Disturbing floaters Tassignon Marie-José ,MD, PhD, FEBO Antwerp University Hospital SFO 2013

Disturbing floaters Tassignon Marie-José ,MD, PhD, FEBO Antwerp University Hospital SFO 2013

Disturbing floaters
Tassignon Marie-José ,MD, PhD, FEBO
Antwerp University Hospital
SFO 2013
Thanks
Jos Rozema PhD, DrSci
Frans Van de Velde MD, PhD
Financial interest:
None in the vitreoscope
Travel Ellex Company
Intellectuel interest « bag-in-the-lens »
What do we know about floaters except that
they bother patient and ophthalmologist !!
• Classification of floaters
• Subjective complaints of the patient
• How to objectivate floaters
• How to treat floaters
• Why interest for floaters
Classification of floaters
• Type I: Well defined and suspended floaters
• Type II: Multiple floaters disperced in the vitreous
• Type III: Well defined floaters for the patient but visible
for the clinician
T Vandorselaer; F Van de Velde; MJ Tassignon, 2001; Eligibility for Nd:YAG laser
treatment of highly symptomatic floaters; Bull Soc belge Ophtalmol: 280, 15-22
Type I: Well specified and suspended floaters
Type II: Multiple and disperced floaters
Classification of floaters:
- visible during examination of the fundus
- well suspended (Type I) by vitreal strands
- located mid-vitreum
- speed of movement depends of the viscosity of the vitreum
Type III: Floaters not objectivated by the
ophthalmologist!
• They are perceived to be very well defined and
very contrasting
• But… the ophthalmologist doesn’t see them !!
• Where are they?:
• In the premacular bursa (although not visible on
OCT)
Subjective complaints of patients dealing with
floaters
• Experience of pressure in the eye
• Tend to rub the eye to try to remove the obstacle
• Blurred view
• Frequent eye movements to displace the obstacle
• Frequent blinking of the eyelids
• Visual obsession
• Impression of lacrimation
• Reading and specific tasks are difficult to manage because
of floaters
• ... And there are many other !!
How to objectify floaters ?
• Ophtalmological examination of vitreum
• Vitreoscope
• Questionnaire
The vitreoscope allows the patient to objectivate their
own floaters = blue field entoscope
Vitréoscope de J Rozema, 2010
Treatment of floaters
YAG laser for type I: “well defined and suspended”
YAG Laser specific for the vitreum: only “Ellex Ultra Q” exists
How to treat: aim the inferior strands to which the floaters are suspended
in order to displace them superiorly (principle of the spider web)
Vitrectomy + PVD for Types II and III
Why the interest for floaters ?
Complex optical implants require a perfect
transparency of the environment, also of the vitreum,
in order to obtain an optimal image quality
Thanks for your attention
marie-jose.tassignon@uza.be