Extreme floaters

[Maryst]

Hi all,

I am now over a year from retinal tear/ pvd with a mass of dark floaters/ cobwebs/ Weiss ring in my visual axis.constantly blurring my vision. Makes everything a struggle and exhausting. My ophlamolgist agrees they are extreme and is willing to do a vitrectomy - I am so tempted to get this done, but at the same time very apprehensive. Would love to hear any thoughts. Thank you in advance.

[JohnHaganMD]

I remember when my Weiss ring drifted into my field of vision. I was reading at my desk at an eye meeting in st. Louis MO. I knew immediately what it was and was amazed at how large it was. I was sure i would never get use to it. Took maybe 6-9 months but I completely tune it out now (along with 10s of others) unless a patient starts to complain about theirs then I can see mine.

This is a reference to one of the new laser procedures:  http://www.healio.com/ophthalmology/retina-vitreous/news/print/ocular-surgery-news/%7Be3262a47-4d0d-4231-8613-6d225ab1c4bc%7D/yag-laser-offers-safe-option-for-floaters

I have no personal experience with this nor does our large practice recommend vitrectomies or laser for 99% of floaters.  Since 50% of people have floaters by age 50 and 75% by age 75 it is ultra common, and of course they really bug some people. You really have to be careful as some "floater centers" are money mills for the surgeons that run them.

If I did anything at all I would consider one of the new lasers rather than a vitrectomy because you'll get a cataract then you'll need cataract surgery then you'll be at higher risk of retinal detachment, more floaters and more tears.

JCH MD

[Maryst]

Thank you very much- I know the vitrectomy is not a good idea. I had been doing a little better with the neuroadaptation, but lately have had a backslide and have gotten very frustrated again. I think once you get it in your head that maybe you can get something done, the floaters seem even worse. There's definitely a mind over matter component to this process. Thank you for your help.

[JohnHaganMD]

Yes but its not a procedure I recommend. The risk/benefits are not good in my opinion.  I have lots of floaters and a huge Weiss ring in my RE and I would not even consider this procedures. If you do a literature search you will find there is a new laser procedure being touted. Its very new, it doesn't always work and there are parts of the eye where it cannot be used. Only time will tell. Standard yag laser attempts to move or break up floaters have not been successfull. The biggest problem is the almost inevitable cataract formation and need for surgery. I would get at least 3 opinions all from retinal surgeons before signing on the dotted line.

[Maryst]

I am a physician and have been reading extensively. I am not am ophthalmologist. Is it true that smaller gauge instruments have made this surgery less risky?

[JohnHaganMD]

Use the search feature and archives and read postings from others who have had vitrectomies done for floaters and still have problems. The risks you are taking include highly likely develop cataract that will need surgery within 2-3 years, infection, bleeding, retinal detachment, persistent floaters still there after surgery and loss of eye.

JCH MD