Retina and Vitreous Center

Patient History and Analysis of Vitrectomy for Correcting Visual Impairment Resulting from Severe Floater Fields

Author: Male patient, age 72, in excellent physical health

Physician: Dr. William Rodden, MD, Ashland, OR

History: In 2005, two problems left me with serious visual difficulties. My left eye became obviously disadvantaged by macular degeneration, and at about the same time there was a dramatic increase in the number and extent of floaters in both of my eyes. I do not mean the small dark spots that are common, but what I call “cloud floaters”—large clumps of translucent matter that move back and forth across the visual field. Without macular degeneration I might have adapted to the floaters, but the combination disturbed me to the point that I became very preoccupied with my vision. By 2008, I often found myself feeling a couple of steps back from reality, as though experiencing the world from behind a veil. This was not conducive to driving and other aspects of daily living. Reading became very difficult, especially without strong light. I decided that I needed to find some help.

If you have looked into the problem of floaters, or discussed the subject with an ophthalmologist, you have likely read or heard that there is no treatment for them. At that point I suppose most people give up and tough it out. However, I spent hours on the Internet, looking under every stone. It became apparent that there are in fact two methods of treatment, each quite different from the other. At least three clinics in the United States use laser technology to deal with floaters. In this process the patient is evaluated, and if their condition is suitable, they undergo a day or two of treatment wherein their floaters are essentially vaporized by the laser in a painless outpatient procedure. From what I can tell from their websites, they may have better luck with smaller, more compact floaters. In one case, success was measured by clearing 80 percent of existing floaters.

The other method is the surgical procedure called a vitrectomy, where the vitreous gel inside the eye is removed and replaced with a clear sterile fluid that the eye, in turn, replaces with a new vitreous within a few days. In the process, every floater is also removed and clarity is immediately restored to the visual field. This operation takes place in a hospital or surgical center on an outpatient basis. The actual procedure takes about an hour, under light general anesthesia, and a regiment of eye drops that protect against infection and promote healing aids recuperation. Usually, the patient can ease into light activities after a couple of days, and follow-up appointments to check healing and vision continue over a period of three to four weeks. I chose to have a vitrectomy in each eye. Because I heal rapidly, I was able to have the second eye done after only two weeks. Thus my recuperative times overlapped, and I was completely finished in about six weeks.

I cannot overemphasize how important this procedure has been to my overall vision and related mental health. My visual field is spotlessly clear, allowing me to deal only with the remaining difficulty of macular degeneration. My ability to read has improved, including the clarity of street and highway signs. Most importantly, I no longer feel disassociated from the world around me, which enables better concentration and focus. In short, the veil is gone, and I am happier and more productive because of it.

Kerry Lay