Floaters After Cataract Surgery: Causes & Treatment
Cataract surgery is the most commonly performed eye surgery in the world and it is generally a very safe procedure in the vast majority of cases. Anyone who lives long enough will develop a visually significant cataract that needs to be removed in order to maintain clear vision. Eye floaters after cataract surgery are not a common side effect but they can happen.
Depending on how dense your cataract was, you may not have noticed your floaters before having cataract surgery. But floaters can also be a new occurrence after cataract surgery.
What Causes Eye Floaters After Cataract Surgery
New floaters after cataract surgery are not very common. Patients may have always had floaters but they became more noticeable because they have clearer vision following cataract removal. Other causes are PVD, a retinal tear or retinal detachment, inflammation or a hemorrhage. Let’s take a look at these in more detail. In some cases the cause of eye floaters needs further evaluation from an eye care specialist.
Posterior Vitreous Detachment (PVD)
A Posterior Vitreous Detachment is a common age-related condition that occurs when the vitreous, a gel-like substance that fills the interior of the eye, begins to separate from the retina. A PVD can happen after cataract surgery and it is a possible cause of eye floaters. In some cases, the surgery can cause a PVD to occur more quickly or easily, as the surgical instruments or the ultrasound used during the procedure can cause the vitreous to detach from the retina.
However, PVD after cataract surgery is still considered a normal part of the aging process and is not necessarily related to the surgery itself. If you are experiencing floaters or flashes of light after cataract surgery, it’s important to discuss your symptoms with your eye doctor, who can determine the cause and provide appropriate treatment if necessary.
PVDs are typically not treated, and patients simply get used to them over time. If a patient has a severe amount of floaters, they should see a retina specialist to discuss potential surgical options.
Inflammation
Inflammation in the eye can make it seem like you have floaters, but what you are actually seeing is the inflammatory cells inside the eye. This is more likely to be experienced in the first week following your surgery and may also be associated with light sensitivity. The eye inflammation after cataract surgery will go down with time and with the medication that your cataract surgeon has given you to reduce post surgical inflammation.
Overall, post operative inflammation is minimal in most cases because the surgical technique involved needs only a small incision and cataract surgery tends to be fairly fast. In more complicated cases of cataract surgery, especially when vitrectomy surgery is also done, there may be more inflammation.
Inflammation is treated after cataract surgery with steroids. Sometimes the surgeon will give a steroid injection during surgery, but more common eye drops are used. Steroid eye drops after surgery can help to manage the side effects of inflammation after cataract surgery
Residual Lens Material
During cataract surgery, the eye surgeon will take out the natural lens of your eye. The natural lens is then replaced with an artificial lens so that you are able to see. While it is uncommon, in some cases, small pieces of the natural lens may be left behind. Depending on how big these pieces are, they could float around in the eye, causing the appearance of floaters.
If your floaters are from residual lens material, the treatment will depend on how big the residual lens material pieces are. Some large pieces may need to be removed by the eye surgeon by returning to the operating room. In other cases, smaller pieces can be resorbed by the body with time.
Retinal Detachment & Retinal Tear
The retina is the tissue that lines the back of the eye. The vitreous gel is between the cataract lens and retina. Cataract removal does slightly increase a person’s overall risk of having a retinal detachment. Retinal detachment following cataract surgery is associated with young age, male gender, long axial lengths and surgical complications. The cumulative risk of RD after lens surgery was about 2.3 times the natural. If you feel like a curtain is dropping over your field of vision or you see a rush of floaters and flashing lights, these could be concerning for a retinal detachment. Retinal detachments are also associated with blurry vision and a dilated eye exam is very important in determining if you are having this issue.
If you are experiencing light flashes and vitreous floaters, you should contact your cataract surgeon or eye doctor. Loss of vision can occur in the case of a retinal detachment or a retinal tear but treatment options do exist if caught in a timely fashion. In the case of a retinal tear a laser can usually be done in the retina doctor’s office. In the case of a retinal detachment, patients will need to be treated with surgery in the operating room.
Bleeding Inside The Eye
Having a serious bleed during cataract surgery is not common. There may be some amount of small blood during the surgery that remains inside the eye and this usually resorbs with time. This may be more common if you are also having a surgery done for glaucoma at the same time. MIGS procedures, which is short for Minimally Invasive Glaucoma Surgery, may have some bleeding associated with it. The blood can cause the appearance of floaters in the eye. This is likely to resolve and should not impact the long terms quality of life of the patient.
How To Treat Floaters After Cataract Surgery
Treatment for floaters after cataract surgery is typically not done, unless there is a specific thing to treat such as inflammation or a retinal problem. Most floaters after cataract surgery do not medically require treatment. If the floaters are from a retinal tears or retinal detachment, this will need further intervention. In the rate case of debilitating floaters that interfere with the patient’s quality of life, a retina specialist may be able to offer a vitrectomy, but this is not commonly done.
Floaters After Cataract Surgery: Summary
After cataract surgery floaters are not uncommon. Because cataract surgery is one of the most common procedures in the world, may patients wonder about new-onset floaters after cloudy lens removal.
One of the most common reasons for this medical condition is the fact that a patient’s cloudy vision from the cataract itself was making the number of floaters not visible. Once the cataract is removed, the floaters which always existed become more apparent now that the patient has a new lens.
Cataract surgery itself may cause a PVD, but other causes of feeling like there are floaters in the eye are inflammation from the surgery itself and less commonly, residual lens material. A retinal detachment can also happen and patients may experience new floaters and new flashes if this occurs. A sudden increase in floaters is a sign to call your eye doctor right away for proper care and to protect against permanent vision loss.
If you are experiencing floaters after cataract surgery, the best thing to do is to schedule a follow-up appointment with your ophthalmologist. The eye surgeon can then determine the cause of your symptoms. In some cases, you may not need any treatment. In some cases, you may need a referral to a retina specialist if there’s any concern for retinal damage. Depending on your specific situation, a visit to your ophthalmologist can help to determine the cause of the floaters. Once the cause of the floaters after cataract surgery is determined, a plan that is tailored to your medical needs can be made.
