The age group that is by far the most successfully treated is the older than 45-50 year old patient. This group makes up the bulk of our patient base. They have often experienced a posterior vitreous detachment (PVD) described also on our floaters page.
fig.1 The early stages of a posterior vitreous detachment with thickening and dehydration of the vitreous and pooling of fluid in the center of the globe
The vitreous detachment may occur quite rapidly as there is a posterior movement and shift of this fluid. As this occurs, the vitreous body moves forward separating from the retina. The patient may experience a sudden onset of a large floater, or multiple scattered floaters, or thousands of small round specks scattered all throughout the eye.
fig.2 As the pooled fluid shift backward, the vitreous body moves forward and away from the retina.
Weiss Ring Floaters
A Weiss ring floater is a particular type of floater that is always associated with a PVD. There is often a particular thickening of the vitreous outer containing sac that surrounds the optic nerve head where it enters the eye. These floaters are classically ring-shaped, but may also collapse into a dense central floater.
fig.3 A example of a floater duet: a Weiss ring combined with diffuse cloud floaters
Weiss ring floaters rarely occur in isolation. There is often other floaters that coexist such as strands and dense clouds, but the Weiss ring tends to be the most prominent and bothersome.
Treatability of older patients
The good news is that even thought the floaters associated with a PVD are typical larger and more extensive than with the younger age groups, these floaters are more successfully treated. They are usually clustered away from the critical eye structures (retina and lens), and the density of the Weiss ring-derived floaters absorb the laser energy readily and are definitively vaporized. There is some fragmentation of the floater into microscopic pieces that may benefit from further treatment or they may be so small as to be optically invisible. As with all patients, the other, cloud-like floaters that may also be present can be treated, but tend to have more of a tendency to regress or reform. This effect is described in detail on the Expectations of Laser Treatment page.
I have had laser eye surgery in both eyes. Will this affect treatment of floaters? I have had floaters all my life but within the last few years have seen an increase. I have been checked and my doctor has told me that it’s part of aging and there is nothing to do about it.
Brian, I presume when you say “laser eye surgery” you are referring to laser vision correction to the cornea such as with the LASIK or PRK procedures (laser can also be used to treat retina holes and such, but less common). I quite commonly treat people with previous corneal refractive procedures. There are some changes to the cornea that may make my laser procedure somewhat less efficient, but it rarely anything that would affect the eventual outcome. The reason is that laser vision correction creates different optical zones within the cornea which may dissipate some of the laser energy. It is important to emphasize that prior laser vision correction does not increase any risk to the patient. I’ve written about this particular issue HERE. Regards, Dr. Johnson