IS LASER TREATMENT AN OPTION?

Scott Geller MD and the staff at South Florida Eye Foundation have helped thousands of patients over the past 20 years. We have the largest number of patients worldwide and have the experience to know who can be treated safely. Most patients are helped, but some of the more difficult cases may still need vitrectomy to get an outcome that the patient is seeking. We have helped people who were told 'nothing can be done - live with it'.

But this is medicine, not mathematics. We can only give a prognosis after an examination. Patients come from all over the world to our facility, and our intention is to make sure a consultation with us is a worthwhile experience. Laser Vitreolysis works.....most of our patients leave happy. We'd like to help you too.

The prognosis for treatment varies with the type of eye floater, so please review the information presented carefully.


MID-VITREOUS FIBRILLAR MASSES

These floaters are the easiest to treat. The age range is usually 40 to 55 years. A large mass that appears to the doctor like a ball of lint. It is well suspended in the mid vitreous, and the rest of the vitreous is generally clear. It obscures the object the patient is observing, and does not move easily. There is no posterior vitreous detachment. It is especially disabling to one-eyed patients. In almost all cases, merely getting it out of the visual axis has a dramatic effect.

POSTERIOR VITREOUS DETACHMENT
The separation of the vitreous body from the retina results in a shrunken jellyfish like bag attached behind the iris like a deflated airfield windsock floating in the sphere of the eye. The bag can contain fibrillar clumps and strands. Dense ring like or solid structures can be attached to the surface. These solid structures are easy to treat and in most cases can be pulverized to the point of minimal or no perception. The masses inside the bag can be reduced for visual improvement. Even after laser, patients will have some perception of floaters since the bag itself is still there. Patient ages usually range from 45 to 70 years.

VITREOUS SYNERESIS STRANDS
The vitreous gel has somewhat liquified and the normally invisible fibers have aggregated into many stands and clumps that are very mobile with clear liquid vitreous in between. Patients are often nearsighted and range in age from 35 to 70 years. Laser can eliminate a lot, but there still is some floater perception after treatment.

YOUNG AND POST-LASIK PATIENTS

Patients range in age from 20 to 33 years. The vitreous is generally clear except for small opacities close to retina and very mobile. They are often in the central visual axis within the 'pre-macular bursa' directly in front of the central retina. They are often no more than 100-200 microns but appear large to the patient due to the proximity to the retina. In LASIK patients, the suction ring placed on the eye has literally sucked a peripheral opacity to the central pre macular area. These floaters tend to be extremely disturbinging to young patients, and are extremely difficult to treat. Even with success, there are often some residual opacities. These patients are advised to have their local ophthalmologist examine them with a 'Goldmann Lens'. It is the ONLY way to really visualize these floaters. They usually cannot be seen with a standard slit lamp - ophthalmoscope examination. If they can't be easily seen by your ophthalmologist, they are probably too small or vague to be lasered.

IF YOU ARE UNDER 35 YEARS OF AGE, PLEASE READ THIS:

Many patients under 35 (especially post LASIK ) have floaters that are often untreatable by laser, usually because they are extremely close to the retina in a potential space called the 'pre-macular bursa'. And these patients had been told by their ophthalmologist that they could 'see the floater' and that the floater(s) was 'xx millimeters from the retina'.

The unfortunate fact is that these floaters are impossible to see with the usual examination methods. The only way of examining the vitreous is with a Goldmann Examination Lens to check for floaters in the pre-macular bursa.These floaters are particularly annoying since they are usually trapped in the central 20 degrees of the visual field, and appear quite large due to their proximity to they retina. But their actual size is often no more than 100 microns ( 0.1mm ). 

Even if your Ophthalmologist can 'see the floater', if a Goldmann Lens was not used (it is physically placed on the surface [cornea] of the eyeball ) the doctor is usually wrong in patients under 35. We know this from our experience with hundreds of patients who have had the same story. 

Before you go in for an exam, ask if your Ophthalmologist is willing to examine the vitreous with a Goldmann Lens. Have your doctor call Dr. Geller prior to the exam to explain exactly what to look for. Many Ophthalmologists have never seen or paid attention to this type of micro (but large to the patient ) floater. We urge you to take this step, as many patients have come from all over the world, only to be disappointed after a proper evaluation by Dr. Geller.