Floaters are shapes that people can see drifting across their vision. Floaters are small bits of debris floating in the vitreous jelly inside the eye. They can come in a variety of forms such as hair-like, small black dots, short squiggly lines, small fly-like or tadpoles, or even large cobweb shapes. Shortsighted people tend to suffer from them more, and they increase as we get older.

Assessments
If you have new symptoms of a PVD (floaters, flashes, shower of spots) it is important to have a prompt and thorough examination of the retina to search for any retinal breaks. If a retinal break can be discovered before a retinal detachment develops it can be treated with the laser to seal the break and prevent a retinal detachment. Finding a retinal break can be difficult and requires a very complete examination of the edge of the retina.

The pupil must be dilated for a proper exam, which includes indirect ophthalmoscopy with scleral depression. This is the exam where the retina specialist wears a light source on his head and examines the retina with a handheld lens while pressing gently in on the edge of the eyeball with a blunt, smooth-tipped instrument (scleral depressor) to bring the periphery of the retina into view. Examination with a special contact lens for viewing the retinal periphery may also be performed to be sure if any and all retinal breaks are located.

Treatment Options
Since floaters do not harm the eye, and in the vast majority of people, they do not cause a significant problem, and no treatment is generally recommended for them. This is because your brain constantly adapts to changes in your vision, and learns to ignore floaters so that they do not affect your vision.

In people with very severe floaters or in those who cannot adapt to them, the floaters can cause visual disturbances that affect their quality of vision. The persistent floaters can interfere with social, work and driving life. It is possible to carry out an operation to the eye to remove the vitreous gel (vitrectomy), which will also remove the floaters. A complete consultation is recommended with your retina surgeon, and you can be counselled about whether this operation is suitable for you. The "Floaters Only Vitrectomy" operation offers an excellent outcome in the vast majority of patients.

Risks of Surgery
Vitrectomy floaterectomy surgery carries with it the risk of various complications. The most common side effect of vitrectomy surgery is the development of cataract at an earlier stage than it would have done otherwise. Rarely this can be immediately after the surgery but more commonly; this may come on 2-3 years after the operation.

The most severe complication from this kind of surgery is blindness in the eye, usually because of a severe bleed during surgery or an infection in the eye after the operation. This is an extremely rare occurrence (approximately 1 in every 2000 cases) but it is important that patients are aware that there is a chance that it could happen, albeit very small and a rare occurrence.

There is a less than 1% risk of patients developing a retinal detachment after the surgery which can sometimes lead to reduced vision in the eye afterwards. Once again this complication is unlikely to happen after surgery. In this situation, further surgery is required to reattach the retina and Mr Muqit is a retinal surgeon who can manage this complication.