05 May 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.
Karen BuethePosted at 21:43h, 02 November
Dr “Randy” Wong, (My husband, Dr. Robert Andrew Buethe, is called “Randy” also!)
I enjoyed meeting and speaking with you today. After reading your informative website, I am even more comfortable with my decision to have my eyesight restored when you perform the surgery for my large floater. I will call your office tomorrow to schedule the surgery for as soon as possible. Thank you for all your time and training. Karen Buethe
Randall V. Wong, M.D.Posted at 21:47h, 02 November
I, too, enjoyed meeting you today. Thanks for the plaudits regarding the web site. I am very proud of this site.
I look forward to seeing you again.
Many thanks for taking the time to comment!
See you soon,
William JohnsonPosted at 20:38h, 04 November
I have waited long enough. I do now want to have the viitrectomy for my eyes. I am seeing some bit of deterioration in the total vision experience with these floaters. I do need to know how long it will take, should we do one eye at a time or both eyes at the same time, is the procedure covered through Medicare? Thanks for being patient with me. I do trust that you will do your best for my eyes. When would be the best time? How much time do I need for recovery? Finally, from a physics standpoint, is there any refractive index differential from what is in my eye now and the fluid that you will use to replace it? Do I need to have it replaced or refreshed at a later date?
5103 Redwing Dr
Alexandria VA 22312
Randall V. Wong, M.D.Posted at 08:33h, 05 November
The operation will take less than 30 minutes. We will do one eye at a time, but perhaps as close as 2 weeks apart,or so. I’d like to play that by ear. There is no noticeable change in the index of refraction for water and the vitreous. The vitreous will be replaced by artificial saline on the day of the operation, but will be replaced by your natural fluid by the next day.
I will have the office call you today to schedule.
See you soon.
Cheryl RussPosted at 23:13h, 01 December
Dear Dr. Wong
I appreciate, so much, this informative website. I have been considering FOV surgery and was wondering what your patient satisfaction (as well as complication) rate is. How many patients have you performed FOVs for? I was also wondering if you induce PVD (for individuals who do not already have it) in order to get as many of the floaters as possible?
Randall V. Wong, M.D.Posted at 13:24h, 04 December
The overall satisfaction rate with vitrectomy for floaters is 100%. I am pretty careful about screening patients to make sure that, absolutely, what they describe as floaters obscuring their vision is, indeed, due to floaters.
The surgery has a very, very low complication rate. The chance of infection inside the eye is less than that of cataract surgery (I usually cite numbers such as 1 chance in 10-15,000 for vitrectomy). There is about a 1% chance of the surgery causing a retinal tear.
Vitrectomy is pretty safe these days, especially with the use of 25 gauge instruments.
Almost always, a PVD has already occurred in patients with complaints of floaters. If not, a PVD is commonly induced.
Hope this was helpful. If you prefer, feel free to email me.
KevPosted at 17:04h, 18 January
Dear Dr. Wong
nice explication in your website
i have some question you Dr.
I am 25 years old and I suffer of floaters for two years.
all reviewed that I pass on that wase floaters very small.
but me I see them very large and they become larger approximately every month and new is also formed.
I go twice in US for yag laser but too small to handle success.
I believe that the only thing has to do is the FOV?
How are the risk of having a cataract after the operation?
If I am a cataract its takes another operation?
and after the cataract operation do you think it’s pocible to have pieces of the cataract go in the new vitreous?
Please send me back some answers fast i realy need it.
Thank you Dr
Randall V. Wong, M.D.Posted at 09:01h, 19 January
I would agree that you should consider vitrectomy if the floaters are still bothersome. In most cases, especially with an experienced cataract surgeon, you shouldn’t have worries about the cataract “falling” into the vitreous if, and when, you need cataract surgery. Remember that many retinal patients develop cataracts. Make sure to pick a cataract surgeon used to working with patients who have had retinal surgery. They are not too hard to find.
While the cataract would be another operation, it can be planned and scheduled….if needed.
Sue RaffenspergerPosted at 14:54h, 26 January
Just wondering if floater surgery and cataract surgery can’t be done at the same time, since I am developing cataracts, and possibly considering floater surgery in the near future.
Randall V. Wong, M.D.Posted at 10:46h, 30 January
The technical answer is yes, it can be done at the same time, but I’d suggest you have separate procedures. First, and foremost, different surgeons with different skill sets should be doing the two different operations. This can also present certain complications in the operating room as it is a break from normal routine.
I would also suggest that if you are going to have both done; have the cataract surgery first. There are two reasons; 1. Cataract surgery might improve your vision enough so that you don’t need a vitrectomy, and 2. The cataract surgery will be slightly more complicated if there is no vitreous present. While many cataract surgeons are used to the slight difference in the two settings, why make it harder for the cataract surgeon?
Take care, thanks for asking. Great question.
StephanyePosted at 16:51h, 26 January
Hello Dr. Wong,
It was nice to speak with you recently about the “floaters” in my one eye and the possibility of vitrectonomy to correct this. I am considering the surgery but have a couple questions: -if the vitreous is replaced by natural fluid within a day, is it safe to assume that the floaters will not return? -What is the purpose of the vitreous–simply lubrication of the eye? -Does the vitrectonomy reduce the chances of a retinal detachment in the eye in the future?
I look forward to your responses, as I am considering the surgery. One last question: can this procedure be performed in the office?
Thank you, Dr. Wong.
Randall V. Wong, M.D.Posted at 10:51h, 30 January
Very intuitive. It is very safe to assume the floaters will not return. The vitreous is not regenerated. It is a vestigial tissue (something needed for embryonic development and that’s it) and is not needed once we are born. The only function of the vitreous, after development, is to possibly “plug” gaping wounds in the eye in severe trauma.
There are slight risks of retinal tears developing during any intraocular surgery, such as vitrectomy and cataract surgery. To answer your question, however, yes, removing the vitreous does decrease the likelihood of developing a retinal tear and, thus, a retinal detachment. Often a vitrectomy is performed in cases where patients have repeated retinal tears.
The procedure is performed in the operating room under sterile conditions and as an outpatient.
Nice to meet you. Hope this was helpful.
harry stephanouPosted at 12:32h, 06 February
after having a virectomy(floaters) and lets assume it was sucessful,are there any long term risks of any kind that one needs to know?
Randall V. Wong, M.D.Posted at 15:56h, 07 February
I’d have to answer “no.” The immediate concerns are the risk of infection inside the eye and the chance of a retinal tear forming from the operation, but in the long run…pretty safe.
autry welchPosted at 13:44h, 07 February
Hello Dr Wong,
I have recently developed a many small floaters and a few strands in each eye. Doctor said there was nothing evidently wrong. Even though my case is not nearly as bad as many here I was wondering, do you treat patients with just large floaters or do you also treat them with many small ones? It is like a snow globe for eyes and it has sent me into a great depression. Thank you for your time and for helping people who struggle with this.
Randall V. Wong, M.D.Posted at 16:14h, 07 February
I personally never look nor regard the exact size and shape of the “floaters” that bother you. Big or small, as long as I’m convinced that you have floaters causing you angst and that you understand the few risks, you would be a great candidate for surgery.
There is no reason for depression as I believe, based upon your comment, that you can be helped.
Good luck. Hope this makes your day a bit brighter.
autry welchPosted at 12:04h, 08 February
Dr Wong, your AWESOME!!!! There are not many doctors I have found who give hope and inspiration to people who’s lives have been so damaged and changed by eye floaters. Thank you for answering questions so quickly for all of us looking for a little ray of hope. God bless you!
autry welchPosted at 15:45h, 08 February
One last question Dr Wong. It is stated that the onset of cataracts within a year is as high as a 50-60% chance. What would you rate the percentage of this in your own observation.
VincePosted at 15:33h, 10 February
Dear Dr. Wong:
I stumbled across your website today while doing post vitrectomy research and would appreciate
your professional opinion.
I had a vitrectomy proceedure performed on both eyes. One in Oct 2010 and then Dec 201o to correct PVD and soupy floaters which greatly effected my vision. The procedure was conducted
using the 25ga 3 port process. Healing was rapid with no medical complications. However I have noticed a significant decrease in visual acuity within 2 to 5 weeks after surgery.
Prior to surgery my vision with glasses (looking between the floating debris) was pretty good. I could easily read street and road signs while driving and see images clearly on the TV screen. After about 2/4 weeks I noticed a decrease in sharpness and detail.
I had my eyes checked and purchased new glasses but the corrected vision is no way close to my former vision. I discussed this with my Retinal Specialist who stated that lenses in my eyes must have moved or changed position resulting in the loss of acuity. No other problems or complications
were observed except for a small cataract beginning in one eye. I am 60 years old.
Dr. Wong, Is this the likely cause? Your professional opinion is greatly appreciated.
Randall V. Wong, M.D.Posted at 19:20h, 19 February
You did not have cataract surgery yet, correct?
My first thought is cataracts.
RLKPosted at 13:56h, 14 February
I had a vitrectomy Oct 14th of 2010, its been 4 months. I was highly myopic (-15) and had bad detachment (per surgeon). Cataract forming already (but it was expected). My question is regarding the vitreous, the good doctor says its needed for birth, but not life. Is it not also a “shock absorber” for the eye? Isn’t the eye more vulnerable to shock after a vitrectomy? Thank you
Randall V. Wong, M.D.Posted at 19:49h, 19 February
Your doc is right. The vitreous has no purpose, other than plugging a gaping wound of the eye after trauma, once we are born. I am unaware of any “shock absorber” functions.
Shelly BarkerPosted at 21:33h, 15 February
Hi Dr Wong,
Are you aware there is an Australian Dr Wong who is also practising in this field? Can you please help me with a query. What do you know about Lattice Degeneration? Is it all doom and gloom as Ive been led to believe? After laser treatment for this condition, which precipitates floaters, do you suggest a Vitrectomy? Please am hoping you will have some good news about this condition and that after laser treatment, it has a good outlook (pardon the pun!).
Thank you so very much. Awaiting your reply eagerly.
Randall V. Wong, M.D.Posted at 23:15h, 21 February
Am not aware of an Australian with the same name. There are several of us.
Lattice degeneration can, but does not always, lead to retinal detachment. Laser treatment, if needed, should reduce the chance of a tear or hole forming.
It’s really not doom and gloom. Many people have it and never have issues.
ryanPosted at 20:23h, 20 February
Dr wong, I am a 35 year old that has had floaters for 14 years. I had gotten used to them but then seemed to get hit with a bunch in the last couple weeks that have been difficult to deal with. I especially have a hard time concentrating while using a computer. Is a virectomy something I should put off since it appears I will keep getting floaters in the future? I have nearsightedness but have no other eye issues. Do floaters settle down and sometimes leave a persons field of vision. It is the black floaters that are of most annoyance. I did see a dr and he ruled out a retinal tear. I appreciate your candor and would appreciate hearing from you. Thanks , ryan
Randall V. Wong, M.D.Posted at 23:08h, 21 February
I see no reason why it needs to be delayed. They don’t really come back. Sometimes they go away and many times they don’t. 14 years is a pretty good indicator that they are not going any where.
SHUOYANG LIPosted at 23:41h, 20 February
Sorry for I have already developed epiretinal membranes and very bad floaters in my left eye. however my vision is still 20/20. the floater is getting worse and making me hard when reading and using computer….. I am wondering can I have a Vitrectomy to make both of them disappear?
Randall V. Wong, M.D.Posted at 23:09h, 21 February
If you have an ERM, both can be accomplished with one surgery; removal of the vitreous and ERM.
JulioPosted at 22:28h, 21 February
Hello Dr Wong
I am a Brazilian, 44 years old (sorry for english mistakes). In May/10 the first floaters appeared. I went to 2 retina/vitreous specialists:
The first doctor told me that I had a PVD in the right eye and this was the cause of the floaters and they would be going to disappear with time. He doesn’t do vitrectomy for floaters..
In November the floaters increased. Then I went to the second doctor, and after several exams he said that my left eye also had PVD, and my vision and retina are ok. The diagnosis is Vitreous Sineresis. He said to wait approximately 6 months and if the floaters will not disappear he is going to study a vitrectomy. Nowadays I have several floaters,(clumbs, clouds, etc) annoying me!
I have some questions:
– Beyond age, which other sineresis causes? Is any recommendation to delay it?
– Do the floaters really disappear with the time?
– About 25gauge vitrectomy, Are all the vitreous removed or only the floaters? How is the “post-operative”? How is the recover? Is it painful?
– Which is the cataract probability after vitrectomy?
– The clinic have the “Alcon – Constellation” – It is reliable ?
Thanks a lot!
Randall V. Wong, M.D.Posted at 23:10h, 21 February
No recommendation to delay anything. “Constellation” is great. Nice machine.
Floaters can, but often do not, disappear with time.
During vitrectomy most of the vitreous is removed, especially the central portion with the floaters.
SHUOYANG LIPosted at 00:16h, 22 February
Thank you Dr Wong. Could I have another question, according to my condition, which visual is still 20/20. What result can I expect?
ryanPosted at 10:34h, 22 February
Dr. Wong, I appreciate your repose and just have a couple further questions. What are the long term effects of someone my age having a vitrectomy? Does it increase the possibility of glaucoma later on and how serious are cataracts for someone my age? I’m 35 years old. Thank you. Ryan
ryanPosted at 10:59h, 22 February
Sorry, one more quick question. Would this affect my vision and could I still wear contacts after the procedure? Thanks again, ryan
John HenenPosted at 22:06h, 27 February
Hi Dr. Wong,
I just want to know in cause of infection, is the vision is gonna be lost permanently or there is something that can be done to restore it??
Randall V. Wong, M.D.Posted at 09:40h, 01 March
If one were to sustain an infection inside the eye, the result is usually permanent loss of vision. Blindness is a possibility, but the chances of this happening is quite low. To give you a comparison, patients undergoing cataract surgery have a higher chance of intraocular infection compared to patients undergoing retinal surgery.
Shelly BarkerPosted at 08:14h, 04 March
Thank you so much Dr Wong.
Your reply is the most positive thing I have been told about my Lattice Degeneration. Your words: “Many people have it and never have issues” fills me with so much hope and joy! All Ive been told about it is all bad news and that in time it will cause blindness (even with many laser treatments Ive been told there is no guarantee it will help). I am only in my late 30s so this has been DEVESTATING for me. ;(
The fact that Im not a rare case because many others have it and that it can mean no issues and vision is fine, fills me with more joy than I can express. Thank you so much. God bless you for taking the time to reply and for your kind words of encouragement in my depression over this.
Randall V. Wong, M.D.Posted at 11:53h, 10 March
glad to be of some use!
otaconPosted at 08:01h, 05 March
I am 30 years old. myopia -6.50, astigmatizm 0.75 in both eyes.
I have been suffering from floaters since 15 years. By the years, it increased a lot. There ara tons of floaters. My vision is very cloudy, lots of flashes, webs, black dots, halos and in pain.
I also have very small cataract in both eyes, that comes from the birth. The colors are somewhat strange. Living like this is a hell.
3 years ago, they did argon lazer to right eye. But there was not any retinal detachments. Now especially my right eye is in a very bad condition.
Last week, a specialist in Turkey offered me to do combined vitrectomy and cataract surgery. He said my retina is O.K.I have some questions to people who have already got fov and cataract together.
1)My vision is very cloudy, lots of flashes, webs, black dots, halos and in pain. Are all these caused from floaters, or cataract, or both? May they be worse after vitrectomy?
2) which IOL to use? multifocal or monofocal? what are their advantages and disadvantages?
3) my right eye visual field is narrow. when I look a point, ı dont see the sides. is this caused also from PVd.
4) I have tilted disc also:(. what are the effects of this?
Randall V. Wong, M.D.Posted at 11:55h, 10 March
Any thing that is “moving” is probably from the floaters as they lie within the vitreous. The vitreous “moves.”
Probably the floaters will more noticeable after cataract surgery due to the change in contrast.
Can’t advise you about the IOL: I don’t deal directly with them. I’d let you and your doctor decide.
Tilted discs are of no consequence with regard to either the floaters or the cataract.
Best of luck,
John D.Posted at 01:09h, 11 March
Dear Mr. Wong,
I am writing to you regarding me severe case of floaters. I have visited multiple surgeons, some of which are top notch in upstate new york, one is a professor at Syracuse University, unfortunately, I am unable to convince any of them to perform a floater only vitrectomy. They tell me my vitreous is health, I have a healthy eye (I believe them, no question) and would not consider a vitrectomy in my case.
My floaters have cause me to drop out of college and I am no longer able to drive and I take depression pills to try to deal with my situation somewhat. I no longer have any control of my life.
Is a Floater only Vitrectomy something you would do or even consider in my case?
I do not think I can bare another let down traveling from NY to VA.
Randall V. Wong, M.D.Posted at 11:31h, 15 March
Dear John D.,
I can’t possibly know, without examining you, if you need a vitrectomy.
HOWEVER, if you and I agree that a vitrectomy might be of some benefit, then I could consider operating.
Please let me know if I can help further.
otaconPosted at 11:43h, 11 March
thanks mr randy.
my vision in side is very dark and narrowing. But doctors did not see any retinal detachment and eye pressure is normal. are darkness caused from floaters? I only had argon laser from right eye, and my right eye is much worse.
I think I have the worst floaters in the world. They just blocked my vision. And what do you think about facovitrectomy?
Randall V. Wong, M.D.Posted at 11:37h, 15 March
Not a big proponent of combined phaco and vitrectomy. But that is my opinion. If your doctor(s) are comfortable performing both simultaneously, then go for it.
Without an exam, it’s tough to say for sure, but it seems likely that floaters could be a cause of your problem.
Let me know if I can help.
Matthew MindolovichPosted at 15:34h, 12 March
Dear Dr. Wong;
I am 55 years old and have had very severe floaters in both eyes since I was 19. They are so annoying and present everywhere in my field of vision that I avoid doing so many things, including reading, hiking and anything that has to do with looking at stuff, Everytime I ask a doctor to perform a vitrectomy, they say my eyes are healthy, no problem. Then they say something like, “You don’t notice them when you’re out fishing and having fun, right?” Wrong. I notice them constantly every moment. My only relief from the eyestrain is sleep, and even they are present in most of my dreams. Finally, the ones in my left eye clumped together enough where the Dr. said, “Wow, you probably can’t see through that.” And I couldn’t, so he performed a vitrectomy on that eye. Now there are just very faint floaters in that eye that I remember seeing as a kid when I looked at the sky while sunbathing. They never bothered me as a kid, until age 19. At 19, when the big fuzzy floaters showed up, I had to quit skiing, because I’d get the shadows in my eyes from floaters confused with shadows in the snow due to moguls etc. I went to college, but spent much of my study time looking for a dark place to study and flicking my eyes to get the floaters out of the way. Anyway, the one operation on my left eye was successful, but he won’t do my right eye, because they haven’t clumped together in a big mass yet. Now I wear an eye patch at work to block the view out of the right eye with the big fuzzy floaters. How can I find a doctor that will perform a vitrectomy on that eye?
Randall V. Wong, M.D.Posted at 11:40h, 15 March
Two options based upon your desire….
1. Where do you live?
2. Do you want to travel to Washington DC?
You may answer me privately if you want.
Take care. Hope to see you.
Joe HunterPosted at 16:51h, 13 March
Hi Dr Wong. I am 56 years old and recently (1 month ago) had cataract surgery on my left eye. After 3 weeks, I developed a number of floaters in the repaired eye (a large spidery semi-circle and some clouds) as well as flashes when I looked to my extreme left. I immediately went back to my surgeon and he had his retinal specialist check me out, and he says that the retina looks fine. He attributes the flashes and floaters to an “excited vitreous” caused by the operation. That was a week ago, and while the flashes are getting somewhat less frequent, the floaters are stil there, and they appear to be even getting a little worse. Should I be worried? I feel self-conscious running back to my eye doctor again after a week…Butthese floaters are very annoying, ,and the flashes have me worried.
Randall V. Wong, M.D.Posted at 11:41h, 15 March
At best, keep the frequent appointments with your doctor.
If the floaters get dramatically worse, then make sure you tell him/her.
Overall, these should settle down, but it may take a few weeks.
ScottPosted at 17:10h, 16 March
Hi Dr. Wong.
Last October, I developed a severe case of floaters in both eyes. I went to see my eye doctor and he told me all was OK and to live with them. I have since seen a retinal doctor who has examined my eyes twice over the last 8 weeks. He also told me all was OK but to let him know if the floaters get worse. He also told me they may subside after 6 months. He told me I had no options for treatment and they continue to bother me.
Why do some doctors say that and you actually will perform a vitrectomy’s. This is a terrible way to live and I’m willing to take some risk to get my eyes better. Any suggestions?
Randall V. Wong, M.D.Posted at 19:37h, 20 March
I don’t have a great answer for you regarding doctors’ limitation of treatment. If floaters are indeed your problem, and you understand the risks of surgery, you should have surgery.
If you are willing to travel, I’d be happy to see you i consultation.
otaconPosted at 04:44h, 22 March
This is the sixth day of post-op. Gas has not dissolved yet.my eye is bloody. According to doctor, it will take 20 days to dissolve.
what are your suggestions in order to speed up the healing process?
Thanks for your concern. You are so kind.
Randall V. Wong, M.D.Posted at 14:05h, 22 March
Really nothing you can do to increase the absorption time of the gas.
Stay in touch.
otaconPosted at 03:26h, 25 March
Eye is getting better day by day. İ started to see from the top of the eye. But i have a problem, original floaters seems to disappeared but i see hundreds of very black dots. They move very freely. They vibrate also if i slightly move my head or eye
Are these floaters inflamation cells? Or are they gas particles?
Randall V. Wong, M.D.Posted at 14:27h, 29 March
Probably neither. I’d wait until all the gas is gone before worrying.
otaconPosted at 08:52h, 04 April
Today is the 19 th day after facovitrectomy. Gas has completely dissolved. My eye is still dilated. Although it is not as much big as the first days of post surgey, it is still big. Light comes so strong that i can not open my eyes.
are these normal?
Randall V. Wong, M.D.Posted at 07:48h, 07 April
Probably a result of long acting dilating drops or you may be currently using dilating drops (common during the post-operative period). Ask you doc what he thinks is going on.
otaconPosted at 07:47h, 09 April
İ do not use dilating drops but i use fml liquifilm. İt includes fluorometholone. As i investigated from the internet, it may cause dilated pupil as a side effect. My doc says it will undilate. But sometimes the eye may remain dilated permanently after cataract surgery. İ am afraid of this.
Jeff LubinPosted at 18:57h, 31 October
I am a 62 year old male and am a professional portrait photographer in McLean, Va . I recently had a PVD episode of flashing lights and floaters invaded my right eye. The next day my vision totally changed. I had some webbing type vision and a horseshoe shaped floater that kept settling in front of my eye blurring my vision. This is akin to driving in a rainstorm but day and night, never ending. My optician referred me to Dr. Wong who had me come back a number of times to see if I had a retinal detachment or any lessoning of the floaters.
I had no detachment but the floaters didn’t lessen any. After reading about the low probability of problems, I opted for the Vitrectomy which I had only four days ago. Amazingly enough the floaters are long gone, my vision is perfect and the operation was painless.
I had a bandage on my eye for only a day and being floater free is a dream come true! I understand I have to wait a few weeks before the all clear sign can be given but I understand that chances of any problems are infinitesimal, one in thousands so I feel like all will be fine.
Dr Wong is an expert surgeon, caring and highly experienced. I feel great comfort in having him as my physician.
If you have any questions, please feel free to contact me through my site! http://www.JeffLubin.com.
Randall V. Wong, M.D.Posted at 10:43h, 05 November
Thanks so much for your evaluation and trust. Good luck!
DaphnePosted at 23:49h, 16 November
Hi Doctor Wong,
My left eye is seeing flashes & floaters for the pass 2 months. Had 3 eyes examined at one of the local eyes specialist center. The doctor said no detachment, the gel still stick well with the retinal. However, I’m freaking out cos the eye condition is keep changing.
The floaters is getting lesser. The flashes seems to be reduced times of apperance. Besides these, currently i experience a new thing on the left eye. When I bling my left eye, in a particular area i see small black spot & it disappear in seconds. Also from the same area, i feel dryness of my left eye. Whats wrong again?!
I’m getting confuse whether should go for another eye checkup with the same doctor again. Your advise will be much appreciated.
Randall V. Wong, M.D.Posted at 00:19h, 18 November
The two complaints may be unrelated. Anytime you don’t understand one doctor….get another opinion!
CraigPosted at 23:38h, 03 January
Thanks for such a great website and being so compassionate and able to answer questions.
What are your thoughts on performing vitrectomy for a very large dense PVD immediately behind the lens in a 40 year old individual who works in a field requiring significant visual function (i.e. pilot, surgeon, etc)? The PVD is preventing one from performing their occupation.
I have lattice, and a history of bilateral retinal detachments, both repaired with scleral buckle and extensive laser retinopexy. The first buckle was performed on the left eye 15 years ago (asymptomatic retinal detachment seen on routine eye exam). The right eye which now has the severe PVD had successful scleral buckle 5 weeks ago. The PVD occurred 8 weeks ago, and apparently produced retinal tears. Of note, the PVD’s effect on my vision hasn’t improved in the 8 weeks. Laser held the tears for 2 weeks, but ultimately the buckle was required due to a peripheral detachment. It is hypothesized by surgeons that this right eye PVD may have been induced by suction during refractive surgery (LASIK) 2 months prior to the PVD, but this also is not certain, given the time interval between intervention and PVD. Interestingly, 3 days after the right eye PVD, a small PVD developed in the left eye, and this also required laser for tears.
Do you believe that in the RIGHT eye, the prior PVD and prior 360 deg laser retinopexy and a prior scleral buckle is PROTECTIVE from detachment during vitrectomy, or do the lattice and the history of tears actually increase my risk? What would you estimate the detachment risk to be, as well as other risks? If one has had a PVD, is it safe to assume it is complete? Or would some “peeling” of vitreous from the retina still be required and is this dangerous in someone with lattice? Any way to know if further PVD induction would likely be necessary prior to “going in”? Finally, how long after buckle surgery do you feel is safe to wait prior to vitrectomy?
Randall V. Wong, M.D.Posted at 11:20h, 09 January
1. Thanks for the compliments about the site. I hope more docs will follow suit….someday.
2. If the PVD is interrupting functioning at job or hobbies, and the opacity is responsible for the decreased vision, I’d recommend vitrectomy.
3. My general belief is that scleral buckles decrease the likelihood of subsequent retinal detachments once outside the recovery/post operative period.
4. If the lattice were treated correctly, probably safe to move forward, but I’d obviously recommend that you follow the advice of your doc. We all have different comfort zones in the way we practice.
5. A PVD probably takes several weeks to “complete,” but once completed…it won’t change.
6. I’d wait several months after scleral buckle surgery…the floaters might move and become less noticeable.
DennisPosted at 00:12h, 22 January
Am a Adult Onset , T1 Diabetic since 95′ at age 45, now 64. VG , BG’s but.
-I’ve had 3 Vitrus Eye hemmorages a few yrs ago
-The Reitna Speicalist I see had me just tolerate them, wear a Eye Patch and Let them Disove on their own and clear up. Each took about a Month
– After each one, they left some Floaters bedhind ,but he feel no need to clean them up and to tolerate them
– My biggest question is? If I get another Eye Hemmorage? Can They clean it up right away, instead of letting them disolve on their own and go thru all that Stress?
For I realize that the other Eye can have one as well and Can Become Totally Blind..
Dennis in Wi.
Randall V. Wong, M.D.Posted at 09:41h, 01 February
Did you get PRP after the bleeding?
Yes, a vitrectomy can be done shortly after bleeding if needed.
TedPosted at 17:53h, 11 February
It sounds like you characterize vitrectomy as a fairly routine procedure. If so, I am confused why all the eye specialists who I have seen refuse to recommend such an “extreme procedure” and tell me to “get used” to my extreme floaters. I have visited several specialists and have had my eyes throughly evaluated and I am told my eyes are “fine” (other than the floaters)
Unfortunately I cannot just “get used” to my floaters. I have dozens of long thin strings of “crystal” floaters of different sizes in both eyes that criss-cross when I move my eyes. I now have two in my direct field of vision in my right eye …extremely distracting. I can function in low light situations, but while in the office environment, such as being in a meeting room with UV lights, white walls, etc., looking at white paper and white plans, I almost am to the point of madness with the distractions.
I live in South Florida, but I willing to go to DC if that is what it takes to get my vision back.
Randall V. Wong, M.D.Posted at 12:27h, 14 February
I would be happy to see you.
I would need to agree that there are floaters bothering your vision. I do not always see “your” floaters on examination. They are not always visible to me, especially in younger individuals.
Let me know if this works for you.
floateredPosted at 00:33h, 16 February
Perhaps, the highest number of comments on any of your postings, Dr. Wong. This just only shows how much agony floaters cause, yet these patients have been time and time again ignored by the majority of the ophthalmic community. If the community had at least striven to do something to help these patients, I am sure today we would have a bit less invasive treatments for floaters. But no. Arrogance is the mother of all failures.
Randall V. Wong, M.D.Posted at 09:04h, 16 February
Thanks for the insight and background. Hopefully this is a beginning for the floater community. Advances in technology have made vitrectomy much, much safer than 10-20 years ago!
TedPosted at 15:49h, 18 February
Dr.Wong, I will plan on getting up there as soon as my schedule allows. Yes, I have been told that, other than the affected individual, it is difficult to see floaters. I was told during one examination that he could see at least 4 lined up in my right eye, but they are not very large to him. I have 3-4 more in my right eye peripheral which must be very close to my cornea because they are huge in my perspective. Hopefully you will be able to see them. Thank you for having this forum. Ted
Randall V. Wong, M.D.Posted at 12:25h, 22 February
Look forward to meeting you.
floateredPosted at 00:28h, 20 February
Hopefully, Dr. Wong.
Thank you for being a source of hope for those who got vitrectomy for floaters done by you and for those who are still in contemplation mode.
Do you plan to publish some sort of a case series publication for floater vitrectomies sometime in future?
Randall V. Wong, M.D.Posted at 12:26h, 22 February
I think it’s a great idea and will keep in mind.
TerryPosted at 18:47h, 27 February
Dear Dr. Wong. I am 49 yrs old and had cataract surgery last year on both eyes. Everything was going great until I was recently struck in the right eye with a stray basketball. This resulted in a PVD in the right eye with many cloudy floaters.. My eye doctor has suggested vitrectomy as an available option. The question I have though is could this surgery disrupt the corrective lense placement of a successful cataract surgery? And could this surgery cause new cataracts to return? And would only the bothersome eye need surgery, or is it wise to do both eyes anyways? I used to be very nearsighted, but the cataract surgery corrected it. I would hate to disrupt that correctiveness in anyway. Thank you so much for your time!
Randall V. Wong, M.D.Posted at 18:18h, 28 February
The vitrectomy should not jeopardize your implants at all.
Betty MorrisPosted at 01:19h, 07 March
I am to have surgery to remove the vitreous from my left eye. They told me I would have to keep my head down to my feet for 7 to 14 days. Do they mean I will have to look down or will I have to move my head down towards my feet. My husband is on a feeding tube, and they said I would not be able to do it. Thank you for your reply
Randall V. Wong, M.D.Posted at 19:59h, 07 March
They probably mean that you should keep your head over, looking at the floor, with your face parallel to the ground…..
It must not be easy, but it will help save your vision.
All the best.
MPPosted at 11:39h, 02 April
How much do you charge for FOV procedure?
Randall V. Wong, M.D.Posted at 06:57h, 04 April
There are 3 basic charges for any surgery;
Most of the time insurance will cover most of the costs. Please feel free to email me and I can forward to my surgical coordinators and we can check.
TimPosted at 19:03h, 10 April
I have recently had double cataract replacement at the age of 44 after months of struggling with doctors telling me that cataracts were not the problem.
The surgery was a major sucess in terms of improving my vision and I am now left with trying to decide if something can be done to help with my floater problem which includes one that impedes my vision pretty seriously in my left eye.
I was told my cataract surgeon that the procedure to remove floaters is quite risky and he did not give me a referal.
I would like to know if having prior cataract surgery will have any impact on this surgery or if it is a contraindication under certain circumstances.
My vision is paramount to my profession and if done what is the standard healing time or time needed off work to recover.
Randall V. Wong, M.D.Posted at 22:11h, 17 April
You need another eye doctor.
Removing floaters is actually less risky (or at least at the same risk) than cataract surgery.
If you are having problems with floaters…don’t give up. Seek the help of a retinal specialist.
susanPosted at 05:28h, 18 April
I HAD VITRECTOMY IN BOTH EYES DUE TO RETINAL DETACHMENT , BUT WHY IS IT – THAT I STILL HAVE PLENTY OF FLOATERS & FLASHES-ONCE IN A WHILE? (ALTHOUGH NOT AS INTENSE BEFORE THE SURGERIES) AND AT TIMES I HAVE “LIGHTED FLOATERS’ – THAT COME AND GO. DO I NEED ANOTHER VITRECTOMY DOCTOR?
Randall V. Wong, M.D.Posted at 14:32h, 20 April
You might indeed need another vitrectomy if the floaters are driving you crazy!
Warren RenderPosted at 22:56h, 19 April
I am 66 years old and on Easter Sunday I had a small floater start in my good eye. I lost my other eye in 1967 due to scar tissue surrounding the optic nerve. This has gotten worse with a large piece floating around. How long does this normally take to clear up. My eye doctor stated that this is the 2nd largest one that he has seen. There is no damage to the retina. With just 1 eye, I am very concerned about having surgery. Do you have any suggestion? Thanks
Randall V. Wong, M.D.Posted at 08:19h, 21 April
First things first. Make sure that there are no tears. It’s hard to say, but if the floater is simply due to opacification within the vitreous, then it may not leave…but it may move and occupy a different position in the eye causing less change to your vision and….no need for an operation!
Jack ThomasPosted at 01:16h, 05 May
About 4 weeks ago I experienced a PVS in my left eye causing a tremendous amount of floaters and little dots in my field of view along with flashing in the left side of the eye as I moved my eyes left to right. My Opthalmologist found 3 vitreol hemmoraiges but no tears in the retina. He also determined I had developed a Posterior Subcapsular Cataract in the eye. Today I was re-examined and so far I have not developed any retinal tears. The floaters continue to be a major distraction especially with development of the cataract. At least the dots have faded which he said were from blood cells that were released during the PVS. Like yourself my eye doctor performs many vitrectomies a month (over 30) and about 3 per month for floater removal. He recommends cataract surgery first and then a vitrectomy for the floaters. Is this the sequence you would follow or do you think it matters which surgery is performed first?
Randall V. Wong, M.D.Posted at 15:20h, 13 May
I don’t think it really matter which is first. There are subtle differences in performing cataract surgery if a vitrectomy has been performed. Make sure the person doing the cataract surgery is used to performing surgery on retinal patients.
OVerall, not a big deal.
StawfPosted at 01:05h, 11 May
I am 38 and I had a vitrial detachment 4 years ago te floaters have not gone away but now I am told that I am also developing Cataracs. Do you recommend if I do the Cataracs surgery that I do a vitrectomy at the same time is that even possible?
Randall V. Wong, M.D.Posted at 20:52h, 13 May
I’d go with cataract surgery first, then vitrectomy, but only if the cataracts need to be removed now.
Otherwise, you can get the floaters removed with anticipation of cataract surgery.
Fagner KisnerPosted at 13:08h, 30 May
Hello Doctor, excuse my bad English, I am Brazilian, I have a lot of floaters in the right eye, I’m 30 years old, my eyesight is 100% and no disease in the retina, a vitrectomy was safe to do? what percentage to give a problem?
Randall V. Wong, M.D.Posted at 14:35h, 04 June
Yes, in my opinion, vitrectomy for floaters is as safe, or safer, than cataract surgery. The chance of a retinal detachment from a retinal tear is probably the same…around 1%. The chance of blinding infection following vitrectomy is less than cataract surgery.
DavePosted at 21:05h, 02 June
Thank you for being so accessible. I have a couple questions. I’m 26 with mild floaters (perhaps acceptable, but irritating).
Is this procedure less risky depending on your age and overall health?
I get the impression that the younger the patient, the more difficult it is for a doctor to see the floaters, is this true?
My understanding is that after the procedure, there should be very little to no new floaters forming, is that correct? Does it depend on how much vitreous fluid was left with the saline solution?
Again, thank you for your time.
Randall V. Wong, M.D.Posted at 15:15h, 04 June
1. Risk of retinal detachment or blinding infection, both uncommon, is not age related.
2. I personally don’t try and see “your” floaters. I don’t know why so many doctors try and “prove” this to themselves. I (as your doctor) can see your entire vitreous. Normally, you can’t see your own vitreous. Most of the time, it is unlikely I could see the very same opacities/floaters that bother you. Also, floaters/spots/dots/cobwebs moving to and fro with eye movement can ONLY be in the vitreous.
3. I don’t think floaters can return after vitrectomy as most of the vitreous is removed. The initial problem is related to light changes in the vitreous gel itself….if the gel were removed…
PatrickPosted at 12:14h, 14 June
what does it mean: “The initial problem is related to light changes in the vitreous gel itself….if the gel were removed…” After the surgery, floater-sufferers see little dots forever because of the saline solution? In younger sufferers – the doctors do not remove the vitreous in front of the lens – can such patients be floater free after the ppv?
I had three vitrectomies on the right eye – and I see three fine black dots and a lot of cells like filamentous … It is frustrating…
Randall V. Wong, M.D.Posted at 10:07h, 18 June
Indeed, I think young/old patients can be floater free after vitrectomy. My statement was to mean that the initial problem in most cases is that the floater problem develops from changes in the proteins which refract light differently (gel goes from being optically clear to having spots/haze/floaters).
Also, inflammation of the retina/eye can cause floaters and can be recurrent. Is this a possibility?
PatrickPosted at 18:03h, 18 June
the surgeons I have say nothing about inflammation in my eye. The saw floaters in front of my natural lens and the doc think part of vitreous stays on the surface of the retina. This case here http://www.ncbi.nlm.nih.gov/pubmed/19320311 looks similar to my case – what do you think about it? And what would be the therapy by inflammation? Could another vitrectomy help me?
The cutter cuts the vitreous and later – little filamentous swim in the saline solution?
And what is your experience in distorted and wavy vision after ppv? How often does that happen?
Thanks for your help here!!!!!!!
Randall V. Wong, M.D.Posted at 09:23h, 26 June
It’s really impossible for me to say why you have residual floaters. Even the linked article is vague and the authors make a supposition about something they admittedly can’t “document.”
Is the distortion and waviness constant or just with eye movements?
matsumotoPosted at 08:53h, 23 June
I am 21 years old which cannot speak English.
Since translation software is used, a sentence may be amusing, but please allow.
Although vitreous surgery is considered, supposing it reserves, how long must it wait now?
Moreover, how much is a charge?
I am glad if you answer.
Randall V. Wong, M.D.Posted at 13:31h, 26 June
Vitreous surgery to remove floaters can be done. There is no definite time to wait.
If you are interested in charges, please email us with your insurance information. It is likely covered.
Nick CotsarelisPosted at 15:34h, 23 June
Dear Dr. Wong, my understanding of laser treatment of floaters is that the laser vaporizes the floater. You stated that a laser is used to reposition the vitreous? Please explain how vaporizing a floater that is located at a “safe” distance away from the retina can cause retinal tears? Also, you explain how you remove the vitreous but nowhere to you discuss what you replace it with- is it saline?
Randall V. Wong, M.D.Posted at 13:37h, 26 June
Vaporizing is not true. The strands of the vitreous are cut using a Nd:YAG laser and thus the floater is either broken up into smaller ones or the “glob” is moved to another position in the vitreous cavity.
Think of the vitreous as one homogeneous tissue. When the posterior portion of the vitreous separates from the retina, we call this a PVD (posterior vitreous detachment).
The anterior vitreous is always adherent to the retina. If you are physically manipulating the vitreous with strong pulses of energy…the vitreous may shift and tug on the retina causing tears.
This is why tears are always found in the peripheral, or more anterior, retina.
Saline is used to replace the vitreous. Your eye will then replace the artificial saline within a day or two.
RandPosted at 21:36h, 25 June
I had floaters in both eyes and had them removed at the hospital through a procedure where a needle went through my eye and sucked all the fluid from the back of my eye. This removed all my floaters. Saline solution replaced the natural eye fluid.
The procedure on my left eye was a complete success but I had vision loss in my right eye. My vision pre-op was -1.00 and is currently -3.00. The doctor told me cataracts are inevitable in 6 months to 2 years after the procedure. I now have a mild cataract in my left eye which was done 9 months ago. My right eye was done 3 months ago and developed a serious cataract in just 3 weeks post-op. At the end of July I will have surgery to remove that cataract from the right eye. I hoping this will help restore my vision.
My cataract surgeon told me I cannot have a corrective lens implanted since I had Lasik in 1998 so I will have a clear normals lens in my eye and still need glasses or contacts. I’m not sure of the technical name for my procedure. Maybe I am wrong but it sounds different than vitrectomy or what you are doing Dr Wong. I’m happy with the results of my left eye which had a seriously high amount of floaters, the right eye which had fewer floaters is a different story so I wish I would have not done the procedure on that eye.
Randall V. Wong, M.D.Posted at 07:47h, 27 June
Perhaps the cataract was present before the surgery for floaters?
Best of luck with the upcoming cataract surgery.
TedPosted at 22:14h, 18 July
Finally after stating my wishes to fly out from Miami, Florida to see you, I have setup appointment(s) to see you late September. Look forward to meeting you. I have enjoyed reading your comments and your detailed explanations about floater surgery during the last 6 months.
matsumotoPosted at 03:25h, 19 July
It is matsumoto connected on June 23.
Thank you for giving a reply.
Is e-mail good if it sends where?
I had the state of eyes examined in ophthalmology of Japan.
The result was not PVD but a physiological thing.
In Japan, it was said that a crystalline lens had to be used as an artificial lens.
I want a teacher wonderful by all means to have a look.
Thank you for your consideration.
DuyPosted at 04:17h, 08 August
Hey I want to remove eye floater. I’m deaf and 19 year old.
Randall V. Wong, M.D.Posted at 09:47h, 17 August
Would you like us to contact you?
paul petragliaPosted at 14:16h, 24 August
Dear dr wong
I am curious on the procedure to remove floaters,I would like to know the cost these things are ruining my life.
Randall V. Wong, M.D.Posted at 08:10h, 28 August
I will have Chrissy contact you separately by email.
DenisePosted at 23:38h, 30 August
I have posterior vitreous detachment of my left eye. I have had flashes for 6 mos or more. The Doc said no tears- good sign. Will the flashes ever go away. I am so afraid I will have retinol detachment and wake up blind one day.
Randall V. Wong, M.D.Posted at 09:02h, 03 September
Sometimes the flashes persist. You were at greatest risk for a tear during the first six weeks of the PVD. Even if you were to detach, you most likely wouldn’t wake up blind.
PaulPosted at 15:53h, 04 September
Im sure you’re busy its understandable,I sent a message about a week ago you said you would have chrissy contact me I havent heard anything yet. I just want to make sure im going to get the information about the costs of the proceedure so I know what the next step I should take. Looking foward to hearing from you.
Randall V. Wong, M.D.Posted at 10:46h, 06 September
I believe she contacted you again.
paulPosted at 09:46h, 13 September
I recently went to an opthamolagist to see what he could do about my floaters,He is one of the few doctors that uses a yag laser, his office is was local so i figured I would atleast get a consultation. he used a couple of lenses on me to see if he could find the floaters, unfortunately he could not seem to find them, none the less i am still in the same situation stuck with these floaters,its becoming tiresome and i am looking for relief. I would like your opinion on this subject, they do really bother me do you recomend getting the vitrectomy? and how effective is it?it would be a miracle to finaly get rid of these things.
momanPosted at 08:52h, 17 September
Just wondering why my post from 9/15 was removed without response? Thanks
Randall V. Wong, M.D.Posted at 21:07h, 25 September
You find it yet?
TedPosted at 13:10h, 03 October
I had the surgery on Friday and other than my eye remaining dialated still everything is great. floaters are gone from right eye… will be back to get left eye done soon. I made a good decision… thanks and talk to you soon Dr Wong… next time we are there… maybe you will be interested in eating out for Thai food with my wife and I. 🙂 Ted
PaulPosted at 08:29h, 10 October
Dr wong you had chrissy send me some info a few weeks ago,unfortunately I cant seem to find the information. I would like to set up an appointment to meet with you can you have her contact me as soon as you have the time. thankyou
Randall V. Wong, M.D.Posted at 19:49h, 14 October
I believe we have sent you emails.
PaulPosted at 11:01h, 10 October
I made an appointment to come and see you,looking foward to meeting you late nov
Randall V. Wong, M.D.Posted at 19:50h, 14 October
I look forward to meeting you!
paulPosted at 09:41h, 12 October
Just curious to how many people on here have had the surgery? How did eyerything go post op? How is your vision now and whats your age?
Tiago ComérioPosted at 19:44h, 22 October
Hello My name is James, I’m Brazilian 24 years have floaters about 10 years but a few months they’ve become a real big problem. My eyesight is the best possible. Despite the large amount of floaters have only a small detachment of the vitreous, because the current situation I am totally willing to go pro one victretomy. Doctor wondered if something could consider surgery relatively safe? You perform this surgery a long time? We could arrange a phone conversation to come to perform surgery on you? If yes which could be through phone? Apologies for my poor english. Thank You.
Randall V. Wong, M.D.Posted at 07:30h, 24 October
Thank you for your consideration.
I have been in practice for 20 years and vitrectomy is the principle operation of a retinal specialist. I have performed thousands of vitrectomies. The procedure is safe and complications are very few.
I look forward to helping you and meeting you.
While it is not possible for me to speak with you, please feel free to email.
ehsanPosted at 13:35h, 25 October
Hi Dr Wong,
I was wondering if you induce PVD during the FOV? I am 31 years old and developed tons of floaters in my right eye in april 2012.
Do you think a PVD is necessary for the microscopic, close to the retina floaters?
I need to get a referral to see you but do you know anybody in Boston doing the procedure?
Randall V. Wong, M.D.Posted at 12:41h, 30 October
I usually do NOT induce a PVD during an FOV. I believe it’s unnecessary as it can tear the retina leading to a retinal detachment. Also, a vitrectomy without PVD is likely to prevent or prolong a PVD from occurring in the future (as you age). Remember, too, that a PVD does NOT guarantee new floaters. This is a huge incorrect assumption in the FOV world.
Most patients with a PVD are unaware they’ve developed one.
Tiago ComérioPosted at 12:07h, 26 October
Thank you doctor. I sent you an email.
Randall V. Wong, M.D.Posted at 12:06h, 30 October
Received and replied!
Hope to meet you soon.
Jan BrazellPosted at 17:07h, 27 October
I just wanted to say that I recently had a vitrectomy on my left eye, about two months after having my right eye done. I had really bad floaters. I had floaters since I was in my 30’s and now in my middle 60’s. The floaters got worse in the past year. I have already had cataract surgery and Restor lenses in both eyes, so I shouldn’t have to worry about vitrectomy causing cataracts. Anyway, just wanted to say I am happy with the results and it wasn’t a complicated surgery & didn’t hurt. My ophthalmologist recommended my retina surgeon, so I felt confident because of that. I just wrote this to encourage those who are nervous about having it done. I had heard scary stories online before having mine done, but felt it was worth the risk. They were affecting my eyesight. I love not having floaters after more than 30 years of having them. There aren’t many surgeons here in Fort Worth, Texas who will do floater surgery. I’m thankful I found one.
Randall V. Wong, M.D.Posted at 12:14h, 30 October
Lucky you! Thanks for sharing and for your support.
Louie BrooksPosted at 18:53h, 03 November
Dr. I had a PVD Oct. 1 resulting in two retianl tears and laser photocoagulation, cryotherapy and gas bubble. There is a large floater of coagulated blood and collagen (I think that is what the material is) along with other debris and blood. It is not changing. How long should I wait before asking for a vitrectomy or even more important is there a waiting period? Thanks.
Randall V. Wong, M.D.Posted at 12:18h, 11 November
Blood, from whatever the cause, sometimes goes away and sometimes not. I usually recommend waiting a few weeks or more before offering a vitrectomy. For cases where I can NOT examine the retina, I’ll operate much quicker.
Just giving the range in which I practice. Your doc may be different.
JochemPosted at 07:41h, 05 November
Hello Dr Wong,
I’m based in Europe and over here the retinal surgeons that perform FOV always induce PVD to remove the premacular bursa. I guess it’s a European preference! Anyway, as Im stuck wit this method probably, I was wondering: Does it matter a lot when PVD is induced at the age of 25 or 35 for example? I know it is easier on later age but I have no idea about significant differences.
Best regards from the Netherlands
Randall V. Wong, M.D.Posted at 12:24h, 11 November
My reasoning is that inducing a PVD can cause tears. Tears can lead to retinal detachment. Tears are more likely at a younger age (there’s been less degeneration and the adhesion between the vitreous and retinal surface is stronger).
Inducing a PVD is also NOT necessary for clearing all the floaters from your vision…this is a huge misconception.
PaulPosted at 11:48h, 04 December
Had surgery on my left eye to remove my absolutely untolerable floaters,vision is crystal clear. I want to thank dr wong for helping me when so many doctors turned me away, as soon as I am able to get the money I will get my other eye done.I would also like to thank the staff,they are some of the nicest people ive ever met.
Randall V. Wong, M.D.Posted at 06:13h, 07 December
Thank you very much for your kind remarks and for your willing to share on this site!
Best of luck.
LeighPosted at 01:52h, 12 January
I have suffered from numerous floaters in both eyes for about a year now. I am 98% sure that I want to get a FOV in at least one of my eyes. I’m still trying to find the right doc. to do the job, which is a hard task considering how few doctors there are who preform this type of surgery.
I went to a retinal specialist today for a checkup. She said that my vitreous looked crystal clear. This makes me worry that I won’t be able to find a doc. willing to preform a FOV on me because my floaters are not visible upon examination. Do you think this will be a problem?
I’m also having a hard time deciding if I should have PVD induced or not. I am 21 and don’t have any signs of PVD already occurring, which would make inducing PVD harder. Another doctor that I communicated with via email told me that a FOV without PVD is useless because the floaters are likely to reoccur. I’d like to avoid having to get an eye re-operated on.
I have another question which you may or may not be able to answer. About the same time my floaters developed I noticed large starbursts and halos around lights. They make driving a nightmare! No doctor that I’ve seen so far has been able to determine the cause of the starbursts. I’m wondering if the floaters could be causing the starbursts that I see because they both occurred at the same time. Have any of the patients that you’ve treated for floaters complained of having starburst symptoms? If so, did they notice any improvement in the symptoms after surgery?
Sorry for the lengthy response!
Randall V. Wong, M.D.Posted at 19:05h, 22 January
Rest assured, I don’t feel the doctor (e.g. me) needs to the see the floaters. It is not important nor necessary to see the floaters if we are considering an FOV.
I think the doctor who said that vitrectomy without PVD is useless…probably doesn’t want to operate in the first place. There are several reasons why I feel this way: 1) Most people who have a PVD don’t notice them, that is, they don’t have floaters 2) no telling when you’ll have a PVD after the vitrectomy…could be 10-20 years, but without floaters! and 3) with most of the vitreous removed, I believe a PVD will either occur much later in life or not at all.
Can’t comment on starbursts and halos. May/may not be related. I’d have to examine you.
Bill MorrisPosted at 12:30h, 12 January
Hello, I have had floaters for many years now. I have seen a gradual increase over the years.
I have been told that one will get used to them. Well let me tell you yes, maybe in a cases of mild floaters, however when they are severe one doesn’t get used to them.
Another misconception is that floaters will disappear or reposition themselves by moving your eyes, this is complete nonsense !!! Many floaters aren’t simply floating loose in ones eye, many are actually attached strands which will move slightly and swirl but will always return to a given location. In my case that location is dead center in my visual filed of view !!!!
Randall V. Wong, M.D.Posted at 19:06h, 22 January
You are not alone; floaters can be bothersome and don’t usually disappear.
Best of luck!
KantonaPosted at 10:46h, 15 January
Hy dear doctor im from Austria, i know to i bad speaking english, im sorry for that. I will in summer visit USA, and i will visit you. Could you tell me how cost Floaters only vitrectomy and How mouch time FOV surgery.
Randall V. Wong, M.D.Posted at 19:19h, 22 January
I’ll have Chrissy contact you regarding the scheduling and cost of surgery for our international patients.
edPosted at 13:10h, 27 February
can you do fov if i have nystagmus.
Randall V. Wong, M.D.Posted at 12:37h, 02 March
Yes. See previous comment (Eye will be motionless due to anesthesia/retrobulbar block). No problem.
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
RanqPosted at 10:32h, 02 March
Could you email me the scheduling cost of surgery for international patients also? Thank you.
Randall V. Wong, M.D.Posted at 12:49h, 02 March
Yes. I’ll have Chrissy send you a separate email.
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
JimPosted at 17:28h, 05 March
If a vitrectomy is done for floater removal, will a cataract develop?
Randall V. Wong, M.D.Posted at 12:03h, 23 March
Not necessarily. If a cataract is present at the time of surgery, it MAY develop faster.
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
Nichelle HaynesPosted at 21:37h, 22 March
Hello, Dr. Wong
I have alot of floaters especially in my right eye. I live near Columbus, GA. I don’t have any eye doctors that can perform laser surgery for floaters. I wish that I lived near VA so that you could perform them. Do you know of any eye doctors that can do vitrectomies and laser for eye floaters? Cost etc. Thank you.
Randall V. Wong, M.D.Posted at 07:49h, 24 March
No, I know very few and none in Georgia.
I’ll have Chrissy email you separately.
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
peter tudorPosted at 21:57h, 23 March
hi..ive suffered with parsplanitis for 13yrs..
I have many floaters which are driving me crazy..they actualy cause panic attacks..
I was told id get used to them..so why is it every day and moment they are there??.
yes it affects your quality of life .
at times im swatting out as its like a cloud of insects attacking me..
can anything be done ??.
the specialist whom I see says hes never heard of lazer to remove them.
can someone help me please???pete
Randall V. Wong, M.D.Posted at 07:52h, 24 March
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!
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
peter tudorPosted at 22:05h, 23 March
ive also had cme in both eyes one to which was lazered to prevent it keep leaking..
ive now developed what im told is a scar on my retina which has rippled causing distortion..
I tend to read using one eye..
surgery is available but im forever being fobbed off..
any adice please??pete
Randall V. Wong, M.D.Posted at 07:53h, 24 March
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.
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
BenmPosted at 20:59h, 29 April
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.
Randall V. Wong, M.D.Posted at 16:19h, 11 May
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.
Randall V. Wong, M.D.
HollyPosted at 21:47h, 30 April
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?
Randall V. Wong, M.D.Posted at 16:30h, 11 May
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!!!
Randall V. Wong, M.D.
cheryl sandyPosted at 13:21h, 30 May
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.
Randall V. Wong, M.D.Posted at 14:38h, 07 June
Tough situation. What is the status of the other eye? Slightly nearsighed? Cataract?
Is your doctor willing to consider exchanging the IOL?
cherylPosted at 15:42h, 08 June
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.
Randall V. Wong, M.D.Posted at 10:38h, 12 June
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.
BrianPosted at 21:58h, 10 June
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.
Randall V. Wong, M.D.Posted at 10:00h, 12 June
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.
HannahPosted at 17:52h, 21 June
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
Randall V. Wong, M.D.Posted at 16:34h, 22 June
An eye exam should be quite helpful for you.
Randall V. Wong, M.D.
JackPosted at 13:36h, 27 June
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.
Randall V. Wong, M.D.Posted at 17:02h, 14 July
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.
Randall V. Wong, M.D.
Fairfax, Virginia 22031
PaulPosted at 10:36h, 30 June
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,
Randall V. Wong, M.D.Posted at 14:04h, 02 July
TedPosted at 11:51h, 15 July
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.
Randall V. Wong, M.D.Posted at 19:14h, 27 July
I’m glad your vision has improved in both eyes.
Your concerns prompted me to write a post on subconjunctival hemorrhage!
Congrats to you!
Randall V. Wong, M.D.
Fairfax, Virginia 22031
Del DuncanPosted at 00:34h, 23 July
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.
Randall V. Wong, M.D.Posted at 19:33h, 27 July
You can absolutely have vitrectomy following cataract surgery. No problems at all. Don’t understand about not worrying about a small tear.
Randall V. Wong, M.D.
Fairfax, Virginia 22031
yannickPosted at 17:48h, 02 October
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,
Randall V. Wong, M.D.Posted at 10:05h, 06 October
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!
Randall V. Wong, M.D.
Fairfax, VA 22030
@bossangusPosted at 11:19h, 24 November
Do you laser the floaters?
Randall V. Wong, M.D.Posted at 06:25h, 26 November
No, floaters are removed along with the vitreous. YAG laser is not a viable option.
TerryPosted at 14:51h, 30 November
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 !!
Randall V. Wong, M.D.Posted at 01:34h, 01 December
Look forward to meeting you and, yes, Chrissy is exceptional!
Randall V. Wong, M.D.
Fairfax, VA 22030
shahzadahPosted at 03:18h, 02 December
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
Randall V. Wong, M.D.Posted at 14:19h, 23 December
I’ll have Chrissy or Andrea contact you re: scheduling and costs.
Thanks and Happy Holidays!
Randall V. Wong, M.D.
Fairfax, VA 22030
shahzadahPosted at 03:51h, 02 December
with young patients like me iam 28 is the surgery possible or you dont offer the FOV for young patients ?
Randall V. Wong, M.D.Posted at 14:23h, 23 December
Surgery is absolutely possible!
Thanks and Happy Holidays!
Randall V. Wong, M.D.
Fairfax, VA 22030
magedPosted at 13:35h, 19 March
Dr, is laser cerclage before vitrectomy can help avoiding retina detachment .
Randall V. Wong, M.D.Posted at 10:40h, 01 April
The short answer is yes, but it is not usual.
Randall V. Wong, M.D.
Fairfax, VA. 22030
JasonPosted at 19:52h, 28 March
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
Randall V. Wong, M.D.Posted at 07:05h, 02 April
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.
Randall Wong, M.D.
Fairfax, Virginia 22030
magedPosted at 11:13h, 01 April
Dear Dr, is retina break always associated with vitrectomy?
is it better to do laser for retina prior to vitrectomy.
Randall V. Wong, M.D.Posted at 07:01h, 02 April
Retinal breaks are NOT always associated with vitrectomy. They usually don’t occur, but can.
Ben LovejoyPosted at 18:42h, 05 June
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.
Randall V. Wong, M.D.Posted at 13:53h, 10 June
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.
RonPosted at 19:20h, 08 July
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.
Randall V. Wong, M.D.Posted at 14:57h, 12 July
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.
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