Vitreous Degeneration (floaters) after LASIK?

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Vitreous Degeneration (floaters) after LASIK?

Postby AJM » Wed Jun 06, 2007 6:50 pm

I am 26 years old and had LASIK performed last June. Soon after the procedure I noticed floaters--faint strands (or occasionally spots) in my vision. I thought they might go away as my eyes adjusted, but they have not. They are much more noticeable in bright settings or against light backdrops, and they are more noticeable when my eyes shift from one point to another. Last week, at my 12-month checkup my doctor said that what I was experiencing was VITREOUS DEGENERATION.

My question is, can LASIK cause this? I don't recall having any floaters prior to surgery, and from what I've read, I seem young to be experiencing floaters. My doctor said it was highly unlikely that the surgery caused the problem, but he failed to offer another explanation for the coincidence other than I probably had them before and just didn't notice. I don't think he was trying to be disingenuous, but I find that hard to believe.

My follow-up question... is there anything I can do about them? The floaters are not debilitating, and my LASIK results have otherwise been very good (20/15, 20/20). But it is depressing to think that I'll have these for the rest of my life. In certain settings I cannot help but notice them; and according to my doctor they will only worsen as I age.

Any help is greatly appreciated. This site is an incredible resource, I checked it before and right after my LASIK and it answered all of my questions. If anyone can answer this one I'd be very grateful

A.J
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Postby LasikExpert » Wed Jun 06, 2007 8:42 pm

Lasik would not have caused a vitreous degeneration, but it may have exacerbated an already compromised situation.

The back portion of the eye is filled with the jelly-like vitreous. It helps to keep the eye's shape and all the interior walls and membranes intact. If the vitreous becomes smaller due to degeneration, a “vacuum” will form and the vitreous can detach from the inner walls of the eye. This vitreous detachment is common in older adults and does not normally cause vision loss...but it can really freak you out. You can get odd flashes of light and minor temporary vision disruptions.

Floaters are pieces of the interior of the eye floating around in the vitreous. Floaters are very common, but normally they are not in the way of the light that is “seen” and the brain does a good job of learning how to ignore them. The brain is great that way. You have a very large blind spot in your vision from where the optic nerve enters the eye, but you don’t see it. That is because during early development and over the years your brain has learned how to ignore the blind spot. This can happen with floaters too.

The first step of Lasik is to apply a microkeratome to the eye to create the Lasik flap. The microkeratome is held in place with suction. The suction raises the internal pressure of the eye dramatically and is why vision briefly goes to black. This raise of internal pressure could have caused the vitreous to dislodge or otherwise shift. If your vitreous was degenerating there could have been a bit of extra room for movement and the microkeratome suction may have stirred up the floaters already there. It is also possible that the suction may have even contributed to dislodging some that were about to give way. Lasik would not have caused vitreous degeneration, but may have contributed to your floater situation. Just moving a floater from where the brain has learned to ignore it can be enough to make a floater a problem.

A person with a healthy eye and vitreous would likely not have these kinds of problems, or perhaps even more precise is that a person with an unhealthy vitreous would be more likely to have these kinds of problems.

A vitreo/retinal specialist will be best able to give you a prognosis of what you can expect. I'm not very well versed in vitreous issues. This is a naturally occurring disease of the eye and would not be caused by elective surgery, therefore your major medical insurance should be responsible for the cost of treatment.
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