Eye Surgery Removes Floaters

Persistent floaters that decrease vision can be removed.  A vitrectomy, a retinal eye operation, can be used to successfully remove the vitreous and the “floaters” located within this gel-like tissue.

Most Floaters are From a PVD

Most new “spots” or “cob-webs” are due a posterior vitreous detachment (PVD).  A vitreous detachment increases the risk of a retinal tear and/or retinal detachment.  As we have discussed previously, a PVD is a common occurrence (especially as we get older).  Patients should be examined when the symptoms of a PVD first appear and then 6 weeks after the symptoms started.

From a medical point of view, if a retinal tear has not occurred at the 6 week point, the patient may not need to return for another exam.

These Spots Can Be Annoying

Sometimes, the floaters are so numerous or so large that they are annoying, prevent normal function and may decrease vision.  There is hope and there is help.

A Vitrectomy is the Only Solution

A vitrectomy can remove most of the vitreous, and thus, remove the vitreous opacities.  The vision returns to “normal.”

Vitrectomy eye surgery is routinely performed by retinal specialists.  The operation is usually performed for other reasons rather than just opacification or cloudiness of the vitreous.  It can be used to repair retinal detachments, macular holes or remove epiretinal membranes, for instance.

Of course, there are risks of vitrectomy surgery.  Though very rare, the biggest risks are blindness from infection or retinal detachment.

Some doctors advocate the use of a special laser (YAG laser) to reposition the vitreous within the eye.  I personally don’t feel this is a wise choice as there is a chance of causing retinal tears, and possibly, retinal detachment.

What Does This Mean? It is true that most people learn to tolerate small changes in vision.  In my practice, I rarely performed a vitrectomy for just floaters while I was in Baltimore.  I operate on floaters much more often at my present locations.

Perhaps our tolerance for visual changes is different here.

The point is that, if needed, the surgery can be helpful.  It is not a fancy operation, but rather a routine procedure and does not involve new technology.

Reblog this post [with Zemanta]

Comments

  1. Nichelle,

    No, I know very few and none in Georgia.

    I’ll have Chrissy email you separately.

    Randy

    Randall V. Wong, M.D.
    Ophthalmologist, Retina Specialist
    Fairfax, Virginia

    http://www.TotalRetina.com
    http://www.RetinaEyeDoctor.com

  2. Dear Peter,

    Floaters, with pars planitis, can be removed. They might return, but they can be removed with vitrectomy.

    Good luck. Hang in there, but there is help!

    Randy

    Randall V. Wong, M.D.
    Ophthalmologist, Retina Specialist
    Fairfax, Virginia

    http://www.TotalRetina.com
    http://www.RetinaEyeDoctor.com

  3. Dear Peter,

    Please see my last answer. You can still hope for improvement!

    You don’t have to put up with them.

    I realize the health care system is different, but there is hope for you.

    Randy

    Randall V. Wong, M.D.
    Ophthalmologist, Retina Specialist
    Fairfax, Virginia

    http://www.TotalRetina.com
    http://www.RetinaEyeDoctor.com

  4. Dear Dr.Wong,

    I am a 29yr old guy suffering from floaters for 4 months. While I haven’t seen any new floaters appear after the initial batch, a few of them have become thicker and cause glare when they pass by my central vision, constantly… I fear that the most bothersome ones are in the premacular bursa region since they cast somewhat dark distinct shadows in most lighting conditions. Can a Core FOV remove those or do I need to have PVD induced? My Ophthalmologist assured me I do not have any problems with my eyes besides myopia (-3.7, -4) and as expected told me to “get used to them”.

    What is the general cost without insurance? My insurance (NHP of MA) unfortunately does not cover out of state procedures.

    Thank You

  5. Dr. Wong,

    I have spoken to you before but I have another question.

    I am 21f and have recently developed eye floaters, I’ve been checked by an eye doctor and my eye is other wise “perfectly healthy”.

    However, I was worried about getting frill after surgery as I have seen can happen (most recently I saw one of your patients, Dan, talk about it on floatertalk). Also, many doctors have told me that cataracts almost always happens within a year.

    My three questions are:
    1. What would cause frill, and would it be possible to remove it?
    2. How likely would a cataracts happen to a young person?
    3. WIthout inducing a PVD are floaters that are dark and close to the lens still able to be removed?

    Thank you!

  6. Dear Benm,

    Sorry for the delay. I receive quite a few comments and questions.

    I am sure all you need is a vitrectomy. No need for a PVD. Unfortunately, no need for you to put with them either.

    I’ll have Chrissy send you some of the information you’ve requested.

    Randy

    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, Virginia
    http://www.RetinaEyeDoctor.com

  7. Holly,

    1. I don’t really know about “frill. It is probably remaining viteous which is still visible after vitrectomy. The vitreous may still be visible for a variety of reasons; inflammation after the vitrectomy, blood or left over vitreous.

    2. The cataract issue is confusing. It is unlikely a young person with NO cataract at the time of vitrectomy will develop a cataract.

    3. Without inducing a PVD, the floaters near the MACULA are still going to be removed. A PVD does not affect the likelihood of floaters near the lens to be removed.

    You are welcome!!!

    Randy

    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, Virginia
    http://www.RetinaEyeDoctor.com

  8. Dr. Wong,

    I have a bit of frill left over from a vitectomy. What can I do about this? I have just had cataract surgery dated May 28th because four months after the vitrectomy I developed the cataract and had become myopic -3.5 to -4.0 depending on who is taking the measurements. My right eye is +.25 to +.50. The cataract surgery went well, as the Dr. was shooting for distance at Plano. But what has happened now is I am +1.5..it was way overshot the measurement and strength of the lens. It is hard for my brain to adjust to the different depths. By the way I had to have a second vitrectomy after the first on because of a hemorrhage. So two vitectomies, one in Nov of 2012 and the second one in Dec. 0f 2012. Cataract surgery May 28th, 2013. I am not happy with the outcome of being +1.5. I also implanted the En Vista lens..having light streaks from a lower left moving to upper right angle. Can you make any suggestions as to what I should do next? The dr. said he could possibly do Lasik to correct the long distance vision to plano..but I don’t want to do lasik. Any suggestions would be so welcome. What do yo feel is the best lens for my circumstance?

    Thanks, I hope this question will also help others.

  9. Dear Cheryl,

    Tough situation. What is the status of the other eye? Slightly nearsighed? Cataract?

    Is your doctor willing to consider exchanging the IOL?

    r

  10. Dr. Wong,

    My unoperated eye is fine, althougth I do have some shadow type floaters. I had the vitrectomy in my left eye because of floaters and the shadow type stuff that moved around as well as the worm like floaters. I am not near sighted at all. I became myopic in my left eye after the vtirectomy. I wore a contact to help adjust from the diopter difference, but was still very off..I couldn’t wear the -3.5 contact I had to wear a lower strength of -2.25 even though it was still blurry.

    The Dr. wants to wait no more than two months before we move forward to exchange the lens. I still have the side flickering which he says can happen with the en vista lens as well as other lens. That is why he is suggesting the Nanoflex for me.

    Would the measurements be any different post-vitrectomy to get me to plano or should I go a bit myopic like a -.25. Again I am a +.75 in the other eye. How does a Dr. adjust to accomodate for the fact one has had a vitrectomy to get you to Plano or close to plano?

    I recently read an article that said a post vitrectomy eye can have a deep anterior chamber therefore it is better to shoot a bit more myopic otherwise the patient will get a hyperopic surprise. I feel that is what happened to me.

    I had a +22 envista with the Hallogin (?) I forumula.

    My eye does not feel normal at all. It feels out of wack and sometimes even hurts. Sometimes I wish I had not gone and done any of this…just kept my floaters and taken medication to deal with them.

    Thanks,
    Cheryl

  11. If the floaters are only half a millimeter from the Retina will they still be removed with a Core Vitrectomy?

    Thank you for your time.

  12. Brian,

    It’s a good question, but basically think of the removal with a vitrectomy as a vacuum cleaner. There is a small hole at the tip of the vitrectomy instrument which can aspirate (“suck”) vitreous. Thus, you can remove material off the surface of the retina without actually touching it.

    Randy

  13. Dear Cheryl,

    I am not sure that the error is with the location of your IOL, i.e. too deep or too shallow.

    I’d agree with operating sooner than later to exchange the IOL.

    Measurements should be the same with/without vitrectomy. In my 22 years of working within practices which do a lot of cataract surgery…this doesn’t come up.

    Randy

  14. I am noticing a lot more white cell looking floaters that have clumped together forming long strands in my right eye. They are transparent they do move with my eyes is it fliaters or in the cornea cells

  15. Hannah,

    An eye exam should be quite helpful for you.

    Randy

    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, Virginia
    http://www.RetinaEyeDoctor.com

  16. Dr. Wong,

    First, thank you for providing this resource. I watched your webinars and they were very helpful.

    I’m 32 and a high myope (> -8 in both eyes, some astigmatism in left eye, and had LASEK 3 years ago). I’ve had clear strand-like floaters in my eyes for as long as I can remember but they have not been a problem. Three weeks ago, overnight I simultaneously developed two large dark floaters (one in each eye) that are very motile but settle in my central field of vision. The opthamologist said my retinas look OK and said my left eye is beginning to show a PVD. I am hoping that the floaters settle, but if they do not, then I think I must consider FOVs in both eyes because the floaters are constantly and extremely distracting, especially since I spend much of my day in front of a screen.

    My questions are:
    1) How long would you recommend I wait until having an FOV? Should I wait until I develop a PVD in both eyes for lower risk and the best chance of removing all the floaters?
    2) I would like to consult with you first, but I’m afraid I might be limited to doctors in my state (due to my insurance possibly not covering out-of-state procedures and my inability to pay out of pocket, but I will do more research on this). My understanding from watching your webinars is that a core vitrectomy with 25-gauge instruments without inducing a PVD is the recommended course for floaters because of the lower risks. Are there any other surgical variables I should be aware of when talking with doctors? Thank you.

  17. Hey randy its paul,vision is getting betterand the bubble is gone,im just waiting for the restof this stuff to clear up,I know you said a week hope so,

  18. Paul,

    Awesome!

    r

  19. Jack,

    1. There is no set time, but I usually like to know that “we” waited several months before considering surgery. In general, the younger you are (like you), the less likely the floaters will move and be less noticeable.

    2. You can email Andrea re: your insurance coverage. I am pretty adamant that a vitrectomy without inducing a PVD is the smartest and, by far, the safest. Some retina surgeons use air/gas at the end routinely, I wouldn’t choose that method.

    Randy
    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, Virginia 22031
    http://www.TotalRetina.com

  20. Hello again Dr. Wong (and all):

    I wanted to give an update for the FOV I had on my right eye in late September, 2012. The eye is perfectly healed, so I came back from South Florida for the left eye last week. (I wanted to let those on the blog know this)

    I had the FOV surgery on Friday, 7/12/13 on my left eye. I wanted to ask is it common for each experience to be different? After the first surgery, everything went really well initially except a little redness, and the eye remained dilated for about a week. This time, the dilation is gone, but the whites of the eye are completly red and I have slightly blurred/ slightly double vision with a feeling like there is sandpaper in that eye. I’m really asking for the benefit of all of us on here, because I sent you a separate email with a photo of my eye.

    Thanks!

    Ted

  21. I’ve had cataract surgery. Can you have a vitrectomy after cataract surgery? My doctor at Kaiser said that I have a small tear, but nothing to worry about. I have a clear floater parked right in my field of vision. It is bothersome at night, causing glare. I’m 73, have a pacemaker, but otherwise in great shape.

    Thanks, Del

  22. Ted,

    I’m glad your vision has improved in both eyes.

    Your concerns prompted me to write a post on subconjunctival hemorrhage!

    Congrats to you!

    Randy
    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, Virginia 22031
    http://www.TotalRetina.com

  23. Dear Del,

    You can absolutely have vitrectomy following cataract surgery. No problems at all. Don’t understand about not worrying about a small tear.

    Randy
    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, Virginia 22031
    http://www.TotalRetina.com

  24. Hi Dr. Wong,

    My name is Yannick Cleary, I’m 32 years old and I’m from Quebec, Canada.
    For a few years now, I have had problems with my eyes and I have heard many good things about your expertise and I have a question for you.

    I am farsighted and astigmatic, and for the past few years, I have had eye floaters. I would like to be operated by vitrectomy.
    However I have been told that I cannot have the treatment here because my problems are too serious.

    My options are to go to Paris for a laser operation and after a vitrectomy with you, or, replace my crystalline by a multifocal lens and after a vitrectomy. I know that there are some risks for both options. The second one provoques halos and I don’t want that if I can avoid it.

    What I want to know is what are my chances of developping cataracts after a vitrectomy, because I don’t want to waste my time and money for that operation if the risks are too big?

    What can you suggest?

    Thank you for your time,

    Yannick Cleary.

  25. Yannick,

    Being farsighted with astigmatism are not factors in the decision to have a vitrectomy. They might; however, be factors in choosing the correct implant for cataract surgery.

    If you do not have a cataract at the time of vitrectomy, you are unlikely to form one faster than if the vitrectomy were not performed. Remember, that everyone eventually gets cataracts!

    I would recommend making a decision based upon the annoyance of the floaters….

    Best of luck!

    Randy
    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, VA 22030

    http://www.TotalRetina.com

  26. Do you laser the floaters?

  27. @bossangus,

    No, floaters are removed along with the vitreous. YAG laser is not a viable option.

    Randy

  28. Can’t wait to get it done! will be there in march, don’t get me wrong i am scared but i need my life back, also i would like to say Chrissy is the very best !!! she help me so so much and I love her for it , wish there where more people like her in the world !!

  29. Terry,

    Look forward to meeting you and, yes, Chrissy is exceptional!

    Randy
    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, VA 22030

    http://www.TotalRetina.com

  30. shahzadah says:

    Hi doctor nice to hear about you iam 28 and i have floaters in both eye transparent like smoke and more shapes first will they tend to became less bothersome or fade away over time if yes how much time exactly and at my age i searched alot and didnt find solotion to get rid of these floaters i found you and you are impressive it sounds great to see your post and about your success rate i read alot that FOV cause cataracts bleeding or any other retinal problems in your experience how much safer the surgery would be and you know iam 28 and dont have any other eye problem my vision is perfect and about the cost of the surgery how much it cost thanks alot
    for cooperation sir

  31. shahzadah says:

    with young patients like me iam 28 is the surgery possible or you dont offer the FOV for young patients ?

  32. Shahzadah,

    I’ll have Chrissy or Andrea contact you re: scheduling and costs.

    Thanks and Happy Holidays!

    Randy
    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, VA 22030

    http://www.TotalRetina.com

  33. Shahzadah,

    Surgery is absolutely possible!

    Thanks and Happy Holidays!

    Randy
    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, VA 22030

    http://www.TotalRetina.com

  34. Dr, is laser cerclage before vitrectomy can help avoiding retina detachment .

    thanks

  35. Hi Dr Wong, I will be 36 in May & I have floaters mostly in my left eye. I went & had my eyes checked a month ago & the doctor said I have 20/15 vision & perfect eye health. It’s hard to find a Dr that takes the floaters seriously & by doing some research your name seems to come up the most frequently. I know your time is valuable, I was wondering of someone on your staff could call me & answer a few questions? I’ve tried finding a Dr in the Portland Or area but haven’t had any luck. Thank you. Jason

  36. Dear Dr, is retina break always associated with vitrectomy?

    is it better to do laser for retina prior to vitrectomy.

    thanks dr.

  37. Maged,

    Retinal breaks are NOT always associated with vitrectomy. They usually don’t occur, but can.

    Randy

  38. Jason,

    I’ll have Chrissy contact you under separate email. Look forward to meeting you. Don’t know a retina specialist in Portland, much less someone willing to consider FOV.

    Randy


    Randall Wong, M.D.
    Retina Specialist
    Fairfax, Virginia 22030

    http://www.VitrectomyForFloaters.com

  39. Ben Lovejoy says:

    Hello Randy

    I am a 22 year old male. I developed a sudden onset of floaters in both eyes when I was around 14. I have had eye exams and my eyes are perfectly healthy . I gather my floaters are the cell like ones close to the retina as they appear very pronounced and project very big onto everything! I notice about 20 in each eye, it is like looking through a snow globe. I have lived with these long enough and I am thinking about having surgery. I am living in Australia and I think there are a couple of doctors who may do it for me. I am just wondering should I go induced pvd? I have heard that there is not point in having a vitrectomy without it because of the location of these type of floaters. Also I notice BFEP in my eyes on every bright surface outdoors, it is almost as annoying as the floaters! Have you ever heard of someone noticing BFEP like that? Anyway having floaters sucks because you get absolutely ZERO sympathy from doctors! Any help would be greatly appreciated.

    Ben

  40. Ben,

    If you were to get a vitrectomy, I’d recommend inducing a PVD, but that’s my preference. Your doctor may not be very comfortable with the idea. If you have true BFEP (Blue Field Entopic Phenomenon), it may be related to the bright light.

    Best of luck.

    r

  41. Dear Dr Wong, I am 70 and have had constant flashing and floaters for 8 years which included a retinal tear in 2013. i have been treated by an ophthalmologist for most of that time but yesterday he told me the two large floaters (one in each eye) have not moved for 2 years. They are annoying and he recommends a vitrectomy – it would have to be done in Brisbane, Australia, and he did outline some of the risks involved. He is not forcing the issue and it will be my decision. My question to you is, “In your experience, how numerous/common are are the problems resulting from this operation? Thank you.

  42. Ron,

    In my experience, there are very, very few complications from vitrectomy. Blinding infection rates are quire low – lower than cataract surgery. Retinal detachment is also very low, 1-2%. Unfortunately, abilities do vary.

    Randy

Speak Your Mind

*


Privacy Policy · Terms of Use

Search Engine Optimization by Medical Marketing Enterprises, L.L.C.