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 been told since my very first eye exam when I was a teenager that I had floaters. I am now 60 years old and have also had laser eye surgery. But I have so many floaters it is as if I am seeing thru gauze. So if I were to have this treatment what are the odds of them returning in that I have had them since such a young age? I have had vitreous detachment now in both eyes.
answer: Lorrie, first with the usual disclaimers: each eye is different and there is no foolproof and reliable way of describing the floaters or predicting their “treatability” without seeing them in person. Usually the floaters that people have in their teens are quite different from the ones that they experience in their 50′s or 60′s. The floaters that younger people describe are typically filaments and fine strands or dots with very definite shape and outline. These are most often located within 1 or 2 mm proximity to the retina. The one bit of good news is that when that patient experiences a posterior vitreous detachment, that event should pull all of that material away from the retina where they will be less bothersome or not seen out all. The bad news is that that patient may have bigger and more bothersome floaters associated with the PVD, such as the gauze that you described. So to answer your question, I do not think that these small and fine filament-like floaters would return as there is no longer a thick vitreous fluid to trap them close to the retina. If you are describing eye floaters that are like looking through gauze, then it is not likely the same type of floaters that you had when you are younger.
I’m 54 years old and have had a large floater in my right eye since I was a child. Until just recently I’ve been told that there’s nothing that can be done and I just have to live with it, which I’ve done for a very long time. Due to this, I have always read through my left eye (which is 20/20) while my right eye just wanders. Being right-handed, this floater makes it difficult to aim a rifle as well as a few other activities.
It’s not a ring-shaped floater but rather looks like a tight group of little strings or hairs, and it’s right in the center of the vision area of my right eye.
Can you give me information on where I can go to get this corrected, and whether my insurance covers the procedure(s)?
answer: Bob, There may be more to your eye history that may be important to know. Rarely are the eye floaters so bad that it would block or obscure your central vision enough to cause occlusion amblyopia and strabismus which what I think you have just described. This would be extraordinarily rare in a child unless there are some significant remnants of the hyaloid the did not regress and disappear before birth. I could not make a recommendation for treatment with me or anyone else until I had more information. You can send me a private email to: info(at)vitreousfloatersolutions.com . If you would like to send records, you can do so to my fax: 949.253.5769 and I’ll be glad to take a look. – Dr. J
Hello!
I am in Ohio. Do you have plans to open a treatment center here? I have no way to get there for evaluation and I just developed two large floaters last week. I am 56 and very nearsighted. These floaters are very distressing!
I’m sorry, no plans for Ohio in the works although I wouldn’t rule out opening another office somewhere in the middle of the Country. Maybe I’ll wait to see where my daughter ends up going to college. In the meantime, I’ll be here in Southern California across the street from the Orange County Airport.
I had what might be described as a “trauma” induced PVD. About a year ago, I suddenly turned my eyes to look away from something and felt something give in my left eye.
A few minutes later I saw a small red dot for only a second, then a swam of floaters filled the eye–and have been here ever since. They are several large masses (from my subjective view) that moves rapidly every time I turn my eye–in the opposite direction, like a windshield wiper.
My right eye has significant increase in floaters in the past year or so as well, but they move much more slowly, and follow eye direction with some lag time –so I get this crossover effect from the floaters moving in opposite directions–very annoying.
The left eye is also dry and irritated, and still has some slight light flashes on the far left periphery at times. I am sure the irritation is related to the same event as the floater–could this be a damaged vitreal sac that is moving back and forth? And, most importantly, is this windshield wiper effect something that can be helped with YAG, or other methods??
Thank you
answer: Dave, it may seem traumatic to you, but moving your eye rapidly would not be considered trauma even if it was the event that seemed to precipitate the posterior vitreous detachment (PVD). More likely there were aging changes to the vitreous that preceded this even my weeks perhaps. The near instantaneous shift of fluids that occurs with a PVD can make it appear traumatic. Regardless of how loose and liberated the vitreous is, it CAN NOT irritate the surface of the eye where dryness and irritation is perceived and takes place.
If there are relatively specific groups and clusters of floaters, then the YAG laser may be helpful. If there is a diffuse, non-specific, cloudy, hazy sense of movement, then it may be more difficult or impossible to treat effectively. – Dr. Johnson
thank you Dr Johnson for your answer–hard to say re the grouping vs hazy–there seems to be both, with a large out of focus cluster (?) that seems to move rapidly and opposite to my eye movement, and creates blurring of about 1/3rd of my visual field as it darts by. I believe my eye Dr said that it was a big grouping of floaters–and also that they were far enough away from the retina that he would consider “cutting” them loose–he apparently will do this occasionally with a YAG with floaters. I am not going to do this, will see you if anyone–thanks again
answer: I have not found the “cutting them loose” to be a predictably effective technique. There is no primary strand that suspends or holds the floaters in position. Something as large as you have described probably will take a bit of work. It does not sound like a few well-placed shots would make a huge improvement. Oh and thanks for your vote of confidence. – Dr. Johnson
I am 72 years old. I had cataract surgery at the age of 43, but I was considered too young to have an intraocular lens implant. I received a perforation in the capsule posterior by laser a few months later. I have 20-20 vision in my right eye with a contact lens. My left eye is amblyopic with 20-80 vision. About 6 years ago a large C-shaped floater developed in my right eye. I received the usual advice – the eye is healthy so learn to live with your floater. However, it drives me crazy and I would love to have it removed if it can be done safely, bearing in mind that I have poor vision in my left eye. What do you think?
answer: A sudden-onset floater with a C-shape is likely a Weiss-ring (partial ring). These are my favorite floaters to treat because of the high success, immediate gratification, and especially their location which is usually in the center of the eye safely away from the retina and lens. I have carefully treated others with one good eye (or one eye only). You may very well be a good candidate. Every eye is different, and ultimately it takes an in-person evaluation to say for sure.
Hi, I’m 56, was always nearsighted until having cataract surgery lens replacement. Both eyes, but done about 9 years apart; most recent eye done 3 years ago. (I loved that they were able to dial-in the correction for the myopia; I’m now focusing about 18″ in the first eye done, and distant in the second.)
Floaters began to appear about 5 years ago in the first eye done. My eye doctor said to learn to ignore them, of course. The floaters are worse in the first eye that had the cataract surgery. (Right eye). They wave around like a flag in the wind as I move the eyes. My doctor said he could “definitely see the floaters”, but I don’t have any further detail on what type they are.
My question is, Is the laser procedure impeded by the cataract surgery artificial lenses present?
Thanks!
answer: It is quite common for me to treat through an artificial implant lens. The main challenges with the implant lenses is a smaller diameter that I have to work through, typically about 5.5 mm. The typical fully dilated pupil is more like 7-8mm in diameter. The difference of 5.5mm vs 8 mm diameter is a 50% reduction in the surface area to work through. There is sometimes some funny glare and reflection from the lens implant, but all that said, I’ve had some very successful treatments through these lenses.
First, I am 65 years old and fall often. On Christmas Eve 2011, I tripped and fell onto my right eye. I was taken to the ER at one of hospitals with double vision. By the next day, my double vision had corrected itself, but I was left with a floater that was larger than any floater I’ve had before. Since then, I have noticed hairlike strands in my vision. I figure the strands are scratches to my eye from the fall. I plan to make an appointment with the eye doctor, but I wanted to ask you about your laser procedure. I really didn’t think there was a procedure for floaters. Thank you, Ruby.
answer: Ruby, I’m sorry to hear of the floater and I’m gad there’s no major damage to the eye. The hairlike strands you describe ARE NOT scratched in the cornea. Irregularities of the cornea, if significant , can blur or degrade vision but they would have to be more like permanent scars. The surface of the cornea heals very quickly and usually without scarring. Any moving shadows or images is almost by definition in the vitreous fluid. Most likely you experienced a posterior vitreous detachment (PVD)and what you see are the shadows cast onto the retina. Very common in your age demographic. A PVD occurs in about 25% of 60 year-olds, and the incidence goes up from their. The good news is that these are usually treatable with the laser. They can also be removed by more traditional (and invasive) surgery but the retina specialists aren’t to inclined to offer it “just” for floaters.
my wife has a floater what can be done you are 200 miles from us
It depends on the type of floater(s) and where it/they are located. If she is older than 45-50, and the floaters came on pretty suddenly and especially if your doctor was able to see the floaters, then she is more likely to be a candidate for treatment. If she is younger than 30-35, then the prospects are much less likely. If the floaters have been present for more than a month AND they are very bothersome affecting either (or both) the quality of vision or the quality of life, then it may be worth you time to make the drive down here for an evaluation at my office to find out if your wife is at least a candidate for treatment with the laser.
Cheers, Dr. Johnson
Doctor I started having floaters in my right eye two months went to the eye doctor stated nothing wrong with my eyes, something going on in the brain, went to the doctor he ordered a mri with contrast no mass no tumor,I am 68 year old so MS was rule out no other symptoms no eleveted blood pressure no high closteral , I do have diabetits and over weigh, please help frieda eagan
I would like to how confident you are that you have floaters. Self-diagnosed? As a general guideline, any moving shadows or moment-by-moment fluctuation in your vision is due to some density in your vitreous cavity. Problem of the tear layer, cornea, lens, retina, optic nerve, or any part of the brain can not duplicate the sensation and subjective experience caused by vitreous eye floaters.
So the question then is do you have eye floaters based on what I just described? If so, is it possible your doctor is just not using the right lenses and lighting and magnification to see the floaters? It is possible even with well qualified and experienced eye doctors. Ordering an MRI may just be defensive medicine. If you wish, send me a private email or call my office. I’ll be glad to talk to you about your frustrating situation. Of course, without examining you in person, I’ll be speaking in generalizations. Every situation is different.
I am a 75 year old woman, who is recently diagnosed with floaters of the left eye. My vision is rapidly decreasing in my right eye as well. With this information, what do you suggest as a doctor that I should do next? And am I a possible candidate for your procedure that you offer? I am also curious as to know what is the rate of floaters coming back, and what is the aftermath of this procedure.
Hello Unette, You mentioned that your vision is decreasing in that right eye. Is that due to the floaters? or something else like cataract or macular degeneration? It is important to sort that out. Macular degeneration and cataract can both cause decreased quality of vision – BUT it is only floaters that cause moving shadows and fluctuation of vision from moment-to-moment. As far as candidacy for the treatment, there is no simple set of questions that will definitively determine your candidacy. I can say that floaters associated with a posterior vitreous detachment in the older age demographic are usually treatable with the laser. Different types of floaters (e.g. diffuse clouds vs. smaller and condensed floaters) are more or less efficiently treated and that assessment can really only be made in person. -Dr. Johnson
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