I came across some lame website and sister-co-promotion site selling a PDF book that is guaranteed to rid you of all your floaters. It never states what the system consists of – whether psychological distraction , or excercises, or what – but for $37 and an instant download later, you can find out. Here are some screen shots of what was made to appear as advice from contributing “experts”:

This is a header screen shot from the "How to get rid of stuff" website.

At least it is convenient. You can learn how to get rid of odors, household pest and computer viruses as well as your floaters without ever leaving the web site. Here is some of their “advice”:

“Dude, slow down your mind. Ur overheatin’ your vitreous. Chillax. ” Oh, if I had a dollar for every time I said that… Here’s another:

Don’t scream and if you do, blink the floaters out of the way. More sage advice.

“Medication could help alleviate the symptoms of migraine if the condition worsens” What? There is no such thing as pain associated with simple floaters and certainly there is no connection with migraines. These “cut and paste” experts get it wrong more often than not. So here is the “Floaters Be Gone” product. Please le me know how it all works out. By the way, if anyone has read the contents of this “book”, please let me know what it is all about. Don’t be embarrassed. They make their money by taking advantage of those frustrated with medicine’s general lack of interest and lack of offering for those suffering eye floaters.

A nice text message from a patient with diffuse, cloud-like floaters all over. I told him after the treatment, I wasn't sure if it would be much better as there was so much hazy vitreous present. This was sent to me the evening of that treatment.

I have yet to see or hear of an ophthalmology training program or medical textbook that emphasizes the diagnosis of simple eye floaters. There is plenty of time devoted to pathological conditions that can cause floaters such as proliferative diabetic retinopathy, vitreous hemorrhages , inflammation, etc. but generally, it appears that the standard of care is to simply rule out the pathology and then comfortably declare the diagnosis of floaters. This means that when your doctor told you that you have eye the floaters, they may or may not have actually seen the culprit floaters responsible for your symptoms – even though they competently made the diagnosis. How can that be? Is that even ethical?

fig. 1 The ability to see the fence in the foreground depends on the depth of focus, the aperture of the lens and the focal point.

Optics are a funny thing sometimes. The eye floater sufferer may or may not see their floater, or they may see it to varying degrees of distress depending on the ambient lighting, the size of the pupil, whether they are looking at a bright plain background or a busy distracting one, etc. similarly, the examining eye doctor may or may not see a prominent floater based on the instrumentation and lenses they are using as well as where their plane of focus lies. The ophthalmoscopes and examining lenses used in ophthalmology are designed to focus in the focal plane of the retina. Much like the example in figure 1 where the photographer is shooting through a chain-link fence.

So a patient presents to their local eye doctor’s office with the concern over their new “moving shadows” in their vision. The doctor, upon reading the complaint on the chart, is thinking “probably floaters” but is obligated to find or rule out any significant pathology of the retina or other structures of the eye. Using retina-examining lenses and scopes, they look right through the “chain link fence”, that is, right through and past the eye floaters. They simply may not see, or may not be particularly impressed by the floaters that they do see. It happens all the time. Thinking back to when I was a general ophthalmologist, I can not really remember any particularly impressive eye floaters and yet I’m sure I had many patients suffering them. I do not criticize the other doctors, but I do believe the profession itself and its dogma have generally missed the boat when it comes to recognizing the significance of eye floaters.

So when you think back to your frustration when you left the eye doctor’s office and were wondering why the doctor did not seem interested, it was more likely optical reasons rather than not caring about your conditions. – Dr. Johnson

“I’ve had vitrectomy surgery in both eyes for floaters…followed by cataract surgery in both eyes….and recently capsulotomy by YAG laser in both eyes….vision is 20-20…..however the left eye has 3 large floaters…from the capsulotomy as well as 3 or 4 smaller ones…..I’m considering another vitrectomy…..the floaters float about in and out of vision…could your procedure help…they are debris from the capsule…not vitreous floaters I had before.”

The YAG capsulotomy is a very common procedure performed for people who have undergone cataract surgery with a lens implant. The artificial lens is placed into the original “capsule” which held the lens before surgery. The capsule is relatively dense basement membrane between 2-20 microns thick. Fragments of the capsule liberated during a capsulotomy can behave like a more typical floater caused by vitreous gel condensation. Because they are denser, tey are more of a challenge and require very focused energy and repeated shots to “fluff it up” and vaporize the material. The pieces should be relatively small if typical of what I’ve seen before. It would seem like a vitrectomy would require a accepting a moderate amount of risk for something so small. Likely the laser could fragment and obliterate it if it is not too close to the retina. It is certainly less risk and to do the laser procedure would not prevent you from later doing a vitrectomy if it didn’t work. Your situation is interesting: 1. You develop floaters… 2. Underwent the “Gold-standard” vitrectomy procedure to remove floaters… 3. Developed cataracts as a common side effect of vitrectomy… 4. Capsule opacifies, and you undergo YAG Capsulotomy which is a common side effect and treatment after cataract surgery… 5. You develop floaters. A rather circuitous route, I’d say. So back to your specific question… If the floaters can be seen, and they are not too close to the retina, you might do well with the laser procedure. I think it would be preferable than returning to the operating room, especially if the fragment is small. Cheers, Dr. Johnson