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LASER Treatment of Eye Floaters in office – Please call office for details
YAG LASER ABLATION (Photoablation) OF VITREOUS FLOATERS
(919)942-8701 , ext 114
People see eye floaters as small spots, specks, cobwebs, or clouds moving in their field of vision. Floaters can range from being a nuisance that can be ignored, to interfering with essential daily activities such as reading or driving. Eye floaters that are not close to other ocular structures are ideal for laser treatment because they have no blood supply and will not bleed.
Floaters (Vitreous floaters, eye floaters, vitreous opacities) are small, cloudy, clumps of cells that are suspended in the vitreous, the thick fluid or gel that fills the back three fourths of the eye. Thus, they follow the rapid motions of the eye, while drifting slowly within the fluid. When floaters are first noticed, the natural reaction is to attempt to look directly at them. However, attempting to shift one’s gaze toward them can be difficult since floaters follow the motion of the eye, remaining to the side of the direction of gaze. Floaters are, visible only because they do not remain fixed within the eye. Stable vision is often interrupted by floaters, especially in cases where floaters tend to remain visible.
Floaters are particularly noticeable when looking at a blank surface or an open monochromatic space, such as blue sky. Despite the name “floaters”, many of these specks have a tendency to sink toward the bottom of the eyeball, in whichever way the eyeball is oriented; the supine position (looking up or lying back) tends to concentrate them near the fovea (the center of the retina responsible for detailed vision), which is the center of gaze, while the textureless and evenly lit sky forms an ideal background against which to view them. The brightness of the daytime sky also causes the eyes’ pupils to constrict, reducing the aperture, which makes floaters less blurry and easier to see.
Laser disruption is accomplished as follows. After dilating the pupil, numbing eye drops are given. Then the laser is carefully aimed by the physician, through a special lens for treating eye floaters. The Laser is focused on the floater or floaters. The Laser is applied, and bursts of energy, either vaporize the floater(s) (known as ablation) or the floater’s attachments are vaporized (vitreolysis) so that the floater is repositioned to a different part of the eye. This disruption also helps the eye to absorb any remaining tiny particles. In a short period, following treatment, many patients notice an almost immediate improvement in vision. Many floater problems are more complex than others and may require multiple treatments.
The floater disruption is performed with a beam of invisible laser light through the pupil. There is no incision or discomfort. The focusing is very precise and the laser is owned, and used only by our surgeons. The procedure is done best with intense concentration, and without distractions. It is not possible to determine, without an in office evaluation, whether a patient and case can be a candidate. The length of time a particular case may take, also requires an in office consult to determine. An initial evaluation is required to determine the the course of treatment. Only the physician ever operates the laser on a patient. Post-operatively there are very few restrictions on activities. The patient is seen the next day in our office for a follow up visit. Occasionally it is not possible to disrupt the floaters in one sitting, and additional sessions are required. Dr. Wood has treated patients who have been turned away from treatment by others, or were partially treated with unsatisfactory results.
Laser Photoablation works by vaporizing opacities into small gas bubbles that quickly dissolve. Once a laser pulse is emitted, treatment occurs by both ablation and lysis. Floaters are vaporized, and plasma forms.
In a study by Delaney and colleagues, Nd:YAG photoablation and laser vitreolysis were found to be safe and without complication, and had noticeable benefit. Other studies report a visual improvement without complication in nearly 100% of patients treated with laser, though sample sizes were small (Toczolowski et al., Tsai et al.).
The Technical Details: The YAG laser emits the beam in a cone-shaped pattern. At the apex (or tip) of the cone there is a concentration of the energy. Using focusing lenses, this apex is directed onto the front surface of the floater material. The laser “shot” lasts only 20-30 nanoseconds (0.000000030 seconds), and at that moment the concentrated laser light creates a small plasma-state “bubble”. As you all will remember from your physics courses, plasma is the fourth state of matter, (the first three being solids, liquids, and gas). Matter that has been converted to plasma has the electrons pulled away from their usual location and creates a high energy state of the matter. This process actually converts the floater material to a small gas bubble. It is important to understand that the laser does not just break the floater into small pieces, but actually changes it to a gas. The gas is reabsorbed into the bloodstream over the course of a few hours.
Please call our office for more details on Floater Treatment
(919)942-8701 , ext. 114
Floater Ablation Testimonials:
” Glad to say a few words about my experience of having Dr. Wood perform laser surgery on my eyes in order to eliminate, or reduce, the “floaters” that have plagued me for three or four years. The procedure was painless, lasted about fifteen minutes, was stress free, but most importantly, after two follow-ups (as expected), my “floaters” are nearly imperceptible to me. Hooray! My trust and thanks to Dr. Wood. He’s my man!
– Scott P, Chapel Hill, NC ”
I am writing to tell you how happy I am with the success of Dr. Wood’s treatment of eye floaters using the YAG laser (vitreolysis). I have had a large, fuzzy floater in my right eye for at least a dozen years which was persistently in my line of sight. It was moderately bothersome while reading, working on a computer (my day job), or driving – I would have to roll my eyes to get it out of the way so I can see clearly out of that eye for a few seconds until it repositioned itself back into my line of sight.
Over these last dozen or so years I have asked my eye doctors how these could be treated, and the response was always a shrug or “nothing we can do.” Separately I am aware of the vitrectomy procedure which a friend of mine has had in both eyes to great effect. I had been working my way up to having a vitrectomy, but the benefit/risk/cost profile of vitrectomy was not something I could get fully comfortable with. I was, therefore, thrilled when I learned of vitreolysis, its effectiveness, relative lack of risks, and its affordability. My first treatment with your clinic resulted in a marked improvement in my right eye such that virtually all of that big, fuzzy cloud is now gone. I have not seen this well out of my right eye in a long time! Thank you very much for doing this.
– Anonymous, PhD, Chapel Hill, NC
Thanks to Dr. Wood, the vision in my left eye is remarkably improved. I had a large floater causing visual impairment in my daily activities such as driving, reading, and working at the computer. My left eyesight is now distinctly clearer and brighter as a result of the Floater Ablation procedure.
– E.W., Mebane, NC