Should Lasers Be Used to Treat Eye Floaters?
August 4, 2010
I have just put online a unique look at a controversial subject, the use of the ophthalmic YAG laser to dissipate eye floaters. There are only 3 doctors in the U.S. that specialize in this technique: Dr. Scott Geller of Fort Myers, Florida; Dr. James H. Johnson of Irvine, California; and Dr. John Karickhoff of Falls Church, Virginia. I interviewed the three and present their perspectives on using lasers to eliminate bothersome “floaters”. An interesting question addressed in the interviews is why more ophthalmologists are not using this technique.
Some quick introductory comments for patients: eye floaters are tiny spots, specks, flecks and “cobwebs” that drift aimlessly around in your field of vision. They typically appear when tiny pieces of the eye’s gel-like vitreous break loose within the anterior portion of the eye. While annoying, ordinary eye floaters and spots are very common and usually aren’t cause for alarm in the sense that they are not typically a threat to the overall health of the eye. However, less commonly, floaters may be caused by more serious conditions such as retinal tears or hemorrhages, inflammatory conditions, diabetes, autoimmune disorders and infections. Accordingly, the onset of floaters should be promptly evaluated by an eye care professional to rule out such serious causes.
With that, to read my article on the use of the ophthalmic YAG laser to eliminate floaters, please go to: http://tinyurl.com/vitreolysis
I hope you enjoy this treatise, and invite comments on the subject on this blog.
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41 Responses to “Should Lasers Be Used to Treat Eye Floaters?”
I had laser surgery for floaters in my right eye in 2004. I was told this would not cause a cataract.
6 years after the surgery, I developed a cataract only in the right eye. Now I need to get cataract surgery in the right eye.
Looking back, I would not have had the laser surgery.
I don’t know of any doctors who do this in the Miami are. My recommendation would be to go see Dr. Geller, he is the most experienced doctor doing this in the world.
Do you know of any doctors here in Miami where I live that perform YAG laser on floaters? I know Doctor Geller is close to me but I rather go to one here in Miami. Thank you.
As I’ve said to you privately, yes I do know of Dr. Thomas. I’ve looked at his website, but do not feel the need at this time to update my original article about the three doctors in the U.S. that perform this surgery.
Have you ever heard of Dr. Thomas in Norristown PA? He also does this treatment, but i’ve not heard alot about him.
i think very few do it because the success rate is pretty low. otherwise, how to explain why many dont do this low-risk, non-invasive procedure which pays a few hundred dollars for 10 minutes of work? i have tried it several times- it is quite easy, but the results were not great. sure- if you have a nice, defined opacity sitting in front of the macula, which you can blow up into fine bits, then the success will be high. but that is not typical. more typically, its a large poorly-defined vitreous opacity. often, its the whole detached posterior hyaloid that is bothering the patient. these are not amenable to laser. also, i doubt any study was double-blind with sham treatment, and without those criteria, many patients and doctors will be much more willing to call the results a success. i therefore am skeptical of their results. if you can refer me to a double-blind study with sham treatment, i would love to read it.
Just one last thought on this subject — as it turns out, treating floaters is a big deal.
Of all of the more than 180 articles posted on my online Journal, my three articles on using the YAG laser to treat floaters are the most looked at writeups, typically drawing at least 10% of all page views.
So, there is a lot of interest in the population on this subject.
Irv
Ari is right, of course, any ophthalmologist who uses a YAG laser for capsulotomies can do it, but perhaps the real question is, would he/she be comfortable doing it?
From my discussions with a couple of the doctors doing it, it takes more than just skill with a YAG and having the right lens. You have to have a lot of practice — and a doctor just using his YAG for capsulotomies, wouldn’t necessarily be comfortable operating in the vitreous.
Perhaps, that’s why only three doctors in the U.S. specialize in this technique — and a handful in Europe and the UK.
any ophthalmologist with a regular YAG laser can do it, in my opinion.
Jane,
Yes, I have written about several of the doctors in the UK and Europe that use the YAG laser to treat floaters. The link is: http://tinyurl.com/vitreolysis-Europe-UK
Good luck with seeking treatment.
Regards,
Irv Arons
Dear Mr. Arons,
I would like to ask you, if there is some doctor in Europe, which use of the ophthalmic YAG laser to dissipate eye floaters?
I have eye floaters more than 10 years (since I was 18 years old) and in the last time it´s getting worse and worse.
Thank you very much for your answer in advance and best regards,
Jane
if laser cannot help, and they are truly debilitating, then vitrectomy may help- but understand well the risks before you consent to surgery.
Paula,
To answer your question, yes, Dr. Geller did teach Dr. Karickhoff how to do this technique, following Geller’s operating on Karickhoff’s floaters.
As to your main question, and again I am not a doctor, but perhaps a vitrectomy may be the answer for your problem.
Before going over to Europe, you might want to consult with Dr. Geller. His contact information is in my original article.
Irv Arons
Paula – hi, Irv Arons has been interviewing ophthalmologists using lasers to treat vitreous floaters, and recently published an article containing the results of interviews with five doctors in the UK and in Europe who perform laser vitreolysis. I suggest you read the article:
You may want to contact these European doctors and if the discussion is positive and promising, perhaps a trip to Europe for a consultation may be worthwhile. The philosophy of treatment of floaters may differ overseas from the approach in the United States.
Of particular interest is Dr. Franz Fankhauser in Bern, Switzerland, who is the son of the inventor of the pulsed YAG laser. Irv Arons reports that the father, who is in his mid-80s, is retired, but taught his son how to treat floaters and still comes into the office once a week to check up on his son. So they may be particularly interested in speaking with you if yours is a unique case.
I developed vitreous floaters about 6 months ago. I have a large one in my left eye, and now the right eye is covered with these things. I went to Dr. Karickhoff only to be told that the floater in left eye is moving up and down so quickly, and going low in the eye, that he couldn’t perform the treatment on me. I was so disappointed, as I can hardly work and drive. I thought I would finally have relief. I appreciate Dr. Karickhoff’s honesty, but I can’t help but think that this huge (as he called it an enormous floater) can’t be obliterated somehow. This is ruining my quality of life and I don’t know what to do. I have tried some of the natural remedies like apple pectin, hylaranic acid, serrapeptase to name a few. Any advice would be appreciated. By the way, did Dr. Geller train Dr. Karickhoff?
i cant imagine how the procedure can be done without a lens. doesnt seem possible to be able to focus so far in the back of the eye without a lens. sorry it didnt help much.
I’ve had my first YAG laser treatment for extremely bothersome floaters just 10 days ago, here in the UK. The surgeon did not use a lens on my eye, as seems to be the successful custom in the USA. The symptoms are as bad as prior to treatment, although I have noticed more debris in my lower visual field than the upper – so it is marginally better for driving but worse for work and everyday life. For me, not beating the floaters isn’t an option – especially in one eye. I suffered patiently with this condition from being a young teenager in 1982 to 2010 and just a few weeks ago the floaters in my right eye started to develop a new life of their own. My arrangement is a series of hard-edged transparent strings, black dots, cobwebs and stains. Having gotten used to it, I can say that the newly formed arrangement is like living in eye prison.
hi irv- not so sure about that- it’s not the yag laser, but rather the lens. one needs a special lens, but i think any ordinary yag laser would do, as the powers necessary are very low. i bought the special lens and had no trouble performing the procedure.
Ari,
I agree, but only by doctors who have the right equipment that can operate in the vitreous. Not all YAG lasers are capable of doing that. That’s why these three doctors have had so much success — they have the right equipment — and experience.
Irv
my understanding is that the risk is very very low, and therefore its worth trying for patients who are very troubled by eye floaters after, say, six months of symptoms.
