What Are Floaters

The eyes are the photosensitive organs of the body, they allow us to perceive images by processing in the brain the visual information received through the different ocular layers: a light beam goes through the cornea, the lens and other refractive structures like the vitreous and its finally focused on the retina. The retina converts light stimuli into electrical impulses that are transmitted to the visual cortex.

On its way to the retina light must traverse the vitreous which is the eye ́s largest optical element. The vitreous is an extracellular matrix formed by collagen and other molecules but more than 95% of its mass by weight is water. It is an extremely clear structure and this should be considered one of its main functions. It no surprise then that opacities in this affecting this structure results in visual symptoms, especially following a successful cataract surgery patients report an increase perception of floters and blurry vision, this is even more likely when a multi-focal IOL is inserted.

For most vitreous floaters improve as gravity pushes them away from the visual axis. Unfortunately patients suffering from continuous symptomatic eye floaters have been known to ¨shop¨ for ophthalmologists, which highlights, to some extent, the importance of treating patients vision degrading miodesopsias.

Evidence suggests that while floaters are benign alterations, ophthalmologists frequently underestimate the impact on patient quality of life, falling to recognize that some patients with persistent symptoms warrant treatment.

Multiple treatments strategies are available albeit vitrectomy being the more prevalent in spite of other less invasive techniques, notably YAG vitreolysis. Unconvincing results, from non invasive therapies have prevent widespread use and thus vitrectomy remains as the only viable alternative.

Although modern vitrectomy techniques and use of small gauge instruments have reduced the inherent risks of vitrectomy; common practice among most ophthalmologist is to refrain from surgical management in patients suffering from symptomatic myodesopsias who are otherwise healthy, fundamentally due to the lack of evidence of postoperative improvement when measured by visual acuity charts. However patient refer increased visual quality and improved quality of life following a successful vitrectomy.