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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7906
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I had cataract removal and corrective optical implants inserted

Resolved Question:

I had cataract removal and corrective optical implants inserted almost two years ago. I have very impaired vision in my right eye (like a thick Vaseline smear) due to the clumping of "floaters" right in my line of vision. I cannot read at all with my right eye and have very blurry vision at a distance. No good at all for binoculars ! XXXX Is there any thing or procedure to clear these "floaters" ? My eye doctor and G.P both say no. I had some temporary improvement with Acupuncture ie two or three hours every few days of clear vision after 10 treatments. The clear intervals stopped and i have discontinued acupuncture. What if any, are the options available to cure this condition??
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Rick replied 2 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

You have a thick gel material in the middle of your eyes called the vitreous. Over time as it liquefies, this gel material collapses on itself, forms little clumps that you can see as dots, lines or bugs. As these clumps form the vitreous pulls away from the wall of the eye. In the process it can stimulate the retina -- causing the flashes that you may see.

It is recommended that you see your ophthalmologist to look at the retina to make sure there are no problems such as a retinal hole or tear. In most cases, there are no problems, but this exam is precautionary and allows for preventative treatment of any lesions that are found.

If you notice a sudden increase in floaters, flashes of light (like a lightning storm), or a shadow/veil in the periphery of your vision, this can be worrisome for a retinal detachment. You would need to contact your ophthalmologist promptly in that case.

Dr. Rick :

What can you do about the floaters? Well, floaters don't go away, and they don't really get worse. Over time they tend to "sink" out of your central vision and you brain "filters" them out so you don't notice them so much anymore. They almost never cause significant visual problems except, of course, if they cause a secondary retinal detachment as discussed above. The only way to decrease or remove the floaters is with a major surgery called a vitrectomy. As a retinal specialist for almost 2 decades I've only done this procedure to remove floaters in a handful of cases.





 

Dr. Rick :

It sounds like what you are saying that you would qualify as one of those "handful" of patients in whom the risk of a vitrectomy may be worth it since your vision is so impaired by your floaters.

Dr. Rick :

Cataract surgeons usually do not do the surgery to remove floaters. The best thing for you to do is have a complete evaluation by a retina specialist as that would be the best trained person to help you.

Dr. Rick :

Does this make sense to you?

Customer:

Can you tell me about the risks ? Yes your information is understood. The risks?

Dr. Rick :

The risks are significant as vitrectomy is a "big" surgery when it comes to the eyes. There is the risk of bleeding, infection, retinal detachment, dislocation of your intraocular lens, small risk of problems with double vision post op, need for surgery and, of course, poor result. Is there a risk of lights out blindness in the operative eye? Yes, but it is small......

Dr. Rick :

that should have read "need for further surgery..."

Dr. Rick :

And, in my opinion, this procedure should only be done by a retina specialist....

Customer:

O.K. That is understood. I get that the Retinal Specialist can best estimate the risks in my particular circumstances.

Customer:

Can my Family Doctor, G.P make this kind of referral?

Dr. Rick :

That is correct but, from what you have told me, those are basically the risks of vitrectomy surgery. I do this procedure multiple times a week.

Dr. Rick :

I would think that your GP could refer you to a retina specialist as you eye doc has already evaluated your eye and said nothing could be done. Since a retina specialist has more knowledge on this topic a referral seems appropriate in your case.

Customer:

Risks as you describe them seem almost worse then the very limited vision i have .What % uncomplicated success rate do you have or is generally expected?

Dr. Rick :

In the cases I have done over the years I have never had a complication and the final result was positive. Here in the USA we have to discuss all the horrible possible complications in detail for medical/legal reasons. In experienced hands you should, really, be OK. But remember: Bad things can and do happen and you have to be willing to accept them if they do.

Customer:

Alright. You have been very helpful and I thank you very much. Paul Curtiss

Dr. Rick :

My pleasure. Best of luck to you.

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7906
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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