This was the presentation used during my webinar on Floaters: Evaluation and Treatment given in the winter of 2013. Floaters are anything that moves "to and fro" in your vision with eye movement. While they can decrease vision, proper treatment and evaluation is elusive. Vitrectomy surgery, or FOV, is the only way to safely remove any floaters from the eye. Vitrectomy (floater only vitrectomy/FOV) is as safe or safer than cataract surgery.

1. Floaters:
Evaluation and Treatment
Randall V. Wong, M.D.
Retinal Specialist
Fairfax, Virginia
www.RetinaEyeDoctor.com

2. Webinar
 The following was presented during my webinar on “Floaters: Evaluation
and Management”
 Questions:
 RWong@RetinaEyeDoctor.com
www.RetinaEyeDoctor.com
 This presentation is for informational purposes only. You are not my patient
and I am not your doctor. This presentation does not represent medical
advice. Consult your own doctor.
RetinaEyeDoctor.com - Randall Wong, M.D.

3. Agenda
 Define Floaters
 Discuss Causes
 Persistent or Chronic Floaters
 Decrease vision
 Treatment options
 Risks of FOV
 Q&A
RetinaEyeDoctor.com - Randall Wong, M.D.

4. What Are Floaters?
 Anything in your vision that moves “to and fro” with eye movement
 No specific morphology
 Color
 Size
 Shape
RetinaEyeDoctor.com - Randall Wong, M.D.

5. RetinaEyeDoctor.com - Randall Wong, M.D.

6. Causes of Floaters
 PVD
 Vitreous opacification
 Optical Properties of Vitreous Change
 Inflammation (aka Uveitis)
 Retinal Tear
 Diabetes
 Others
RetinaEyeDoctor.com - Randall Wong, M.D.

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9. New Floaters
 Must get examination
 Rule out retinal tear, vitreous hemorrhage from retinal disease
 ….ensure that there is no disease that can be treated to prevent permanent
vision loss
RetinaEyeDoctor.com - Randall Wong, M.D.

10. Chronic Floaters
 Persistent and don’t go away
 Decrease vision
 Cause glare
RetinaEyeDoctor.com - Randall Wong, M.D.

11. Cataracts
 Progressive decrease in vision
 Cause Glare
 Can’t see as well as you would like
RetinaEyeDoctor.com - Randall Wong, M.D.

12. Treatment of Floaters
 Observation (aka do nothing)
 Laser
 Vitrectomy (aka FOV)
RetinaEyeDoctor.com - Randall Wong, M.D.

13. Observation
 You may or may not adapt
 Adapt:
 Great, nothing else to do
 Don’t Adapt:
 Frustrated
 Laser
 Vitrectomy (FOV)
RetinaEyeDoctor.com - Randall Wong, M.D.

14. Nd:Yag Laser
 Popular Treatment Option
 Offered by a very few specialists
 Can NOT Treat All Floaters
 Treat only certain floaters
 Risks are Unknown
 Not Offered by Retina Specialists
RetinaEyeDoctor.com - Randall Wong, M.D.

15. Vitrectomy
aka: FOV
 FOV = Vitrectomy
 Removes the vitreous
 Does not require visualization
 Effective in almost all cases
 Risks are known
 Safer or as safe as cataract surgery
 Only performed by retina specialists
RetinaEyeDoctor.com - Randall Wong, M.D.

16. RetinaEyeDoctor.com - Randall Wong, M.D.

17. Risks of Vitrectomy (FOV)
 Blindness from infection is less than that of cataract surgery
 Chances of causing a retinal tear and leading to a retinal detachment is
about 1-2%.....same as for cataract surgery
RetinaEyeDoctor.com - Randall Wong, M.D.

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19. FOV
 FOV is a core vitrectomy
 Nothing technically different, in fact, technically the easiest
RetinaEyeDoctor.com - Randall Wong, M.D.

20. Induce a PVD?
 I do not for FOV
 No need
 Risk of retinal tear
 PVD does not usually cause floaters
 PVD may NOT occur for 10-30 years
RetinaEyeDoctor.com - Randall Wong, M.D.

21. Ocriplasmin
 Not sure it will help floaters
 Injection
 Infection?
 Vitrectomy may be more definitive
RetinaEyeDoctor.com - Randall Wong, M.D.

22. Pre-Macular Bursa
 Concern if using the laser
 Not an issue with Vitrectomy
RetinaEyeDoctor.com - Randall Wong, M.D.

23. Questions/Answers:
 Thank you!
 RWong@RetinaEyeDoctor.com
 ChrissyMegargee@GMAIL.com
 Email: Contact Information
RetinaEyeDoctor.com - Randall Wong, M.D.