EYE%20FLOATERS

1
EYE FLOATERS

• ALTERNATIVE TREATMENTS
• AND
• PREVENTION

SCOTT GELLER, M.D. FORT MYERS, FLORIDA
2
EYE FLOATERS

• DEGENERATION OF THE VITREOUS BODY
• ONE OF THE MOST COMMON EYE FINDINGS ABOVE AGE 40
• TECHNICALLY CALLED VITREOUS FLOATERS

3
EYE ANATOMY
4
WHAT IS THE VITREOUS?

• A COLLOIDAL GEL THAT OCCUPIES 85 OF THE EYES
  TOTAL VOLUME
• 99 WATER

5
STRUCTURAL ARRANGEMENTMACRO MOLECULAR
CONSTITUENTS

• COLLAGEN
• STRUCTURE OF FIBRILLAR FRAMEWORK
• ACID GLYCO PROTEINS
• HYALURONIC ACID
• COIL-LIKE CHAINS WITHIN COLLAGEONOUS
• FRAMEWORK
• HYALOID MEMBRANE
• CONDENSATION OF COLLAGEN ENCASING
  THE VITREOUS BODY

6
NORMAL VITREOUS

• OPTICALLY CLEAR COMPLEX STRUCTURE OF
  POLYMORPHOUS NATURE
• PSEUDO MEMBRANES AND PSEUDO FIBERS APPEARING
  AS MOVING FOLDS AND PLEATS

7
VITREOUS FUNCTION

• SERVES AS A MEDIUM TO MAINTAIN THE PATH OF LIGHT
  BETWEEN THE LENS AND THE RETINA
• FREE FROM DIFFUSING AND ABSORBING ELEMENTS

8
VITREOUS REACTIONSMERELY DEGENERATIVE

• LIQUEFACTION
• OPACIFICATION
• SHRINKAGE

9
LIQUEFACTION(SYNERESIS)

• CONVERSION OF GEL INTO A SOL
• ASSOCIATED WITH OPACITIES FORMED BY COLLOIDAL
  MICELLAE
• COLLAPSE OF COLLAGEN FRAMEWORK

10
(No Transcript)
11
VITREOUS SYNERESIS
12
FIBRILLAR DEGENERATIVE CLUMPS
13
FLOATERS
14
ASTEROID FLOATERS
15
POSTERIOR VITREOUS DETACHMENT

• COMMON AFTER AGE 40
• COLLAPSE OF VITREOUS FRAMEWORK
• CONDENSATION OF VITREOUS OPACITIES

16
(No Transcript)
17
CAN VITREOUS DEGENERATION BE PREVENTED/RETARDED?
18
MOLECULAR BONDS OF THE CLEAR VITREOUS FRAMEWORK
CANNOT BE RESTORED AFTER VITREOUS COLLAPSE
19
VITAMINS

• FREE RADICAL DETOXIFIERS MAY RETARD THE
  DENATURATION OF PROTEIN

20
AREDS STUDY

• ONLY SCIENTIFIC EVIDENCE AT THIS TIME SHOWING
  FREE RADICAL DETOXIFICATION CAN RETARD EYE
  DISEASE
• CURRENT STUDIES ONLY RELATED TO MACULAR
  DEGENERATION

21
BROKEN MOLECULAR BONDS

• DENATURED PROTEIN CANNOT BE RESTORED TO ITS
  ORIGINAL STATE

22
VITRECTOMY

• TOTAL SURGICAL REMOVAL OF VITREOUS GEL
• RADICAL SURGICAL SOLUTION WITH SECONDARY
  COMPLICATIONS

23
LASER SURGERY

• RARELY USED ALTERNATIVE
• TREATMENT
• UNKNOWN TO MANY
• OPTHAMOLOGISTS
• OFFICE PROCEDURE

24
NEODYMIUM-YAG LASER

• INFRARED SPECTRUM
• FOCUSED BEAM
• ENERGY 4 - 6 MILLI JOULES
• 200 - 600 SHOTS TOTAL
• 1 - 3 TREATMENTS

25
TREATMENT GOALS

• BREAK SUPPORTING STRANDS
• DISRUPT HYALINE OPACITIES
• AND RINGS
• TEASE APART FIBRILLAR DEGENERATIVE CLUMPS

26
SUCCESS RATE

• 90 - 95 - WEISS RINGS AND HYALINE OPACITIES
• 80 - 90 - MID VITREOUS CLUMPS
• 50 - 60 - YOUNGER PATIENTS WITH VITREOUS
  SYNERESIS

27
COMPLICATIONS

• ELEVATED INTRAOCULAR PRESSURE
• CHROIDAL MICRO HEMORHAGE
• RETINAL DETACHMENT
• CATARACT

28
WHAT CAN WE CONCLUDE

• WE CANNOT REVERSE THE AGING PROCESS
• NUTRITIONAL AND ENVIRONMENTAL FACTORS PLAY A
  LARGE PART
• TRADITIONAL CURES ALMOST WORSE THAN THE DISEASE
• LASER IS A VIABLE ALTERNATIVE