Big Algorithm: Types of Eye Floaters, Age Demographics, Treatment Options
HTML-код
- Опубликовано: 25 июн 2024
- This long form video covers A LOT of information you won't find anywhere else. First a breakdown of what is and isn't a floater and an easy way to determine that (and how to communicate it to your eye doctor: "It moves"), types of floaters as exogenous vs. endogenous, and the very important age demographic considerations that will likely determine which of the four treatment options might be available to you.
- - - - - - - - - - - - - - - -
The Floater Doctor, James H. Johnson M.D. is Medical Director of the only medical practice in the world specializing in, and exclusively treating eye floaters, the bothersome spots, shadows, and clouds that affect your vision. Although common, especially changes such as posterior vitreous detachment (PVDs) as we age, these vitreous eye floaters are rarely offered treatment by your local and well qualified eye care providers, even at top specialty institutions. Dr. Johnson uses a specialized FDA-approved YAG laser to vaporize and destroy the proteins in the vitreous that are responsible for your spots, shadows, and moving blurred areas in your vision. He has been doing so since 2007 making him one of, if not the most experienced in this very specialty niche area in ophthalmology, a pioneer in this field.
Links you may be interested in:
► MAIN WEBSITE INTRO: www.TheFloaterDoctor.com/prac...
► FAQs: www.thefloaterdoctor.com/faqs
► TREATMENT OPTIONS: www.TheFloaterDoctor.com/trea...
► THE YAG LASER: : www.TheFloaterDoctor.com/the-...
► WHY AREN'T MORE DOCTORS TREATING EYE FLOATERS www.thefloaterdoctor.com/why-...
►CHOOSE YOUR DOCTOR CAREFULLY www.thefloaterdoctor.com/choo...
►YOUNGER PERSON WITH FLOATER? www.thefloaterdoctor.com/youn...
►THE EVALUATION AND TREATMENT VISIT | WHAT TO EXPECT: www.thefloaterdoctor.com/eval...
►LOW DOSE ATROPINE: www.thefloaterdoctor.com/pupi...
MEDICAL ADVICE DISCLAIMER: All content in this video and description including: information, opinions, content, references and links is for informational purposes only. The Author does not provide any medical advice on the Site. Accessing, viewing, reading or otherwise using this content does NOT create a physician-patient relationship between you and it’s author. Providing personal or medical information to the Dr. Johnson does not create a physician-patient relationship between you and the Dr. Johnson. Nothing contained in this video or it’s description is intended to establish a physician-patient relationship, to replace the services of a trained physician or healthcare professional, or otherwise to be a substitute for professional medical advice, diagnosis, or treatment. You should consult a licensed physician or appropriately credentialed healthcare worker in your community in all matters relating to your health. 
Наука
I’m an optometrist in San Antonio and I’ve mentioned your practice to many of my patients who have problems with floaters. Glad you’re in Texas now! Thank you!
Michael Cerean, O.D.
Thanks, Dr. Cerean.
Really amazing to have someone so interested and involved in the space.
Very grateful for the improvement I have seen after visiting you earlier this year for a pesky blob. I was in that mid-30's youngish crowd at onset. 48 now.
Thanks for the longer-term feedback. Hope all is well.
I have PTSD, the floaters have become fear inducing when it feels like someone has snuck up on me. The floaters have only gotten worse in the last 3 months. My PCP says it's part of growing older.
Thank you for the breakdown and pathology.
Great detail sir.
Thank you kindly
Phenomenal presentation. I truly appreciate how you focus on the impact and daily experience of the patient. It's difficult for those who don't experience these to appreciate the way these affect daily, seemingly simple activities.
Thank you for that. - Dr. Johnson
@@Thefloaterdoctor1 Really really informative. I'm really glad a medical professional has gone in and learnt so much about this that many ophthalmologists are so dismissive about. Also thanks for going all along to replying most of the comments. By the way, did anybody tell you that you look like Jay Harrington?
Appreciate the clear decision-making pathway for floaters treatments. Having a doctor like you is fantastic-talented and dedicated to your expertise. The local doctor I tried was disappointing. You're undoubtedly among the best in treating floaters. Eagerly anticipating becoming your patient, I'm willing to travel for both the treatment and the chance to talk about all of this, doubts, expectation, etc. I enjoy to be part of this process apart from merengly just be treated...
Thank you for all that. I'll look forward to meeting you. - Dr. J
Very helpful
Really appreciate the world have someone like you really understand the patient.
Got some transparent floaters since I was a kid but just found them in blue bright sky, but saw more of them in front of my monitor several weeks ago and I'm just almost 25 only, It is frustrated this happened to me cuz its ruined all the joy that I have (video games, movie, anime, don't have any hobby except those). Can't imagine those who have more serious symptoms than me, how they survive.
But the most irony thing is, the promotion of SMILE or lassik for myopia is every where, which something that a gasses can fix it perfectly, and for floater patient, nobody give a shit.
Not to mention there are many people complains that SMILE cause floater and other problem.
Hope better treatments come to floaters patient one day
You are the right age for the low dose atropine, it has really been helpful for that younger group.
Me to brother. Same age.
I got flies after lasik, be careful with the suction
Nice no-nonsense explanantion.
Glad you liked it
Thanks for work doc- we need more of people like you!
I have one question about your map:
So after the first branch you ask: does the stuff I see move - and i answer yes it does: i'd really say I have stuff floating around that are floaters and the other stuff you described but I also have like maybe 3 or 4 black perfectly round very small but not or almost not transparent dots with an inside dot aswell that COULD be red blood cells and I also have about 3 of perfectly WHITE very tiny round dots with an inside Dot ( that aren't transparent - one of them is REALLY not transparent ) that COULD really be white blood cells. So i have red AND white blood cells - which as you say - could be from an infection.. so after all this started ( like 2 years ago - age 31 now ) I also started to have these ONGOING lightnings right and around my center view really like looks like a small thunder perfectly white .. like current does when you have a gap between minus and plus. that small light that voltage produces.. I really learned to accept my condition and it seemed after that one event in which all startet - nothing changed ( thank god). BUT those lightnings that I see on the daytime do bother me because I see them like every 10 seconds and Im super scared that this is an ongoing Inflammation destroying my vitreous even tho im not seeing new floaters ( i maybe have about 10 in each eye. I also have these CRYSTALL clear crack -like - looking White lines THAT are fixed in position but also 1 crystall clear crack line that floates around. so my question is, as I seemed to be going both directions as of your chart shows: You think there's still inflammation going on ?? I've been to many doctors like 20+ and all just looked at my retina and said it's fine.. Only 1 suggested to start with cortison eye drops to really make sure to stop the inflammation. I chose not to take them, because i feel like i need to find the real cause IF it really is my body attacking the vitreous.
By lightnings i really not mean the blue entopic phenomenon thing ( which i also have ) i really mean it as I described it: like a cable where you hold one end close to the other + to - and see the voltage jump.. what do you think this could be??
Does anyone here can relate??
Thanks everyone
Summering: What are those crystall clear like White lines that are fixed?? The one in my right eye I can see when I look to the left all the way then to to the right . After doing this movement I have one giant white crystall clear ( glass cracked like ) line in my center.. What do you recon this is?? and what do think about my body attacking my own vitreous??
Im pretty i must have had a pvd in both eyes and I can even recall the exact day of the event. I was ignoring my tiredness and still doing computer games every night and eating TONS of peanut butter and FRUITs ( I really mean tons ) ( just mentioning it because of the omega 6 overload and the sugar - could there be a link to some autoimune thing going on?? made hardcore diet and lifestyle changed eventhougj I got a better physique than a pro soccer player..)
There is nothing really to attack in the vitreous, but inflammation can 'spill over' in to vitreous. I can't make a diagnosis, but you describe maybe some small floaters, but overall your symptoms are not typical of the usual more benign floaters that I typically see. Consider a uveitis specialist? and/or look into a fluorescein angiogram to better evaluate the blood vessels.
@@Thefloaterdoctor1 thank you so much for your time and the quick response. I'll research uveitis and have the blood vessels checked. Another information in trying to solve this puzzle.
Have good one Doc! Thanks👍
Hey doc. Thanks for the insightful, and informative videos. I see you are located in Arlington, Texas now. I'm an American living in Hong Kong. Ever handle any international patients that want to decide to come all the way over? I'm 36, and just got a sweeping floater starting a month ago. It really bothers me as I work at a desk most days for hours on white paper (I'm an artist). Visited a local ophthalmologist, but he essentially said my eyes were fine, and not to worry about the floaters. Don't think he really understood my concern level though, especially since my current livelihood is on the line. I'm in the process of trying to really focus on my diet+fitness level more, but if I ever need to see you from this far away can we talk about it in depth? This is starting to really drive me nutty, and I'm nervous for the future. Thanks again.
Hello Astrostar. What a huge adventure living abroad. I lived in Germany for 4 years, certainly not as exotic as Asia... but the food there? (ah,
it started when i was 15 years old and there is this one eye floater in my left eye that followed my eye and it annoys me i even notice it when my eyes are closed when im outside. its been since august when i noticed it i thought it would be gone by now in november.
Thanks so much Doc for this... what are your "off the record" hypotheses for why floaters appear in the first place?
Simple aging for the older group. For the younger...it may be inflammation and oxidation chemicals and cytokines spilling over from the retina to the vitreous. The typical Western/American diet is chock full of these things. Less processed foods and seed oils and fried foods 'may' be protective.
@@Thefloaterdoctor1 Thanks Doc. Sending you best wishes for all the great work you are doing
If I was a candidate for laser vitreolysis (which I believe I might be. 35M, PVD), and wanted you specifically to do it, what is the estimated waiting list time I could expect to be treated?. Thanks for the thorough video!
I only see eye floater patients so it is a different type of practice compared to a general ophthalmology practice. I usually have spots available throughout the week even on short notice.
thank you for such an amazing presentation doctor, i have a question, is there anything i can do to prevent the development of more floaters or more severe types of floaters? i only have a young person floaters thus far, they already affect my mental health substantially tbh, very afraid of it getting even worse. i sit a lot in front of a computer monitor, maybe i should go outside more in the sun or idk, i heard floaters get worse with myopia, i have -1.0D on both eyes 32yo, thanks again!
edit: does wearing sunglasses help in preventing any of it in some way or it doesnt really matter? is there a cause for floaters or any candidates out there?
I don't think sitting and starring into a screen all day causes floaters, but it isn't that healthy either. Maybe we will have a better understanding someday,. My concern/theory is that pro-inflammatory foods (ultra-processed, seed oils, fried foods) may spill over inflammatory and oxidative chemicals into the vitreous. I can't prove it though
Hello doctor. I’m 23 years old and have been dealing with floaters for nearly a year now. They’re translucent threads. I mean I saw them as a kid but they would disappear after a few minutes. Basically I stood up one time, had kind of like a firefly show with lights buzzing around, and I’ve had floaters ever since. I went to an eye doctor and they saw no signs of a retinal tear. I think I may be a candidate for your low does atropine drops since when I had my eyes dilated, I didn’t see my floaters. I know I’m unlikely a candidate for the laser because of my age but I have some questions like is it true that floaters will drift away from my field of vision as I get older and have you told other eye doctors about how helpful your drops have been? Also I kind of came up with an idea. Now I’m not in the medical field but it’s a thought like you know how you blow air into say a fish tank, it moves things around to different place. How about creating a tube to insert into the eye and try to blow the floaters away from the retina to a place they’re less noticeable and bothersome?
You age, the translucency of the floaters is typical of younger sufferers and these peeps usually do very well with the low dose atropine.
The vitreous has a structure to it especially with younger people. The floaters are pretty content to stay lodged where they are. It is possible with time and age that they may move a few mm away from the retinas, but that's still not a good bet. Remember Aunt Edna's fruit jello salad she brought to the last family reunion? Those grapes suspended in the jello? It would be a mess trying to 'blow' them into a different position. Just not practical or predictable.
I wish there was more study on long term effect on using atropine almost daily. Nothing happens to visibility of my floater when using 0.01% so i need to use something between 0.02-0.5 does that effect eye pressure etc
There is/are studies in daily use in children to treat their myopia, every day through puberty. About 3% develop some localized superficial allergy that goes away when drops discontinued.
Aslam o alaekom doc, i wanted to ask about flickering in vision. It usually happens after waking up for some minutes or going from pitch black after sitting for some time to light. And i first noticed this 1 year and about 2 months ago it didn't get worse.( Edit: some amount of flickering is happening almost all the time since day before tomorrow although i just woke up and it is very little compared to before i am sick for past couple of days maybe thats why
Also i have some eye floaters from birth possibly genetic my whole family has it but they have increased in number a little bit.if i close my eyes 90% and look broght sunny sky I can see some kind of flowing liquid
I can't absolutely reassure you that it is benign. It is worth a fully dilated pupil exam by an ophthalmologist to rule out a retina problem.
I had an asymptomatic epiretinal membrane, then 10 years later I had a PVD aged 35. Around 2 years after the PVD, my eye doctor told me that my epiretinal membrane had started to heal itself. Did having the PVD help heal my epiretinal membrane, or is the timing a coincidence? Have you ever heard of such a thing? Thanks!
It is quite possible.
what is about gold nano particle approach that has been successfully tested in rabit eyes?
I think is is really interesting to make the laser treatment much more efficient. There is no suggestion that it will allow us to treat closer to the retina especially for the younger patients whose floaters are typically
Hello doctor,
After a very stressful move and a lot of loading/unloading of boxes and heavy objects, I believe my lack of proper breathing when picking up objects has caused a giant new floater due to intraocular pressure? Do you find it reasonable that this type of pressure can occur from lifting heavy objects?
I'm 34, and I've had loads of small floaters all over my vision since my early 20's (nearsightedness and supposedly a thin retina), but I've felt stable for many years, until this move. Now I have a very large translucent worm like floater vertically down from top of my vision to the bottom, which has seemed to have attached to an old, existing floater in the middle of my vision.
Thank you for any response.
The valsalva maneuver is when you hold your breath and strain to create an increased intrathoracic pressure. This is also what is done when not exhaling when lifting a heavy object. It will increase venous back pressure, and have other effects.
(en.wikipedia.org/wiki/Valsalva_maneuver#:~:text=The%20Valsalva%20maneuver%20is%20performed,if%20blowing%20up%20a%20balloon. )
That would not affect your vitreous which is essentially 100% water and the eye pressure is not affected by short term changes to systemic blood pressures, arterial or venous). Fluids are incompressible and so the physics and anatomy argue against lifting heavy weights affecting the vitreous and causing floaters.
@@Thefloaterdoctor1 I really appreciate you taking the time to respond. It's been a very depressing feeling my family has felt, as I've believed the move and the bulk of the work being on me, was a cause for this sudden new large floaters. Coincidences do happen even if it feels it's tied to a single event.
I had wondered if my sea level elevation living, to suddenly 4,000 and 2,000 feet now elevation could of influenced the eyes, but as you've pointed out the vitreous is in an enclosed space.
Thank you for your time, and although an unlikely candidate being under 35, I do hope to see you one day just to verify if I'm an unlikely candidate.
All the best.
Is it difficult to do laser vitreolysis on eyes that had undergone refractive surgery?
It can be. It doesn't increase the risk to the patient, but it can reduce the energy delivered. I treat people with previous RK, PRK, LASIK, IOLs all the time though. I just consider it part of the job description and not an exception.
@@Thefloaterdoctor1Doctor, is it true what is said that sports or bodybuilding increases eye floaters and lifting heavy objects? Or is it just empty talk?
Hi doctor It's ok to use low dose atropine even wearing graded eye glasses?
Like Progressive lenses? Not a problem.
I had my cataracts done. 2 weeks after the left eye was done I had hundreds of sharp black dot floaters appear. It looked like a scattering of black pepper. The doctors just said it was due to vitreous detachment but could not explain why they were small dots and not the cobweb floaters normally seen after PVD. I had a PVD years ago with cobweb floaters and Weiss ring. I am happy to say that the dots are growing fewer in number every week, and the larger ones have disappeared. I am very keen to know what caused them. To form a very dark, distinct dot they must have been very close to the retina. Any thoughts on this?
Blood cells most likely. Not uncommon when the vitreous peels away. They are 4-6 microns in size, so you can see them, your doctor can not.
@@Thefloaterdoctor1 Thanks for the reply. I suggested blood cells, but the doctor disagreed. The fact that they are disappearing suggests that either they are clumping together and getting lodged peripherally, or are dissolving. Does that make sense?
I read about “prefoveal floater”. Which seems like floaters can be static too.
The reason I’m asking is I cause developed 4 flickering dots in one eye after vertigo. They are static and in my central vision. I saw four ophtalmologistes : all said the eye was healthy … they also said it is not neuro-related .
It’s been a month. The dots still there. Not increasing not decreasing.
If you have an idea of what it may be I would be thankful !
Prefoveal means it's sitting right on top of the fovea/macula. It is still in a gel/viscoelastic fluid and should have even a little movement. If your phenomenon is absolutely static then it is not likely a prefoveal floater. If any associated movement with eye or head movement, then it is in the vitreous. BTW, these microscopic floater are nearly impossible to see on exam, so if your doctors aren't seeing it, I get it.
I'm 22 and have a huge blob of black and grey granules centered in my right eye that appeared fairly suddenly. Takes up about 15% of my vision with my right eye outside. :( I went to get an eye exam but it wasn't detected but the Doctor noted my description of the blob was weird (he tried to double check but still didn't see anything) and gave me another eye doctor reccomendation in case something were to happen... While my eye was dilated during the exam all the granules disappeared, but when I looked around there was still a small clear blur at the center where it normally is...... I just want this to go away, I have no idea why I would get this either at such a young age... Does laser treatment sound possible?
Thank you for your help! I plan on seeing the reccomended eye doctor soon...
Laser? At 22? Not likely. The Low Dose Atropine will (to a lesser degree) duplicate the effect you observed with full pupil dilutions. Check into my Low Dose Atropine Program.
Very helpful with the big picture.
That's why it is "The Big Algorithm"
I'm mid 20's and suffering from floaters.
Well... even though i put diluted atropine in my eye , i felt no improvements. I think it's way close to retina.
So, I'm actually considering full vitrectomy which removes 90% of vitreous except for remaining vitreous nearby lens.
In this case, i heard that saline is filled into my eye.
I have a few question for it , doctor..
1. Supposed i got vitrectomy, Is it more likely for me to have retinal detachment due to constant contact with fluid saline ?
2. If i get induced pvd, then does this affect my retina in a long term?
1. No, 2. No
I believe the 6 month rule is for the brain to either get use to the floater or for the floater to drop out of the line of site. That is what I have been told. How close can the floater be to the macula before treatment is high risk? Is there a measurement?
The 6 month 'recommendation' is common and ubiquitous, but not based on any science, function or anatomy of the eye. In most cases they do not 'drop' out as they are small, neutrally buoyant, and suspended and tethered and embedded in a collagen matrix.
Here is my scenario. I'm 63 and just had breast surgery. Then 1 week later floaters(Clumpy) in my right eye appeared.
Did the surgery do this ?? These floaters are the worst when I drive. Really putting me in a depressed state. Its affecting my work performance also. Eyes are very tired more quickly. The 6 month rule sounds like torture with this.
BTW: Great Presentation here. Very impressed with your website and videos.
Unless the surgeon's elbow was resting on your eye during surgery, it is probably a coincidence. BTW, I don't know where that "6 month wait" recommendation comes from.
After the recent recalls of contaminated eye drops leading to blindness and deaths, how can you assure us your drops are safe? Are doctors allowed to compound drugs?
Fair question. It appears the different eyedrops are coming from one or very few sources. I am sourcing my atropine from McKesson and the manufacturer is not part of this. I use a HEPA filter laminar flow hood and sterile procedure just like a compounding pharmacy.
I got ICL surgery done 4 months ago and its been a month that i have been noticing floaters and they're impacting my mental health. The doctor told me that i have PVD in the left eye . I have all the difficulties in vision that you've mentioned earlier . The doctor told me to ignore all of this but i am not assured. Thankyou so much for the awareness doctor. Can you please suggest what should i do and which treatment modality is the safest?? I am s 26 year old female
I'd be very surprised that you have had an actual PVD. That is very unusual at your age. I'd start with low dose atropine.
@Thefloaterdoctor1 Thankyou so much for the reply Doctor. Not only floaters now I have cloudy vision too. When i go outside surrounded by artificial lights it just gets worse. I Think i made a mistake going through ICL surgery . I have refractive error again as well
I’m 60, was told I have lattice in both eyes, developed floaters in both eyes, a Weiss ring in the right eye, although annoying at times depending on brightness of the surrounding environment, I can tolerate them, my vision under the floaters is normal although I need glasses again as I wore them when I was younger, nearsighted then around 40 needed readers, but my far vision became 20/20 until about 58, now need glasses again and can see close up again without readers, go figure, lol, there’s a big floater in my right eye that may be a prime candidate for laser treatment, what do you think Doc? Thanks
Weiss rings are almost always great candidates for safe and successful treatment. I do like to wait at least a month or so after the abrupt onset to allow the PVD to go to completion.
Thanks, I’m going make an appointment with my ophthalmologist in the new year
How did you come to focus on this specialty over a general practice? (No pun intended) Did you have a family member come to you with this problem?
Pure random chance. I saw the couple of other doctors on the East Coast and thought, maybe I'll try it and add it to my new laser vision correction practice. I was lucky to have some early patients with extreme floaters that could only be made better and started the journey.
Hi doc I'm only 19 is that true eye floaters can settle down with time?
Settle down as in drop from gravity? No, not likely. But microscopic floaters typical to younger patients, may move a few mm away from the retina where they may be much less noticeable. The effect might be the same.
I am confused. Mine are fixed in position, but my ophthalmologist said that they're floaters. I had my retina checked, and the doctor said that everything was okay, except for the fact that I had 'snail slime degeneration' in one eye, and in the other, there was nothing. He said that there were floaters, but as you explain in the first part of the video, I see the problem fixed in place. However, my symptoms lessen with lower light. How can I be certain if I've already seen two ophthalmologists and they said that I was fine? I see perfectly opaque circles that are translucent, and those are the ones that affect my vision the most. What should I do, or whom do I need to see?
If ABSOLUTELY fixed in position it is more likely a retina anomaly, not vitreous. I can't make a remote diagnosis. It would be irresponsible.
@@Thefloaterdoctor1 they move around to where i look but sometimes get bigger and sometimes get smaller theyre weird and they look like opaque circles that i only can see in situations with a lot of contrast, for example at night i barely notice them, but in a white background im able to see them
@@gameplayscondiego4434hi how are your floaters now i have the same
Does the success of the outcome relate in any way to how strong of a prescription the patient currently has?
There is an association of higher myopia with earlier onset PVD and probably worse floaters, so indirectly 'yes'. Just more stuff to treat.
Doctor, is it true what is said that sports or bodybuilding increases eye floaters and lifting heavy objects? Or is it just empty talk?
@@Thefloaterdoctor1 Doctor, is it true what is said that sports or bodybuilding increases eye floaters and lifting heavy objects? Or is it just empty talk?
As a 28 year old Portuguese guy, I pretty much have no option but vitrectomy.
Ask your doctor to prescribe low dose atropine: thefloaterdoctor.com/atropine-request
This man needs a fuc*ing Grammy.
I'm thinking of getting low dose atropine, prescription. But i'm from the Caribbean. You take online appointments?
What about the use of cannabis use? Does that any correlation?
Cause that's typically my only vice.
I do telemed appointments, but I can only mail to US addresses. I have a document you can download (free) and present to your local eye doctor. It might help convince them to prescribe it for you. thefloaterdoctor.com/atropine-request. I don't think cannabis has any relation to floaters, but maybe inflammation? Ultra-processed foods, fried foods, and seed oils (canola, soy, corn) all promote inflammation. So when you get the munchies...