FLOATER TYPES--SUCCESS

This page tells you the main types of floaters we see. By reading this page carefully, you may be able to obtain some idea of the type of floater you have and the success rate in treating it. But a patient's classification of their own floater is rather uncertain. An ophthalmologist's evaluation is more certain, but because this procedure is almost unknown, the only certain evaluation for what can be done is by a surgeon who performs the procedure.

The overall success rate when we treat a floater with the laser is about 92 per cent. However, the rate varies according to the type of floater. For the 8 per cent who report no improvement, there was no evidence a procedure had been performed, and no harm was done.

(A) In patients 55 years or older, by far the most common type of floater is an isolated, fairly large one that develops as a result of a detachment of the vitreous jelly. Most of these floaters are attached to the back wall of the detached vitreous bag.  This type of floater usually appears as a vague glob to the patient, is difficult for them to draw, is seen immediately by the doctor, and is easily photographed. Such floaters which were pulled off the back of the eye are soft.  With considerable experience and skill, they can be treated successfully in 96% of cases.  A Weiss ring is this type of floater.  Several examples of this type of floater that we have successfully treated are shown in the "Case Photographs" page of this web site.  Other floaters associated with a vitreous detachment may be within the detached vitreous jelly and are more difficult to treat.  The success rate of this entire group is about 92 per cent.

(B) In patients younger than 55 years the floater is frequently a small one very near the retina that can not be treated. The floater is seen by the patient as a distinct, discrete particle (not a vague mass), is very easy for the patient to draw exactly, is quite bothersome to them, is usually difficult or impossible for the doctor to find, and is impossible to photograph. Often the patients with this particular type of floater tell of anxiety, depression, or problems on the job which they relate is caused by the visual problem associated with the floaters. If you believe that you may have this type of floater, we strongly suggest that you see your local eye doctor (see "Exam. in your city" page) before coming here. The important questions to the doctor are: "Can you see my floater?" and "Is it very close to the lens or retina?" Remember this type of floater is tiny, but appears big because it usually is close to the retina. If your doctor can't see it, perhaps I could not find it either, and a trip here would not be fruitful.  We can see and attempt to treat only about 10 percent of this type. We are successful in about 50 per cent of those treated. (No pictures are shown because these floaters are too small and transparent to be photographed).

(C) In patients 55 or younger, a less common type of floater comes from early, marked degeneration (syneresis) of the vitreous. To the doctor the vitreous looks like a cob web with multiple thin silk threads, clouds, and clumps. We see three subclasses of this type:

1) If there are only one or two small to moderate sized floaters, they can be treated directly with the laser with about 85 percent success.
2) If there are numerous clumps, or the clumps are very large and free floating in the vitreous, they can not be treated with the laser. These usually can be removed with the vitrectomy operation which we do not offer, but there is significant risk.
3) If a large degenerative clump is being suspended in the line of sight with one or two thin strands, we can frequently cut the strands which relocates the floater clump to another part of the vitreous out of the line of sight.  This improvement is frequently dramatic.  Success in this type of floater is 95 percent or higher (see example below).