Why do I need to see a retina sub-specialist?

Your eye doctor has either determined that there is a condition affecting the retina that needs more extensive diagnostic testing or has determined that there is a condition that requires specialized treatment and/or monitoring.

Will I be changing eye doctors permanently?

No. We are being asked to do an evaluation of (and possibly a necessary treatment for) a condition specific to your retina. Your eye doctor will be sent all test results and treatment plans. You will continue to see him or her for all of your ongoing eye care needs. Once your condition has been treated to completion, your doctor will follow up with you for ongoing care and monitoring.

What if I need surgery?

Many non surgical treatments are available for retinal disorders and can be performed in the Retina Center office. Some problems do require true surgical attention. All surgeries are performed at Saint Francis Hospital in Charleston, South Carolina in the outpatient surgical unit. Recent technical advances allow for procedures to be done without overnight hospital stays; local anesthesia with gentle IV sedation is the current standard, and over 95% of surgical procedures are completed in less than 60 minutes using a “no incision/no stitch” method which minimizes postoperative discomfort and shortens healing time.

I have had “floaters” for years but they only bother me on occasion. Should I consider having a procedure to remove them?

Most likely the answer is no.  While surgery is very safe and effective in virtually all cases, surgical removal of floaters that are only occasionally noticeable are best left alone.  No surgical procedure is 100% risk-free.

I have heard of doctors using laser treatment for floaters. There are several I have found on the internet. How successful is that treatment?

There is little or no scientific evidence that this form of treatment has any lasting beneficial effect whatsoever.

I learned from my eye doctor that vitrectomy almost always creates a premature cataract. My floaters are very bothersome but I don’t want to have cataracts form after the procedure. What should I do?

In all but a very few cases we recommend that patients who have not had previous cataract/implant surgery postpone vitrectomy indefinitely for this very reason.

I am under the care of a retina specialist. Since having cataract surgery, I feel like my floaters are very bad and affect my lifestyle on a daily basis. Why won’t he agree to remove my vitreous?

Even though retinal surgeons have had years of collective experience with this surgical technique, there remains a wide gap of acceptance among practitioners.  No two surgeons are alike in his/her philosophy or confidence when it comes to surgical decision making.  The fact remains, however, that there have been numerous highly respected publications over the years confirming the safety and overall superb outcomes of vitreous removal surgery.  As a result, floater removal – for the right patient- is rapidly becoming a more mainstream and less controversial option.

I’d love to live a life with clear vision. My floaters are a constant source of frustration. If I have them removed will they come back? Also, what is the vitreous replaced with?

The vitreous is not unlike a wisdom tooth or an appendix, in a way.  If it is negatively affecting your life it can be removed.  It actually serves no purpose whatsoever beyond age five.  What goes back in is basically IV fluid- a clear fluid that is slowly infused as the vitreous is removed.  That fluid comes in to balance with the other clear liquid inside the eye.  The floaters never return… just as your appendix doesn’t come back after it is removed.

I used to have floaters that I could identify as specks and spots that would briefly cloud my central vision. Now that I’ve had cataract surgery I mostly feel as though I’m looking through smoke all the time….more like a foggy windshield wiper moving in and out of my vision. Could this be a problem in my vitreous?

Quiet likely, as we age – and especially following cataract surgery- the vitreous will liquefy and become condensed.  This process is known a syneresis.  Examination of the dilated eye by your doctor will determine if this is the problem.  This is the most common combination of symptoms and findings that lead to successful outcomes with vitrectomy. 

I have been told that vitrectomy for floaters is very dangerous. Can surgery cause blindness?

Any surgery has potential risks.  In our practice’s lengthy experience, complications such as infection, retinal  tears and retinal detachment are exceedingly rare.  We have performed over 500 incision-less surgeries for vitreous opacities over a ten year span.  Retinal detachment has occurred in 2 patients, both of whom were extremely nearsighted.  Only one of those two failed to regain full vision after further surgery.  In all, the complication rate associated with the vitrectomy surgery for floaters is very similar to that of cataract surgery.

Does insurance usually cover vitrectomy surgery and will your office file my claims?

Most insurance plans do cover the surgery.  Our surgical team will contact your insurance provider to verify coverage and inform you of any co-insurance or deductible that you would be responsible for.  This will be done prior to your procedure. 

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