Diagnostic and treatment of floaters

The  diagnostics of floaters has changed and improved due to the new diagnostic devices. In this way we have the opportunity to show patients how they look and discuss together what therapy is best, to make an individual therapy.

First we perform a thorough history which include besides the usual questions and questions related to the floater such as: duration of complaints and floater description. After that an ophthalmological control follows (visual acuity, contrast sensitivity, slit lamp examination, mydriasis). Optos (wide field images of the retina) and OCT (optical coherence tomography  that make cross-section pictures of the retina) are medical devices that help us make a clear and precise diagnosis.

For a good success rate, patient choice is crucial. Depending on the type of floater diagnosed, different treatment methods are to be considered. For diffuse floaters and floaters, which are close to the retina (usually in younger patients) or close to the lens,it is recommended to wait or the use of atropine eye drops can be beneficial.  For well-defined floaters to make laser vitreolysis can be first therapeutic option. In the case of massive floaters perform a vitrectomy is the best solution.

The floater classification is one of the most  challenging theme. We have to take into account:

a. Origin of floater (primary or secondary)
b. Localization : 3mm behind lens and 3 mm in front of the retina it is not allowed to laser. 
c. Morphology (structure, number, dimension of floater)- well define or not.


Till now only Dr. Brasse propose a classification of a floater:

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