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When a needle is stuck into your eye, it is probable that you will start to notice small spots floating in your field of vision. This is not because you have holes in your eye but because of the development of vitreous floaters. Can we get rid of them?

Macular degeneration is a condition where you are racing against the clock to save your vision. It is a condition where the macula and surrounding photo-receptors of your eye lose their potency and if you do not seek a macular degeneration treatment immediately, you will lose your central vision [1]. You can try nutritional therapy for macular degeneration but as we have seen in our previous investigations, supplements for macular degeneration rarely help when the disease has already advanced. More aggressive treatment options come into play in the form of Anti-VEGF therapy or laser photocoagulation therapy. [2] Even if they provide a more noticeable improvement in your symptoms, they come with their own inherent risks. You may find yourself asking "what went wrong with my macular degeneration therapy?" when you start to notice things like increased intraocular pressure, intraocular infections, retinal detachments or even vitreous floaters after intravitreal injection. [3]

Why Do You Get Vitreous Floaters After Intravitreal Injections 

An unfortunate fact about Anti-VEGF therapy is the fact the more times someone goes for intravitreal injections to preserve their vision, the more they are likely putting their current vision at risk for complications. Vitreous floaters are phenomena that can happen quite readily after having this type of procedure. In one study, it was determined that the prevalence of vitreous floaters could be as high as 48 percent of cases of patients needing intravitreal injections and the likelihood of getting these appearances increases as you get more and more of these [4]. 

Medically-speaking, vitreous floaters are opaque cell fragments in the vitreous fluid or on the surface of the lens that can create spots in your vision field [5]. They are usually made of water, extracellular membrane components of the cell and collagen and stick together to form bundles. As we age, our eye anatomy changes to be less strong so our eyes naturally have particles of cells floating around. As the liquid component of our eye becomes more gel-like, it is only natural that this debris bundles together and leads to the emergence of floaters. Studies show also these are mostly asymptomatic, as more floaters, they can become quite irritating for the patients and they will experience lower qualities of life. [6]

What Can You Do About It? 

Now that we know that vitreous floaters after intravitreal injection are a likely complication, the key question is what can you do to make them disappear. In modern medicine, surprisingly, there is no standard treatment option to advise patients suffering from vitreous floaters. Because they are benign and happen so readily in the population, most physicians will only provide reassurance and inform patients it is a "price to pay" for aging [7]. 

Should this "lip service" not alleviate your frustration, some modern therapies currently under investigation could provide you with some additional options to remove these floaters. Patients can choose to do a procedure called a vitrectomy. This is a surgery that removes the vitreous gel from within the eye and is typically done for cases of having blood in the eye or in retinal detachments. An off-label use of this procedure has been with patients suffering from symptomatic vitreous floaters and who are not satisfied to just sit back and deal with it. [8] Taking out the gel removes the debris floating in it as well. 

In one study to look at the effectiveness of performing this operation in patients suffering from symptomatic vitreous floaters, it was determined that when using small-gauged needles during the operation, patients were quite happy with the results. Their floaters were removed in most cases and there were few side effects that patients reported. [9] It is a minimally-invasive procedure so patients are not putting themselves at too much of a risk when doing this operation. 

Another interesting option that may help would be using lasers to target and destroy these vitreous floaters. In one study, it was determined that in 15 patients suffering from symptomatic vitreous floaters, using a YAG laser was able to resolve the visual disturbances in all cases. Patients also reported that they tolerated the surgery well and there were no recurrences of vitreous floaters 1 year after follow-up in these patients. [10]

All in all, unfortunately, there are no nutritional therapies for macular degeneration treatment that you can use if you have vitreous floaters after intravitreal injection. Thankfully, however, these are simple macular degeneration treatments like vitrectomy that can be utilized also to help you cope with floaters obstructing your vision. Don't be helpless the next time you question "what went wrong with my macular degeneration treatment". As we have now seen in countless topics, the side effects of anti-VEGF therapy is quite easy to manage and there is no reason (other than the needles) why you should be reluctant to seek treatment for your wet macular degeneration solely based on fear of the potential side effects of the procedure.