Floaters in Eyes After PRK, Why is This?

Question

Hi, Soon after I had my PRK surgery 3 weeks ago, I noticed floaters in both eyes. Before my PRK surgery, I would occasionally notice floaters, but the difference now is that I notice them all the time. I read that PRK can not cause floaters since the surgery does not affect the vitreous humor, but that it is possible that PRK could cause one to notice their pre-existing floaters more. Why is this? Have you doctors had any experience with this? Any help would be appreciated. Thanks.

Christopher Starr, MD · Answer

If you are having new floaters then you should see your ophthalmologist as soon as possible for a full dilated retinal exam. Floaters can be a symptom of retinal tear or detachment and thus should be diagnosed and treated quickly. Nearsightedness, which is the most common indication for laser vision correction, is also a common risk factor for floaters.

Christopher Coad, MD · Answer

Anything is possible but floaters are not expected to change for the better or the worse with PRK. However most PRK is done for myopia (nearsightedness) and nearsighted individuals get more floaters. Your experience may be due more to your nearsightedness. Recent studies have reconfirmed that LASIK and PRK does not result in increased vitreo-retinal events such as retinal detachments.

Andrew E. Holzman, MD · Answer

While the PRK wasn't the cause of your floaters (that is caused by a degeneration in the jelly of the eye called the vitreous), it is frequently noted by patients after both PRK (and LASIK) that they seem to see their floaters more commonly.   More intensely noticing everything about the eyes after surgery is normal and common, it is the most likely reason for your symptoms.  Floaters are noticed most frequently while looking at a distance, in the sky or at a light background. 

	Having said that, it is important to note that if a large increase in floaters occurs, or you see flashes of light or a curtain/vail appearing in the visual field, that could be a coincident problem of a retinal tear requiring an urgent visit to the Retinal specialist.

	In very rare cases after LASIK, the retina may develop a tear and the vitreous can become more filled with floaters, but not after PRK...     if this were to occur after LASIK, an emergent visit to a Retina specialst would be warranted.

Dean Dornic, MD · Answer

I think your hunch is correct. Floaters are "blobs" suspended in the vitreous gel that fills the eye. Everyone has some floaters but most patients will require certain situations to see them such as viewing a blank wall or blue sky. Surgeries in the eye (like cataract surgery) can potentially cause new floaters but PRK, which takes place on the surface of the eye, would not be expected to cause new floaters to form. I think there are two factors at play. First, many patients become much more observant of their eyes after vision correction surgery. I have had many patients notice spots etc on their eyes after vision correction surgery. A check of charts or photos from before surgery will reveal that these spots were always there: just unnoticed by the patient. Second, vision correction surgery changes the focus of the eye. I believe some floaters become more in focus, and thus more noticeable, after surgery.

Floaters in Eyes After PRK, Why is This?

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