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 this
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 of patients who reported no
improvement, there was no evidence that 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 is
caused by a posterior 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.
These floaters which were pulled off the back of the eye are soft and
usually can be completely vaporized and do not recur. Our goal with this
type of floater is to provide a permanent cure.
With considerable experience and skill, they can be treated successfully
in 98% of cases done. A Weiss ring
is this type of floater. Several examples of this type of floater that we
have successfully treated are shown in the "Before/After Photos" (see
Menu on left side of Home Page of this web site.
(B) In patients younger than 55 years the floater is sometimes 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, the most common type of floater
comes from early, marked degeneration (syneresis) of the vitreous. This degeneration does not lead to any
problem in the eye except floaters. This
degeneration is simply water slowly leaving the vitreous gel. When the water leaves, the formerly clear
collagen architecture of the vitreous becomes visible as floaters. To the doctor the vitreous looks like a cob
web with multiple thin silk threads, clouds, and clumps.
If you are YOUNGER THAN 35 YEARS OLD, read carefully our web page Young Patients with Floaters before calling for appointments.
We see subclasses
of this type of floater:
1) If there are only a few small to
moderate sized floaters, they can be treated individually 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 completely removed
with the laser. In this situation the
goal would be to give the patient a significant improvement, not a complete
cure. If the patient does not think the
improvement is adequate, the floaters usually can still 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. This allows the floater clump
to relocate to another part of the vitreous outside the line of
sight. This improvement is frequently dramatic. Success in
this type of floater is 95 percent or higher (see example below).
(D) There is another fairly common floater which I was the
first to describe and have named a “Floater
Duet.” It is combination of a floater pulled off the back of the eye by a
vitreous detachment plus multiple floaters low in the vitreous from vitreous
degeneration which is described in first paragraph of the (C) section
above. If the floater pulled off the
back of the eye is the main offender in this duet, we can usually easily remove
it with the laser. However, if the
floaters low in the vitreous are the main offender from swinging up into the
middle of the vision, we don’t do the case because such low floaters can not be
reached adequately by the laser.
However, these cases can be treated with the vitrectomy operation with
its attendant risks.
(E) The other floaters form a miscellaneous group:
From inflammation--We do not offer the laser procedure if the inflammation
is recent and may be recurrent. If the
inflammation has been quiescent for years (for example in toxoplasmosis), we
may offer the procedure
From asteroid hyalosis--These are bright, multiple (maybe 400) floaters
that are not reduced by laser treatment but usually don’t bother the patient
much. Occasionally these floaters form
into clumps that disturb the vision. The laser can break up the clumps and make them
From hemorrhage--Most hemorrhage associated with a posterior vitreous
detachment absorbs within three weeks.
We don’t attempt to remove large blood clots with the laser.