It has happened more or less to everyone. We are looking at the sea, the blue sky on a particularly bright day, on the sheet that we are writing on or more simply, the white screen of the computer and suddenly, we notice the presence of so many small dark corpuscles, filaments, and spotters floating on our visual field.
Commonly referred to as “flying flies”, these moving bodies are scientifically defined as, by their “floating” nature, “eye floaters”. Although they are not per se dangerous to the sight, eye floaters should not be neglected as they may spell a more serious eye disease (such as retinal detachment) or simply cause discomfort in carrying out daily activities, first and foremost, reading.
To describe the causes of eye floaters, it is necessary to briefly dwell on the anatomy of the eye. The vitreous body, a clear and gelatinous substance that fills the space between the crystalline lens and the retina, therefore retains the spherical shape of the eyeball, makes up about two-thirds of the volume of the eye. The vitreous gel consists of 99% water and the remaining 1% of collagen fibers, sugars, vitreous cells (hyalocytes), proteins, hyaluronic acid, electrolytes, etc., which constitute the scaffold. The deterioration of the microstructure of the vitreous body begins with the fluidization of the gelatinous component: the collagen fibers begin to fragment and form filaments of different shapes that sometimes intertwine. They may project a shadow on the retina and are perceived as opacity, the eye floaters. Vitreous degeneration is a natural phenomenon primarily due to aging, which is why after 40 or 50 years of age it is easy to detect the problem more frequently. Other causes of the defect are due to myopia, which, if rather high (i.e. above 5 diopters), may cause accelerated degeneration processes even in younger years, between ages of 20 and 30. Finally, eye floaters may be caused by head trauma, prolonged use of specific drugs, dehydration or metabolic disorders that favor the degenerative process of the vitreous body.
A thorough eye examination can ward off the danger that eye floaters may manifest, more serious eye diseases. The fact that there are currently no specific medications to treat floaters, two routes can be followed for treatment: laser surgery or vitrectomy. The choice of one or the other treatment is to be evaluated together with the treating physician based on the characteristics of the defect.
The Treatment With Yag Laser
The treatment of floaters with Yag Laser is the preferred treatment when the defects are sufficiently distant from the retina and the crystalline lens. The intervention is simple, not painful, and lasts from 10 to 30 minutes after which the patient can resume normal work or sports activities. Through the laser, the eye floaters can be eliminated in three ways: vaporization, delocalisation, and thinning.
– Vaporization is the laser striking the fibrils directly transforming them (moving bodies) into gases.
– Delocalisation is done by cutting the upper area of the thin filaments that hold them together. They all scatter below and no longer interfere with the field of vision.
– Thinning is preferred when floaters are multiple, fibrous, and harder to vaporize. In the case of having a hundred of moving bodies that have been highlighted, since overheating the vitreous body should be avoided, the solution is to strain them.
It should be emphasized that it may often be more than just a treatment to get the best result and that the purpose of the procedure with Yag Laser is to eliminate opacities in the vitreous, not to remove them from the body. If the patient’s vitreous is permanently damaged, blurred or streaked, the laser can not change it.
Vitrectomy is an advanced ophthalmic microsurgery technique that removes the vitreous of the eye, partially or totally. Used for the treatment of various ocular pathologies that are developed when the vitreous body is irremediably damaged and is no longer transparent, the operation consists of cutting and suctioning of the vitreous humor by inserting microspheres into the eyeball. These microspheres are of extremely small diameter (0.4 mm) so as to minimize complications during and after surgery and provide a faster recovery of the patient.
The surgery is performed under local or general anesthesia and its duration may obviously vary depending on the severity of the problem. Generally, the operation lasts about 20 minutes, while postoperative recovery, except for any complications, is approximately 24 hours. Afterward, the patient has to follow some special arrangements, among of which is the use of particular collars, to follow certain postures for sleep, and avoid the certain effortful activities.
It is therefore appropriate to carefully evaluate the pros and cons of each treatment of choice with your ophthalmologist to reach the safest resolution to the problem.