Dear Doctors: You recently stated in a column about eye floaters that there is no cure at this time. I got a vitrectomy for this condition, and it was life-changing for me. By no means is this procedure meant for everyone as it is not without risk, but there is a cure!
Dear Reader: Eye floaters are so common, an explanation of the term may not be necessary. About 70% of adults have them to some degree. For those lucky enough to not know what we’re talking about, we’ll explain: Floaters are tiny clumps of collagen, protein and other cellular debris that drift through the vitreous. The vitreous is the gel-like substance that fills the back of the eye. Because these particles block the path of light entering the front of the eye, they cast shadows on the retina that can appear as specks, strands or cobweblike shapes.
In most cases, floaters aren’t a risk to eye health. For some people, they can be severe enough to interfere with vision. Extensive floaters can make it hard or even impossible to engage in daily activities such as reading, working at the computer or driving. They can also interfere with visual clarity in low light and adversely affect night vision. When floaters become severe and persistent, doctors may recommend the surgery you had.
A vitrectomy is surgery to remove the vitreous from the eye. The doctor makes small cuts, then suctions out the vitreous. Because the vitreous helps maintain the shape and volume of the eyeball and holds the retina in place, they then replace it. In most cases, they replace it with a sterile saline solution. If there are other retinal issues, they may use a bubble of air or gas or silicone oil.
This is usually an outpatient surgery, and you return home the same day. Side effects can include redness, swelling and a few days of blurred vision. Patients use a temporary eye patch and eyedrops to reduce swelling and prevent infection during recovery. Patients must restrict their driving during the initial recovery period. It is also important to avoid physical exertion for a few weeks. If the eye is refilled with a gas bubble, patients may need to keep their head in a downward position to keep the bubble pressed against the retina. Patients must also avoid high altitudes or flying until cleared by their doctor.
As you note in your letter, this surgery isn’t for everyone. Risks include bleeding, infection, retinal detachment, glaucoma, cataract formation and possible changes to vision. As a result, vitrectomy is often reserved for severe cases where floaters are severely impacting quality of life. Someone with severe floaters should begin by seeing an ophthalmologist who specializes in this condition. They will assess your situation and help you to understand the risks and benefits, other treatment options and what to expect if you proceed. We are happy to know that your own surgery went well and that it resolved the visual problems you had.
(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
