This is a ring-shaped floater that forms as a direct result of a posterior vitreous detachment (PVD). Normally, the vitreous gel is attached to the optic nerve head by a thick, fibrous, circular attachment. When the vitreous gel detaches from the retina, this fibrous ring casts a dense shadow on the retina. This shadow is near the centre of vision, which is why Weiss ring floaters are often very bothersome. Patients will often describe this floater as looking like a “ring”, “circle”, or “jellyfish”.

Most floaters are caused by normal aging of the eye and are not a sign of anything ominous. However, in rare instances, floaters can be a sign of severe eye disease. This is why it is important to always see an eyecare professional immediately if you notice the onset of new floaters in your vision. They will carefully examine the back of your eye to screen for abnormalities.

The serious causes of floaters include the following:

During a posterior vitreous detachment (PVD), the vitreous gel peels itself off of the retina, like Blu Tack peeling itself off of wallpaper. However, during this process it is possible for the retina to be torn. As this occurs, pigment is released into the vitreous gel, which appears as floaters, and the retina is stimulated by the mechanical traction, which causes the patient to see flashing lights in their peripheral vision. Therefore, it is important to see an eyecare professional immediately if you notice new floaters in your vision, especially if they are seen combination with flashes of light.

In uncontrolled diabetes, the retina becomes progressively starved of oxygen. In an attempt to re-oxygenate the tissue, new blood vessels may grow on the surface of the retina. These vessels are fragile and rupture easily. The onset of floaters in a patient with uncontrolled diabetes can therefore be a sign of bleeding at the back of the eye.

If the vitreous gel becomes inflamed or infected, white blood cells will migrate into the gel and clump together. These clumps cast shadows on the retina and appear as floaters. Floaters from eye inflammation or infection will usually be accompanied by eye redness and pain, and often the patient will have a history of autoimmune disease or recent eye surgery.

Floaters are among the most common eye problems affecting adults. They tend to obscure the central vision, and as such, they can significantly impair a person’s eyesight and quality of life. Floaters also move, which causes them to grab our attention. This movement is distracting and makes floaters difficult to ignore.

Although most floaters are specks or strands, some people have diffuse, cloud-like floaters. These floaters present as a veil or sheet over our sight that significantly blurs the vision.

If your floaters are affecting your quality of life, then you might decide to have them treated. Your treatment options are vitrectomy surgery or YAG laser vitreolysis.

Vitrectomy is an operation performed in a day hospital with you under sedation. It takes approximately 30 minutes and is usually very effective at completely removing all floaters from the eye, both large and small. However, like any surgical procedure, it does come with some risks. In addition, vitrectomy is generally not appropriate for anyone under the age of 50 years old. All of the risks and benefits of vitrectomy will be discussed with you in detail during your consultation.

YAG laser vitreolysis is a simple laser treatment performed in the clinic with you sitting up in a chair. You can read lots more about this treatment below.

YAG laser vitreolysis is a non-invasive procedure that removes or reduces visual disturbances caused by floaters. Highly focused pulses of infrared laser energy vaporises the floaters in the vitreous. This results in removal of the floater or reduction in size, which enhances quality of vision. The Ellex Tango Reflex laser used in the clinic is the only laser speciallydesigned to perform YAG laser vitreolysis.

YAG laser vitreolysis is performed over two sessions/visits with you seated comfortably in the clinic. Pre-operative eye drops are used to dilate the pupil and anaesthetise the eye.

The procedure is painless and can take approximately 15 minutes

You can expect that your vision will be blurry until the pre-operative eye drops used to dilate your pupils wear off. This can take approximately 3 hours. You may need to organise to have someone drive you home.

You can continue to do all your normal activities such as exercise and swimming. There are no restrictions.

The goal of laser treatment is to significantly reduce the density and number of floaters, so that you can perform everyday activities with less hindrance. The vast majority of individuals who undertook YAG laser vitreolysis noticed an improvement in floater symptoms.

In a study involving 130 participants, it was found that 91% were satisfied with the improvement experienced in their daily visual functioning¹.

However, please note that complete elimination of every floater is not considered possible. You will always have some floaters. The goal of laser vitreolysis is to significantly reduce the density and opacity of your floaters, so that you can function with less hindrance.

The patients who respond best to YAG vitreolysis are those with one or two large, dense floaters. Patients bothered by lots of tiny floaters don’t notice as much benefit.

There are risks involved in any procedure.

If the laser pulse impacts the retina, then bleeding or a retinal break can occur (risk of 1:100 to 1:1000). Bleeding is usually resolved spontaneously and without treatment. A retinal break may involve additional laser or surgical treatment. A review of 1272 YAG vitreolysis procedures reported one retinal haemorrhage (0.07%) and this resolved spontaneously. No other retinal events were recorded.

A transient rise in eye pressure is rare, although it can be more common in patients who have glaucoma. As a preventative measure, all patients who undergo YAG laser vitreolysis in clinic are treated with a pressure-lowering eyedrop.

The risk of injury to the intraocular lens is rare and is controlled by the precise aiming system of the Ellex Reflex Tango laser. In the clinic, only floaters in the “safe” zone of the vitreous are treated. If the laser pulse were to impact the intraocular lens and affect vision, an operation would need to be performed to correct this.

Floaters are opacities or small pieces of debris drifting in the vitreous humour of the eye that appear in your vision as specks, strands, clouds or cobwebs. Although floaters are common and are a normal aging change of the eye, they can become bothersome and impair your quality of vision. YAG laser vitreolysis is a non-invasive, non-painful procedure that removes or reduces visual disturbances caused by floaters. See an eyecare professional if you notice the onset of new or bothersome floaters in your vision.

1. Singh IP. Treating Vitreous Floaters: Patient Satisfaction and Complications of Modern YAG Vitreolysis. American Society of Cataract and Refractive Surgeons Congress 2016.

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