PVD caused by tennis ball impact

[calvol]

I am 55yo male and suffered a PVD in right eye due to tennis ball impact about two weeks ago. Dilation exam confirms no retinal tears, and vitreous detachment appears to be from posterior to medial quarter.  When I quickly move my eye, I am seeing one large floater sweep across my vision counter to the movement of my eye (probably the loose portion of the vitreous sac).  
- How long does it usually take the vitreous sac to completely separate from the retina?
- Would you suggest a vitrectomy to remove the vitreous, say if it still causes vision problems after a year?
- What do you think of the outpatient victrectomy procedure used at the Charles Retina Institute?

[calvol]

Jodie,  Ok thanks for the reference to Dr. Charles work.  I emailed him about my situation, and he said to wait one month to see if the floater settles down.  My floater is a large one that sweeps counter to the eye movement (horizontally), and I suspect it is actually the back of the vitreous sac.

[calvol]

Sandra,

Thank you, yes, my OD thought the detachment spanned about 1/4 of my eye sphere from the posterior to the medial quarter. I read that once the vitreous separates, it is it acts as a counterweight to eye movement, and thus tears at the points that are still attached.
- Is it wise to keep my running and tennis activities- would this cause undue tearing at the remaining points of attachment?
- Since I am relatively young, will the vitreous sac stay intact all the way through complete detachment (and hopefully not see string floaters, etc.)?

[JodieJ]

And here's one patient's assessment of Dr. Steve Charles, founder of the Charles Retina Institute in Memphis.  The facts speak for themselves.

I had a vitrectomy to peel an epiretinal membrane in 2006, performed by a local (Chicago) retinal specialist (who was named one of the top retinal surgeons in America by Castle-Connolly).  The surgery left me with a larger image size in my affected eye, which had not been present before surgery and caused many problems.  I subsequently consulted three very respected local retinal specialists for additional opinions.  All strongly advised me against having additional surgery, warning me about the horrible consequences it would have on my acuity.  ("You could probably find some quack out there who would operate, but you'd end up much worse than you are now, probably with holes in your vision.")  The report by one of these surgeons stated that there was no epiretinal membrane remaining in my eye, and my surgical outcome was "very good."

In March 2009 on the advice of my general ophthalmologist, I went to Memphis to see to Dr. Charles.  He immediately identified my problem and pointed it out to me in my OCT.  My original surgeon had peeled the middle of my epiretinal membrane but had left the two tails in the macular periphery.  Even an untrained person like myself could see the jagged edges of the ERM in the OCT image.  Dr. Charles stated that many surgeons lacked the skill to peel smaller pieces of ERM, but he was confident that he could do it.  I had surgery the next day.  The following morning I could read the 20/20 line with my affected eye.  (So much for the dire warnings made by the Chicago specialists.)  Reduction in the image size disparity between my eyes has proceeded much more slowly; it's currently about 50% of what it had been.  I'm hoping for more improvement, but the 3+ year delay between my surgeries might limit the extent of my recovery.

You can ask Dr. Charles about your own condition by contacting him through his website (www charles-retina com, see the "Ask Dr. Charles" feature.)  

[Sandra M Brown, MD]

I would never recommend a vitrectomy just to get rid of a floater, or several floaters, or even many floaters.  Vitrectomy carries with it the risk of cataract and retinal detachment.

Since you are still fairly young, your PVD may not progress to completion for years.  Until the PVD is complete you are at increased risk of retinal detachment.  Report immediately to your doctor any symptoms of flashing lights, or a sudden marked increase in floaters.