What is the Vitreous?

A Posterior Vitreous Detachment May Cure VMT

The vitreous is a gel-like substance filling most of the eye.

The vitreous is the gel-like substance which fills most of the inside of your eye.  The vitreous is composed mainly of water and is very similar to a jelly-fish; i.e., a substance which is mainly water, but still has substance.

The vitreous fills the posterior chamber of the eye which is the space behind the iris and the lens.

Purpose of the Vitreous

The vitreous is a vestigial tissue.  Like the appendix, it serves no purpose.  Important for development, once we are born, there is no physiologic function.  We don’t need it.

When I examine patients, I am able to see your vitreous; however, your own vitreous is usually invisible to you.  In other words, light gets transmitted perfectly through your own eye and vitreous without casting shadows or creating any visible shapes.

It is normally optically clear.

Other than filling space, it serves no purpose.

Diseases of the Vitreous

There are no diseases of the vitreous.  Blood (vitreous hemorrhage) and inflammatory cells (vitritis) may accumulate in the vitreous, but these conditions arise secondary to other complications or diseases of the eye.

The vitreous can; however, cause a variety of problems.  In fact, almost every surgery performed by a retinal specialist involves the vitreous.  Below are common indications for retinal surgery and all involve the vitreous in a variety of ways.

Removing the Vitreous is Safe

When operating, I often perform a vitrectomy.  Vitrectomy surgery basically involves removing the vitreous and is a basic part of almost every retinal operation.  When performing an FOV (vitrectomy to remove floaters or blood), simply removing the vitreous is curative.  With other conditions, the vitreous needs to be removed to facilitate operating on the retinal surface.

Modern vitrectomy operations are now safer than modern cataract surgery.  25 gauge technology allows me to operate more safely and efficiently with more comfort to you and a rapid healing time.

What Does this Mean?

Without the vitreous, there would be far fewer retinal surgeries, if any at all.  The vitreous only causes problems.  In general, removing the vitreous is curative for the retinal diseases listed above.  This also explains why most of the diseases are unlikely to recur after an operation.

Luckily, with modern instrumentation, removal of the vitreous has become “routine” compared to even 5-10 years ago and my ability to restore your vision and prevent complications has never been better.

 

 



Randall V. Wong, M.D.

Ophthalmologist, Retina Specialist
Fairfax, Virginia

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Comments

  1. This is an interesting post…thanks. It raises a question I’ve had for awhile now: I had a (very) successful vitrectomy 18 months ago to repair an RD in my right eye. Does this mean I am far less likely to detach again in that eye? I’m currently going through a longer process in my left eye: repeated RD’s, PVR, buckle, silicone oil. It has just made me wonder if I’m likely to face all of this again in my right eye.

  2. I have lots of floaters in my left eye and I am also very short sighted (-8.5) in both the eyes.

    My sister and my younger brother both had retina detachment.

    If I get a FOV surgery to remove floaters, are they chances that I will get a detachement?

    Also if I get this surgery, will the chance of retina detachment decrease because the vitreous layer was removed?

    thanks
    sam

  3. Dear Dr.Wong,

    I have a macular pucker with notable distortions, yet have 20/20 vision. Would you recommend surgery for the distortions alone? The pucker is in the eye that had two retinal detachments, a buckle and cataract surgery. I believe that my affected eye is my dominant eye so that when I look at an object the wavy vision supersedes the vision from my unaffected eye. My retinalogist does not want to perform surgery because I have 20/20 vision and is fearful that surgery may cause more harm than benefit to the eye.

    What would be your recommendation? And thanks for this website. It is so helpful.

    Cindy

  4. Laurence Parker says:

    Hello Dr. Wong,

    I’ve been following your posts for quite some time now and am readily gaining confidence that this might be the precedure for me. I had Lasik surgery about six years ago. Two years ago my floaters took a turn for the worst. I can deal with the couple of dark “strands” or specks in my right eye but, the “smudge” in my left eye has been driving me crazy. I’ve seen three different eye doctors in the last two years, all of which have warned my to avoid vitrectomy at all costs. I recently contacted a doctor in Tampa, FL (I live in West Palm Beach) who performs a type of laser surgery that “zaps” floaters, said to be “much safer”. The cost is around $2200 which brings me to one of my questions. I’ll use the word “typical” lightly but, what is the typical cost of this procedure? Do you think if I took a week off of work and fly to your location it would provide the time necessary for the procedure. I would just have my left eye done at that time. I’m 51 and concerned about long-term side effects. Would you speak to that if you would be so kind?
    Thank you,

    Laurence Parker

  5. Dear Cindy,

    There are two reasons, in my opinion, to operate on an epiretinal membrane, aka macular pucker.

    One is decreased vision and the other is distortion.

    Though your vision may be 20/20, the distortion is another indication for removal.

    All the best,

    Randy

  6. Dear Dr. Wong,

    Thank you for your prompt response. From what I have read, a successful outcome of retinal surgery has much to do with the skill of the surgeon. Would you be able or willing to recommend a specialist in the Kansas, Colorado, or Oklahoma area?

    Best wishes,

    Cindy

  7. Cindy,

    A vitrectomy is a basic operation of any retinal specialist. I don’t know anyone in those states who might be willing to do an FOV however.

    Best of luck,

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

    http://www.TotalRetina.com

  8. Laurence,

    Laser is performed by just a handful of doctors in the U.S., none of whom are retina specialists. In my experience, vitrectomy is covered by insurance.

    I will have Chrissy or Andrea contact you via email regarding visit and costs (I don’t keep track).

    Many patients fly in for a pre-op exam on Thursday, surgery Friday and leave Sat/Sun.

    Hope this works for you. Should not have any worries about long-term side effects.

    What specifically are you worried about?

    Thanks for inquiring.

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

    http://www.TotalRetina.com

  9. Michael,

    No promises, but I would say that you indeed are at less risk for a detachment in the right eye as the vitreous is removed. The history of PVR in the left eye is slightly worrisome, but since 18 months have passed, it may be a good sign.

    Hang in there and best of luck.

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

    http://www.TotalRetina.com

  10. Sam,

    The chance of retinal detachment from vitrectomy performed for any cause is about 1%. I would agree that the chance of retinal detachment indeed decreases with successful removal of the vitreous.

    Good luck!

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

    http://www.TotalRetina.com

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