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About the author : Soon to be Dr. Page Hazen, a fourth year student at SUNY College of Optometry, graduating Class of 2026. She will become an optometrist for the US Navy following graduation.
Acknowledgments: Acknowledgments to Dr. Richard Spaide and Dr. Jerome Sherman, who made some of the initial assessments of the patients floaters and significant contributions to the images available for this patient.
Sources: Webb BF, Webb JR, Schroeder MC, North CS. Prevalence of vitreous floaters in a community sample of smartphone users. Int J Ophthalmol. 2013;6(3):402–405.Stuart A. To treat—or not to treat—vitreous floaters. EyeNet Magazine. 2018 Mar 1. Available at: https://www.aao.org/eyenet/article/to-treat-or-not-to-treat-vitreous-floaters.Ryan EH. Vitreous opacities: Current trends and treatment strategies. Retina Today. 2021 Jan
Conclusion: Given this patient’s longstanding history of visually significant vitreous opacities, which have become more pronounced with the multifocal IOL in the left eye, a pars plana vitrectomy may be beneficial. Notably, the patient has previously experienced a PVD, which may reduce the risk of intraoperative vitreoretinal traction and subsequent retinal
These images are taken from the previous video to highlight the impact of the vitreous opacities movement on the patient’s quality of vision. These still images were captured within seconds of each other.
Video of vitreous opacities OS that persist years after YAG vitreolysis was performed. Demonstrates the effect of the patient’s eye movements on the location of the floaters as well as the impact of these floaters on the patient’s vision.
Back to the patient: This patient was referred for YAG laser vitreolysis in 2007. Dr. Scott Geller, a board-certified ophthalmologist recognized internationally for his expertise in treating vitreous opacities, completed two 1-hour long sessions of vitreolysis OS.The patient was recommended to come back for a third session, but she did
Pars Plana Vitrectomy:2,3,5,6 PPV is a surgical procedure that removes the vitreous gel to eliminate or reduce the effect of vitreous opacities on visual function. Advancements in the procedure have made this procedure faster and decreased the risk profile.Contraindications:InfectionOcular tumorConsideration:Presence of an ERMVitreoretinal surgeons may consider performing an ERM peel with
YAG Laser Vitreolysis:4 This is a minimally invasive laser based procedure to alleviate symptomatic floaters. The technique involves delivering laser pulses to fragment and vaporize vitreous opacities with a goal of reducing their visibility and impact on daily function.Contraindications:Numerous floaters can make this procedure unfavorable due to difficulty effectively treating all
When to consider treatment? 2,3 Patient history: The patient reports a significant reduction in quality of life due to the persistence of floaters, especially affecting daily activities such as reading, driving, and professional tasks.It is essential to differentiate between annoyance and true visual impairment caused by floaters to determine if the
