Vitreous floaters are tiny specks, or cobweb-like shapes that appear to float in your field of vision (many patients describe them as insects or flies). They are caused by small clumps of gel-like material (vitreous) in the back of your eye.

In most cases, floaters are harmless and don't require treatment. However, if you suddenly see a shower of new floaters or if they're accompanied by flashes of light, it's important to see an eye doctor promptly. These symptoms could be a sign of a more serious issue such as a retinal tear or detachment.

A vitrectomy for floaters is a relatively short and straightforward procedure, typically lasting about 30 minutes. During the procedure, patients are comfortably positioned on their back, administered with a relaxing medication through a drip, and subsequently provided with local anesthesia to ensure the eye remains numb. Throughout, you will remain conscious, surrounded by the soothing backdrop of background music and the cheerful banter of our dedicated theatre staff. Before you know it, the surgery will have concluded! Following the procedure, your eye will be gently padded with gauze and shielded with a clear plastic cover. I will personally remove these the next day. It's worth noting that I often introduce a small amount of air into your eye, which may cause temporary blurriness during the initial week. Many patients find it intriguing to observe a gradual decrease in this effect, akin to a "spirit level," as the air naturally dissipates over time. Subsequent to this adjustment period, your vision should return to its usual state, now free from the bothersome floaters! You should find yourself able to resume your regular activities and work within approximately a week's time. However, I would recommend refraining from activities such as swimming or those that carry a risk of introducing dirt or dust into the eye for at least two weeks post-surgery. This precaution will help ensure a smooth and uncomplicated recovery process.

Floaters may become less noticeable over time as your brain learns to ignore them. However, they usually do not completely disappear on their own.

Very effective! In my experience, all patients who have had a vitrectomy for floaters have been very happy. The troublesome floaters are gone, there is more clarity without the shadows, and quality of life greatly improves! Patients who have undergone this procedure have consistently reported a significant improvement in their overall satisfaction. Nevertheless, as with any surgical intervention, there are potential risks, albeit rare. The most serious complication is the development of an eye infection, which could potentially lead to severe vision impairment. It is crucial to note, however, that such instances are exceedingly uncommon, with studies indicating an approximate occurrence rate of 1 in 2500 cases. For this reason, I typically advise patients to wait for a few months before opting for surgery. If the presence of floaters significantly impacts your daily life and functionality, I would be happy to engage in a thorough discussion tailored to your specific concerns and needs.

As we age/get wiser, the gel-like substance (vitreous) in our eye undergoes changes. It becomes more liquid and forms small pieces floating within the eye. The shadows that these clumps cause are seen as floaters.

Yes. There are 2 known ways to treat vitreous floaters. Laser - a laser is used to blast large floaters into smaller pieces. I wouldn’t recommend this however, as the floaters aren’t effectively removed, and most patients will eventually want a more definitive treatment. Vitrectomy - this is a surgical procedure using specialised instruments to “vacuum” the vitreous floaters and gel from within the eye. This is a more definitive procedure with much more assured results.

Yes, blood under the retina is toxic and if not removed, can cause permanent damage and scarring to your retina.

The aim of treatment is to reduce the amount of blood in the subretinal space. There are a few options that have been used by various retinal surgeons throughout the world. These can be used in alone or in combination with each other. A. Injection of alteplase into the eye, which breaks down blood clots. This can injected in the cavity of the eye (vitreous) OR into the subretinal space where the blood has accummulated. B. Injection of an expansile gas bubble into the eye to push blood away from the central retina C. Injection of an Anti-VEGF into the eye (a medication that shrinks the leaky blood vessels to prevent recurrence). D. Surgery (Vitrectomy). This is the most definitive procedure, where we use microincisions to go inside the eye, remove any blood in the eye cavity, and perform A, B and C mentioned above. My preference and training is to perform D (if your eye is suitable) as it makes sense to maximally remove as much blood as possible from the subretinal space.

I usually see my patients the next day after surgery, and commence eye drops (an antibiotic, a steroid and a dilating drop). The next appointment will typically be a week after. Depending on the cause of the bleed, you may also require regular eye injections after the initial treatment to maximise healing and to also prevent a recurrence in the future.

Surgery is usually done under local anaesthetic with some mild sedation i.e. anaesthesia is used to numb the eye whilst some relaxing medication is given via a drip. All you have to do is lie still on your back, listen to the relaxing music being played whilst the surgery is performed. This takes approximately 45 minutes. After surgery, a pad is used to cover your eye, and you are then discharged home. We will also give you instructions on how to position after surgery - which is usually to lie flat on your back for 2 hours, followed by sitting upright/sleeping on 3 pillows for the next 3 days.

The most common cause is macular degeneration. In more advanced stages of macular degeneration, there is growth of abnormal blood vessels which can leak and bleed.

A submacular haemorrhage is a serious condition which needs to be managed urgently. If the blood is left for more than 2 weeks, any intervention is unlikely to help much. All the procedures above have had documented success in improving vision. Unfortunately however, it is unlikely that your vision will ever go back to normal. If you are an appropriate candidate for surgery, it may provide the best outcome as treatment is more targeted and precise. However, any surgery carries risks and thus I will discuss the pros and cons with you in detail, including answering any questions you or your family may have.

A vitreous hemorrhage is when there's bleeding inside the eye, specifically in the jelly-like substance called the vitreous. This can reduce or affect vision because blood blocks the transmission of light into the eye. The most common symptom is sudden floaters - those little specks or strands that seem to drift across your field of vision. You might also see flashes of light and your vision could become blurry.

The causes are numerous but this table lists the symptoms or conditions that help provide clues about the cause of your bleed. For example, if you have noticed flashes or floaters prior to the bleed, the cause is very likely to be a retinal tear. If you have poorly controlled diabetes, the bleed is likely due to that.

A vitrectomy for a vitreous bleed can vary in duration from 30 mins to 2 hours, depending on the cause. A retinal tear causing a bleed typically can be treated under 30 mins, however a complex diabetic bleed will require a longer operation. During the procedure, patients are comfortably positioned on their back, administered a relaxing medication through a drip, and subsequently provided with local anesthesia to ensure the eye remains numb. Throughout, you will remain conscious, surrounded by the soothing backdrop of background music and the cheerful banter of our dedicated theatre staff. Before you know it, the surgery will have concluded! Following the procedure, your eye will be gently padded with gauze and shielded with a clear plastic cover. I will personally remove these the next day. It's worth noting that I often introduce a small amount of air into your eye, which may cause temporary blurriness during the initial week. Many patients find it intriguing to observe a gradual decrease in this effect, akin to a "spirit level," as the air naturally dissipates over time. Subsequent to this adjustment period, your vision should return to its usual state, now free from the bothersome bleed! You should find yourself able to resume your regular activities and work within approximately a week's time. However, I would recommend refraining from activities such as swimming or those that carry a risk of introducing dirt or dust into the eye for at least two weeks post-surgery. This precaution will help ensure a smooth and uncomplicated recovery process. It is done as a day procedure, so you will need to have someone to take you home after.

There are many causes, with the more common ones being a retinal tear, poorly controlled diabetes or high blood pressure.

Treatment depends on the underlying cause. Sometimes, the bleeding will clear up on its own, and keeping a close eye on it will be enough. However in more severe cases where the blood is very dense, an operation might be necessary to remove the blood and treat the cause. This will be discussed with you and I am always happy to answer any questions from you or your loved ones. If surgery is required, the operation is called a vitrectomy. I would describe this as using a specialised “vacuum cleaner” to remove the blood which is mixed with the jelly within the eye. Once the blood is cleared and the view is good, I will be able to ascertain the cause of the bleed and treat it. For example, if there was a retinal tear, I would use a microlaser to seal of the tear to stop it from progressing.

A vitreous bleed in itself is not dangerous as blood can be easily cleared by surgery (a vitrectomy). However, the underlying cause will need to be treated. For example, if a retinal tear has caused the bleed, laser will need to be performed to prevent the tear from extending and becoming a retinal detachment. It also may be warning sign of poorly controlled medical conditions such a diabetes.