Vitreolysis with YAG laser – treatment for vitreous floaters

Vitreous opacities, often called floaters, are small condensations in the vitreous of the eye that can be seen as spots, threads, rings or shadows in the field of vision. They are usually most obvious against bright, even backgrounds such as a white wall, a computer screen or a clear sky.

The opacities usually arise as the vitreous changes with age. The gel-like vitreous gradually becomes more liquid, and its collagen fibres can clump together and form structures that cast shadows on the retina.

In most cases vitreous opacities are harmless, even though they can be disturbing and affect how you see. It is nonetheless important to examine the eye first, to rule out other causes of the symptoms.

If you suddenly develop many new floaters, flashes of light, or a dark shadow or "curtain" in your field of vision, you should seek eye care promptly. Such symptoms can in some cases be a sign of a change in the retina that needs to be assessed quickly.

Vitreolysis is a laser treatment used to reduce problems from certain types of vitreous opacity.

During the treatment, short laser pulses are directed at selected opacities in the vitreous. The laser energy can break up or vaporise part of the opacity so that it becomes less prominent and disturbs vision less.

The treatment is carried out without surgical incisions and usually takes place at an outpatient visit.

No. Not all types of vitreous opacity are suitable for vitreolysis. Whether treatment is possible depends among other things on the size, shape and position of the opacities and on their distance from the retina and the lens of the eye.

A thorough eye examination is therefore carried out first, in which the ophthalmologist assesses the vitreous and the other structures of the eye. We can then determine whether vitreolysis is a suitable treatment option.

Before the treatment the pupil is dilated and the eye is anaesthetised with drops. The ophthalmologist then uses a special contact lens in order to direct the laser at the relevant opacities in the vitreous.

The laser treatment itself is usually relatively short and you can normally go home the same day. Your vision may be temporarily affected afterwards, partly because of the dilating drops.

Vitreolysis is not normally painful. The eye is anaesthetised with drops before the treatment, and most people mainly notice flashes of light from the laser during it.

Afterwards your vision may be temporarily blurred or sensitive to glare while the dilating drops are still working.

The aim of vitreolysis is above all to reduce the opacities that disturb vision — not to make the vitreous completely free of opacities.

The result varies depending on what type of opacities you have and where they are positioned. Some people experience a clear improvement after treatment, while others may still have opacities to a varying degree.

This varies from person to person. In some cases one treatment can be sufficient, while others may need further treatment sessions to achieve the desired result.

At the examination, and after the first treatment, the ophthalmologist assesses whether further treatment may be appropriate.

Some people experience an improvement relatively soon after the treatment, while for others it can take longer before vision settles and the result can be judged.

How great the improvement is depends among other things on the type, size and position of the opacities.

As with all treatment inside the eye there are risks, and vitreolysis should therefore only be carried out after a careful medical assessment.

Before the treatment the ophthalmologist goes through the expected effect, the possible risks, and whether your particular vitreous opacities are suitable for laser treatment. If vitreolysis is not judged to be a suitable option, you are told so at the examination.