Issue 20.16
Do you have small specks, clouds or what appears to be ‘little tiny bugs’ moving into your field of vision? These are called floaters. You can often see them when looking at a plain background, like a blank wall or blue sky. These floaters are actually tiny clumps of cells or material inside the vitreous; the clear, gel-like fluid that fills the inside of your eye. While these floaters look like they are in front of your eye, they are actually floating inside it. What you see are the shadows they cast on the retina (which is like the film in a camera). You may have noticed that these pesky floaters can appear as different shapes, such as little dots, circles, lines, clouds or cobwebs. The vitreous is important during ocular development as it forms a scaffold around which the essential structures form. (Remember back to scouts when you constructed a head or mask with paper mache’ around a balloon—once the paper mache’ hardened, it was ok if the balloon deflated). As we grow older, it is common to experience floaters as the vitreous gel condenses and shifts with age and peels away from the inside surface of the eye.
The laser we have always used to treat floaters has been modified with new optics to allow better treatment of deeper floaters, to reduce the annoying distraction floaters cause. This floater laser treatment, called vitreolysis, has shown to have a remarkable effect on patients’ quality of life—on par with such procedures as cataract surgery and refractive surgery. Unfortunately, some patients tend not to divulge symptoms unless specifically asked, since they have often been told there is nothing that can be done to resolve floaters. However, there are very few procedures that have such great benefits with so few risks.
When the vitreous gel pulls on the retina, you may also see what look like flashing lights or lightning streaks. These are called flashes. You may have experienced this same sensation if you have ever been hit in the eye and “seen stars.” The flashes of light can appear off and on for several weeks or months. If you see flashing lights that last more than 5 minutes, you should have a dilated eye exam to determine why.
The retina is the light-sensitive tissue lining the back of our eye. Light rays are focused onto the retina through our cornea, pupil and lens. The retina converts the light rays into electrical impulses that travel through the optic nerve to our brain, where they are interpreted as the images we see. A healthy, intact retina is key to clear vision.
Usually, the vitreous pulls away from the retina without causing more problem than a few light flashes. In 8-10% of cases, however, the vitreous pulls hard enough to tear the retina in one or more places. Fluid may pass through a retinal tear, lifting the retina off the back of the eye — much as wallpaper can peel off a wall. When the retina is pulled away from the back of the eye like this, it is called a retinal detachment.
A retinal detachment is a very serious problem that almost always causes blindness unless it is treated with detached retina surgery. Thus every person that experiences a new onset of floaters or flashes should be evaluated urgently by an Ophthalmologist to rule out a detachment.
The human eye is reasonably fast, adept at detecting contrast, and surpassed in resolution only by birds of prey-a good all-around eye for the most versatile animal of all. Our job is to keep it healthy and functioning well. The YAG laser vitreolysis procedure is a safe, effective option for the treatment of floaters in the majority of patients. If you are interested in finding out more about this advancement in vision correction or have questions, please call Richens Eye Center, 435-216-1226 or visit us online at richenseyecenter.com.