnaire 3.
- A study found that minimally invasive vitrectomy reduced the incidence of retinal tears and cataracts compared to traditional vitrectomy techniques 3.
- However, another study found that pneumatic retinopexy may be a safer and more effective alternative to vitrectomy for certain patients, with superior visual acuity and reduced morbidity 4.