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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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We chatted a couple weeks ago. Since then the cataract diagnosis

Customer Question

We chatted a couple weeks ago. Since then the cataract diagnosis was confirmed and I was scheduled for surgery. However since then I have suddenly developed multiple floaters which seem to be more each day. My doctor cancelled the surgery at last minute when I told her about the sudden onset of floaters because she wanted to do thorough exam (rule out retina detachment). Next day she did exam and said looked good, no retina issue and rescheduled surgery. That was 4-5 days ago. Question I have is, why would the floaters continue to increase? Why suddenly now? Concerned because the floaters are new and increasing in number and size. Seeking advice....
Submitted: 2 years ago.
Category: Eye
Customer: replied 2 years ago.
Relist: Other.
Didn't get a reply
Expert:  Dr. Rick replied 2 years ago.
Hi. I'm online and happy to answer your question today.
Expert:  Dr. Rick replied 2 years ago.
Hi. I reviewed the conversation you had with Dr. Susan on this site the other day and I agree with everything the two of you discussed.

What you are now experiencing, and it is totally unrelated to your PSC cataract, is called a vitreous detachment. I am a retina specialist and deal with this condition all the time. Here is some information on this:


You are likely experiencing a PVD or posterior vitreous detachment, a common event that happens in many people.

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.

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.

Your floaters are increasing, most likely, because your vitreous is still in the process of detaching from your retina. Also, since they are "new to you" and you are concerned about them, your brain may just be paying more attention to them....

Since your surgeon has examined your retina and found everything to be OK I agree -- it should be safe to proceed with your cataract surgery at this time. Is there a slightly higher risk of tearing a hole in your retina during the any pressure changes that may occur during surgery, or should your posterior capsule tear? Yes. But I would not think this slight additional risk, in light of a recent dilated exam showing an intact retina, is large enough to warrant canceling cataract surgery.

I think you will be fine and pleasantly surprised with your clear vision after your PSC cataract is gone :-)

Does this make sense to you?


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Let me know if there is anything else you would like to discuss pertaining to this issue.
Customer: replied 2 years ago.

This is the perplexing part for me .....what are the chances the at the very same time....I have a cataract quickly/suddenly develop...AND then at the very same time....now I have a Vitreous detachment?? Doesn't that seem odd to be at the same time??

 

Also, again let me mention...there was no trauma....

 

About the Vitreous detachment....you say it seems my eye is the process of going through this.....is it normal that the floaters started w/ just 1 big one (about 2wks ago), and daily....more and more things in my field of vision...floaters of various size and shape along with a haze kind of tan in color (from my perception) that moves along with the floaters.

 

Expert:  Dr. Rick replied 2 years ago.
Things happen at the same time but that doesn't mean that they are causally related. I promise you.....there is no relationship between the two, especially given you negative (no trauma, steroid use, etc) history.

Yes. Vitreous detachments present in many, many ways. In almost 20 years of practicing as a retina surgeon I've seen PVDs present just like yours.

There is no need for you to worry.

Good luck on your surgery and let me know if there is anything else I can do for you. It sounds like you are under the care of an excellent eye surgeon who makes sure everything is OK before just moving ahead with cataract removal. I think you can trust her :)
Expert:  Dr. Rick replied 2 years ago.
I see that you have reviewed my posts. Is there anything else you would like to ask me or anything you would like clarified? If not....

I hope that this information was helpful for you. Please, allow me get credit for my time and effort in assisting you and please give me positive feedback for this assist. I will be glad to answer additional questions until you are satisfied. Thank you very much.
Customer: replied 2 years ago.

What is the common course of a PVD? Meaning....what to expect...ever increasing things/floaters in my vision...all over the course of only about 2wks (in fact, the floaters were not present until after Cataract was diagnosed, but prior to the original surgery date which was cancelled). I was reading online that during the vitreous detachment its possible this can cause Retinal tear/detachment......and w/ the volume of things I'm now seeing, can that increase that risk? Besides dots, I see other shapes, curly hair shape, etc.

 

And, do the floaters from this PVD go away or subside? 2wks ago there were NONE and now there are tons...and compounding daily. And you say not related to Cataract, so I have these floaters to look forward to...w/ clear vision after surgery?

 

And when I said no trauma....I think i was told this couldn't be a cause, but a couple months ago I got smoke in my eyes and really rubbed my eyes extremely hard for a prolonged period of time....to me that's what did it.

 

What starts a Vitreous detachment? Sorry for all the questions, I just hate being uninformed....thank u

Expert:  Dr. Rick replied 2 years ago.
Remember: You just had a complete, dilated, retinal exam by an experienced ophthalmologist and your retina was found to be perfectly OK. Can the things you read about on the internet still happen to you?
Could you get a retinal tear? Could that tear progress into a retinal detachment? Of course. That is what I fix all the time. What is the risk of this happening to you right now? I would say on the order of 1 to 2%, perhaps even less given your recent exam.

The shape, size, movement etc of the floaters has no relationship to retinal risk. If you floaters were from blood due to a tear your eye surgeon would have easily seen that on exam.....

I discussed above about the future of floaters. I'll re-post it here for you:


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.

rubbing your eyes, no matter how firmly after getting smoke in them, didn't harm your eyes at all or lead to your PVD

No problem. I can understand your desire to be well informed,especially when facing surgery. But. Right now, you have enough information and, after you give me positive feedback and accept my answer, you should unplug your computer until after your successful surgery -- The internet can be a very scary place ;) lol!

Does this sound like good plan to you?
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7906
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 2 years ago.

thank you.......OK I get it.

 

BUT....one last question, one thing about what I see that bothers me is the haze I see too along w/ the floaters. To best describe it, its like an asteriod field in space...and all w/ a haze, to me Tan in color.......what could that be? Again, that's new too. Its a different haze than the film I was seeing from cataract.

 

thank u again for your input.

Yes answer accepted w/ positive feedback.

Expert:  Dr. Rick replied 2 years ago.
Could be blood from a retinal tear...and I almost hate to tell you that since I believe you will worry too much :(

It could also just be the floater combined with your PSC cataract. Since you will be dilated for your cataract surgery your doc and do a quick retina exam just to double check that everything is OK.

What is the take home message? I think your retina is OK and you should not worry.

Ok. Now. It is time to post positive feedback for me, turn off your computer and give the power cord to your neighbor with explicit instructions not to return it until your come home from having your cataract removed :-)

All kidding aside, it has been a pleasure helping your tonight and I wish you the very best.
Expert:  Dr. Susan replied 2 years ago.
I am sorry that I could not answer you question sooner. I am out of the country and don't have access to my computer at all times. I am glad that Dr. Rick could help you.

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