I have wanted to document and post my story for quite some time. It has been nearly five years since my floaters first appeared and I feel that I need to “pay it forward” for others who are traveling down the path that I once did and are feeling as hopeless and depressed as I also once did.
Some background, I am currently 43 years old, female. I wear contacts for nearsightedness; current Rx is -7.50, both eyes. Myopia started at age 16 and really progressed while in graduate school.
In March of 2012, I was in a bicycling accident; I was 38 at the time. I lost traction on a slick road and the bike caught a storm sewer grate and bounced back against me when I fell. I broke my wrist, had a black eye and required twelve stitches over my left eye. I required a cast on my wrist and I was in a lot of pain for the first couple of days, but the pain medication helped and I went into the office two days later to catch up on emails, etc.
I vividly remember getting out of the car at my office that day and there was a shower of stars in my left eye, they appeared to be raining from the top to the bottom and almost had the same effect as when you are lightheaded and are “seeing stars”. Although unusual and although I had never experienced that before, it was over within a second or two and since my vision was immediately back to normal, I thought nothing of it and went into the office.
A couple hours into the morning, while struggling without being able to write (I broke my right wrist—my dominant hand), I noticed a worm or a spider leg or something visible in my left eye, which moved when I moved my eye. I could make it go away if I looked at it, but then it slowly crept back in from the left field of view—around 10 o’clock if my eye was a clock face. I could see it clearly while looking at my computer screen.
I thought it was something on my contact lens. I wear disposables, so I grabbed my backup set and went to the restroom to change them out. When I got back to my desk and looked at the screen, I was horrified to see it still there. That is when I thought back to the star-shower that I had had earlier when I got out of the car.
I called a client of mine, who is an optometrist, and I told him about what had happened and what I was seeing. He told me that I immediately needed to locate a retinal specialist and have my eyes examined. This was on a Friday afternoon, but I was able to locate a retinal specialist about 15 minutes form my office that was able to see me. When I arrived, he asked me what had happened—clearly, I had a huge black eye from the accident—and what my symptoms were. He dilated my eye and manually checked my eye several different times. He then proceeded to tell me that I had had a PVD, in his opinion, and that that was what had caused my the ‘star shower” event (that was the vitreous pulling away from the retina) and this thin line floater/strand that was in my vision would go away or that my brain would adapt and learn to ignore it as if it were not even there.
I called my client, the optometrist, while on the way home and he said that I was lucky that the retina didn’t have any detachments and that he sees floaters now and then and that I, too, would learn to ignore them. At this point, I didn’t know what to think. I had never seen a floater; I had never heard of them and had no clue what they were.
Over the next several weeks, I waited for my brain to adapt. I waited for it to go away. Nothing changed. If anything, the strands had gotten a bit longer and I was starting to see a spiral type of swirl in my eye when I looked one way and then another. I tried explaining this to my husband. It was the talk of our dinner conversation every evening. My daughter, who was two at the time, loved being outside. I secretly resented being outside with her. When I was outside, I started to make sure that I was seated in a manner that I could somehow make the appearance of the floater less obvious in my eye. I wore sunglasses ALL OF THE TIME when outdoors.
I became introverted and eye floaters were all that I could think about. I googled the subject at least half a dozen times daily. My husband got tired of hearing about it, my business partner got tired of hearing about it, my optometrist friend got tired of hearing about it. It was awful. Nighttime brought relief, but when I put my daughter to bed at night—in her very dark bedroom—I noticed arc-shaped flashes of light when I looked left and right in the periphery of my field of vision. That was evidently strands of the vitreous that were tugging on the retina, still activating the nerves there.
I started researching all I could about eye floaters and I read every Doctor’s explanation on their website and how your brain learns to ignore them. None of that ever happened. I finally, stumbled across this site and, I have to tell you, it was pure joy. Finally, other people who understood—who knew—what I was going through.
I started looking at the Intro posts and reaching out to other sufferers. One of the first people I reached out to was t84fazerowners. He was great. He helped me realize that there is support. I remember browsing YouTube and looking for solutions to floaters and essentially came up with laser and FOV. Honestly, I thought the people in the FOV section of this site were crazy and that I would never go down that route—no matter how bad they got. I never even spent time in the FOV section of the site.
After a couple of months, I went to another retina specialist and I told him that it has been a few months since I first noticed this floater strand, which had become a couple of strands by this time, and he dilated my eye and looked at it and said he couldn’t see anything but that my retina was fine. I asked him about treatment options, specifically what I had seen about laser and FOV. He laughed and said no one would ever do vitrectomy just for floaters and that laser just made more floaters.
After leaving there, I still wasn’t prepared to even think about FOV, but, the laser option, however, interested me because it was non-invasive, required no surgery and, from what I could tell, worked well on large single floaters, like my strand floaters. I was convinced that eliminating this long, dangling strand that moved left and right like a wrecking ball through my field of vision could be possible. I started researching all that I could on laser. I learned how there was a Doctor in California who had a website and I was very excited about what he had been able to do. I read about the Doctor who had written books about floaters and using lasers to get rid of them. I also learned about a Dr. Geller, who, just happened to practicing about three hours from me, in Naples, Florida. I researched his site, watched his YouTube videos, I learned all that I could about laser. I read the bad outcomes, the good outcomes but I was convinced that my floater would be easily treatable.
I made an appointment to see Dr. Geller in mid-June of 2012. I drove down a day early and saw him on a Monday morning. His assistant dilated my eye and I met with him. He said that he could easily see my floater and that it was the perfect candidate for laser. He said that he would do one treatment that day and then I would need to come back the next for a follow up appointment and possible touch-up to get any remaining pieces of the floater.
The laser setup is interesting, if you are not familiar. He takes a glass lens and fills it with a lubricant solution and then has you look into a machine while he holds this lens directly on your eyeball. He explained that he would just begin nipping at this strand piece by piece with laser zaps until he had gotten it all. He asked me to be as still as I could possibly be and he fired one shot of the laser in my eye. I was not prepared for the jolt of energy that reverberated through my eye socket. It was crazy and I sincerely wondered if I had done the right thing. He did a few more shots and said that he thought he had gotten it all. In addition, he recorded the whole session and gave me a DVD presentation of it all. I never have watched it.
I got back to the hotel that afternoon and I was alarmed at all of the little bubbles in the bottom of my eye. I was told that that was normal and that my body would absorb them. The best news of all though, was that my floater was gone! I couldn’t see much, as my eye was dilated, but it was definitely gone, or so I thought.
When I woke up the next morning, once my eye was no longer dilated, I woke up to swirls of stringy mess in the lasered eye. I could also see the “stump” of the floater that he had tried to nip at with the laser. I was depressed and disheartened. I drove back to Dr. Geller’s office and once again, after being dilated, underwent a few more laser shots to clean things up. He said that my experience thus far was normal and that things would improve. I drove home with my mother and daughter and once home I broke down and cried. My vision was worse than the day before when I went to Dr. Geller initially. I came home that night and I was simply miserable. I googled everything I could regarding post-laser complications. Some people said it got better over time. I held out hope that it would.
My opinion, laser doesn't work, not to mention it set me back $1500.
Over several months, my perception did change. The vitreous in the lasered eye was clearly more liquefied. I could look left and right and it was like a bowl of Asian egg drop soup swirling too and fro. Dimly light rooms and restaurants were no longer an escape because the fragments diffused light when I looked at them. My computer screen was white with gray swirls. Worse, these same symptoms were occurring in my right eye now. Since I had had no injury in my right eye, I then wondered if the shock of the laser could of possibly created the floaters in my right eye. I was going mad!
This was 2013. I vowed that I had to do something. I couldn’t live this way. Floaters were taking everything away from me. I live in Florida. I hated being outside. I had a three-year-old daughter at this point; I did not want to be outside with her. One day, while alone at home while my husband and daughter were outside playing, I broke down, again. This was common. I considered hypnotism, medication, anything to have my old life back. I briefly thought that suicide could at least provide a final relief from this. (That seems so crazy for me to write, but I honestly thought—at that low point in time—that life wasn’t worth living this way.) I can tell you from first hand experience, floaters can drive you crazy and Doctors have no clue as to the extent that they do and, it is my belief, that they actually do more harm by being laissez-faire about them and telling you to ignore them.
It was at this point that I realized that I had to whatever I could. FOV was my only option. I started researching sympathetic Doctors. I read every post I could find under the FOV portion of this site. I watched Dr. Wong’s seminars. I watched YouTube videos, I reached out again to t84fazerowners since he had had a vitrectomy. I tried not to sound desperate, but I really was. He asked me if I was close enough to go see Dr. Cohen in Clearwater, Florida. I had never heard of Dr. Cohen. I looked him up and his credentials were impeccable. Harvard Undergrad, Harvard Med School and Bascom-Palmer Retinal Institute at the University of Miami for Internship. Add in that his office is a bit under two hours from my home and I decided to make an appointment.
In advance of my appointment, I made a huge list of questions that I had regarding the procedure. I met with him and my husband came along into the examining room with me. He first did a manual examination of eye and asked me about my symptoms. I told him everything I have recounted here and he said that he believed that my vitreous was possibly starting to detach, hence the flashing arcs due to strands tugging on the retina. He said that there was only one way to be sure and that was to do a retinal scan. This was new to me. He scanned both retinas and, for the first time, I had a definitive answer to that question. The vitreous in left eye had completely detached, but may still have some small strings tugging on the retina. The vitreous in the right eye was intact.
As I said earlier…I am highly myopic. My contacts are -7.50 and my glasses are -8.50, but I don’t wear glasses outside simply because they are too thick. He said that eventually, my eyes were likely to have floaters regardless because the eyeball is stretched and the vitreous struggles to stretch that far and would eventually detach from the retina and would create floaters.
Back to the meeting…I had four pages of questions that I asked him about and Dr. Cohen diligently answered each one professionally. He ultimately said that I should try to live with it and see if I could learn to accommodate. He said that he had seen people with floaters who they themselves didn’t know they had. He told me to give it six months to see if they got better, but that I could always come back.
I left there that day with hope. Hope that it either could get better or that I could come back in six months. Six months went by—nothing changed—and I was back. The second meeting was no different than the first, all the same questions, some new ones and a request from him to wait and see if it would get better. Six months again went by and I, again, came back for a checkup and a repeat of the scans. This time, he said that the vitreous in my right eye was starting to detach. That made sense to me because the floaters were more numerous in that eye, but the vitreous was still firmly attached near the where the retinal nerve is. After some more questions, he said in a very matter of fact way, and to my surprise, said, “Why don’t we go ahead and schedule the surgery?” He also said, “You know, it is a free country, if you want the surgery, I will do it.”
I was elated and shocked. I told him that I would look at my work schedule and get back with him. This was late December of 2013. I had lived with floaters for 18 months at this point. In the interim, while waiting these months, I had been following Dr. Wong online and I had been watching his seminars. I feel I had to at least have a meeting with him too, since he was so vitrectomy-friendly.
I saw Dr. Wong in March of 2014. I combined a brief trip for the Cherry Blossom Festival in Washington DC, with an appointment. Dr. Wong was, to put it simply, non-traditional. He spent a lot of time with me answering my questions and was very open about the risks and benefits of the procedure. He used some colorful language and definitely had a non-traditional bedside manner. He offered to give me some references of those who had also had vitrectomy surgery and he explained how the logistics work in terms of following up with my own Doctor after surgery, etc.
At this point, I knew I was going to have the surgery; I was just trying to determine which Physician was best. On the plane ride home, I debated the pros and cons of each Physician.
In the end, the proximity to my home, in the event there were any complications, Dr. Cohen’s education and experience and the ability to follow up with him throughout my recovery sold me on having Dr. Cohen do the procedure. I called his office shortly afterwards and I was told to come in for a pre-op visit. At the visit, we determined which eye would be first, (left eye) when the surgery would be, my follow up schedule and he wrote prescriptions for my eye drops/steroid drops, etc.
The surgery was scheduled for May 14th, 2014. We drove over the night before the surgery and we stayed in St. Petersburg. We got up the next morning and had to be at Largo Medical Center, which is really a fully staffed Hospital. Prep began with multiple dilating drops, setting an IV, etc. I was scared to death. I couldn’t fathom that I was actually doing this. I was going to have needles stuck in my eye. All of those videos that I had seen of vitrectomy—I was about to undergo that. I think I was in shock most of that morning. Dr. Cohen was running late for surgery because he had been called in to help with a pediatric case that day. All of the nurses told me that he was one of the best Docs that they knew. That eased my mind a bit.
Shortly thereafter, Dr. Cohen came in and said that all would be fine, that the surgery was no big deal and that he would see me soon in surgery and with that, the anesthesiologist came in and said that she would give me something to relax me. Sure enough, within two minutes, I felt like had just finished my fourth glass of wine.
I remember being wheeled into the operating room. They taped my right eye shut with a patch and put a metal bar over my face to keep the drape from laying on face. They then covered everything except my eye with medical draping. That was all that I remembered. I then awoke to them bandaging my eye and taping an eye patch down on the operated eye. It was done.
For those of you who want particulars, it was 28g, PPV, with no sutures or air bubble. PVD was already present due to the accident, so it was straightforward.
We headed back to the hotel and I tried to look at work emails and I succumbed to a nap for a bit. We then went down to the hotel bar and had a glass of wine and walked around the Bay. We went out to dinner and then went to bed. I was nervous. Everything I did was measured and cautious, I didn’t want to upset anything regarding the healing process.
That next morning, I remember my eye being itchy/grainy/sandy feeling and there was a “wet” feeling about it. I had asked Dr. Cohen the night before –he called the afternoon following the surgery to see how I was doing—and he said that all of this is normal. He said that they really goop up the eye with antibiotic ointments and that was what I was feeling. I also remember a strobe-light sensation that morning and from what I understand, that is the after-effects from the sedation nerve block.
Dr. Cohen had told me when I scheduled the surgery that he would not be able to see me the next day. He had to be out of town but he said that his partner in the practice, Dr. Eichenbaum would see me. When I got to the office, I was very nervous about learning the outcome of the surgery. When they called me back, they pulled the bandage off and I just remember everything being so bright—too bright. My husband, who was in the room said the white of my eye looked really bad and bloody and that my pupil was still very dilated.
The technician tried to get a pressure reading and, I could be wrong about this, but I think it was a six. It was really, really low, I remember that and they were concerned about it. But----I didn’t see any floaters. To be fair, I couldn’t see much at all. Even with glasses, my vision was bad with all of the dilation still. The Doctor said that the surgery presented no complications and I had to follow up in a week, a month, 3 months and then six months and then a year out. So began my follow up meetings. When we left the office that day—it was a Thursday---I just broke down and started crying. The feeling of actually having done something about this and being on the other side with no major complications was overwhelming.
I followed my regimen of drops twice per day as instructed. I went to Disney on that Saturday, as I recall. The steroid drop burned the first couple of days—badly—that was because the entrance holes for the tools that were inserted into the eye were still not healed. It was like putting solution into an open wound. That sensation went away very quickly, though.
All of my follow up appointments went fine. The rest were all with Dr. Cohen. I was warned of the risk of cataract development and Dr. Cohen’s opinion was that for someone under 40 to 45, the risk is very low. At my one-year check up for my left eye, he summarily asked, “Well, are you ready to do the right eye?” And that was it; I scheduled almost a year to the day from the first surgery.
This surgery was scheduled for St. Anthony’s Medical Center. This was an outpatient facility that must have been set up for eye surgeon’s who do a lot of cataract surgeries. I could hear from the conversations that there were a lot of those procedures being done.
Again, this surgery went very smoothly. In fact, being a “veteran”, I willingly went out to lunch following the surgery and I spent a lot less time “taking it easy”.
For some reason, this surgery on my left eye was much smoother. In fact, I will post a picture of my eye the day following surgery. It looks almost as if I didn’t have any surgery done at all. In fact, with the exception of bruising around my eye, there really would have been no indication. My IOP on my Day 1 follow up was a 12, as I recall. I believe 15-16 is normal. All of my follow-ups for the following year, went fine—no issues, whatsoever.
Now—to give you an update. It has now been nearly two years since my right eye vitrectomy and three years since my left eye was done. I purposely did not want to post as I was going through this as I wanted to let the healing process occur and I didn’t want to be “self-checking” all of the time as I documented my surgeries and recoveries. At this point, my eyes are better, 95% better, actually. They are not 100% perfect.
After my first surgery, on my left eye, the floaters—the free floating bits within my vitreous were completely gone. Since this eye already had had a PVD, it was a straightforward surgery in Dr. Cohen’s estimation. He simply went in and performed the vitrectomy. I had and still do have a slight strand that is attached at the upper right hand corner of my field of view. It is small and slight and I can’t see it when indoors or on the computer. I can’t see it at night or in dim light settings. I can see it outside without sunglasses if I look up and move my eyes. It is there and I can see it if I do that. I don’t think this is frill—at least as I have read frill being described on this forum. But, clearly, it is remaining vitreous that is tied to the outermost part of the inner wall of the eye.
I asked Dr. Cohen about it, of course, and he said that there simply are limitations as to what they can get out of the eye, even with PVD present, without touching the back of the natural lens. He said that in order to get to the very far reaches of the eye, or corners as it would be in this case, he would have to get the vitrector too close to the back of the natural lens and that if that were touched, there would be rapid cataract formation.
I have inquired about going back in and doing a clean-up procedure and he said that he would prefer I not push the issue. However, he said that if I were to have a naturally occurring cataract in that eye, and if I had an IOL in place, he would go back in as that would allow him to be more aggressive and he could manipulate the vitrector more towards the remaining small piece that I see. He could even touch the back of the lens with the tool at that point because cataract would no longer be a concerning factor.
I was a bit disheartened, initially that my eye wasn’t perfect after this first surgery. I had been through a lot, both with the surgery and with laser, not to mention the emotional roller coasters we all have experienced, and I wanted a perfect outcome. Again, after talking with others on this forum who have gone before me and after me, I have realized that perfection may not be possible. I can tell you this—I am 95% delighted with this outcome on my left eye. I would do it again in a moment. I do not have the start of a cataract and my vision is 20/10 with contacts. I do seem to have more perception of BFE phenomenon in both eyes since surgery, however, but that is only if I look up in the sky and look for it. I maybe see that every two months or so.
The surgery on the right eye was also pretty straightforward. The procedure was exactly the same, except that the PVD had just started and Dr. Cohen would have to “finish the job” and peel the remaining vitreous off the retina. Post surgery, he said that everything went well. Again, this surgery seemed less traumatic. I didn’t spend the next 24 hours and the next 3-7 days walking on egg shells looking for one of the “warning signs”, such as a shadow coming across my field of vision, etc. The recovery was fast and Dr. Cohen took me off the post-surgical drops a few days early.
The outcome on the right eye was better than the left eye in terms of remaining vitreous skirt, etc. I can’t detect anything. The one outcome I have had in my right eye which I did not have in my left, which I also didn’t quite understand after reading about it until now that I have a few, are “target cells”. I do have four or five little, tiny, clear, bullseye-shaped dots that I see a couple of times during the day. Not all the time. They are an acceptable tradeoff in my opinion. That is the only remnant of floaters that I have. Again, two years since surgery and no cataract.
I have not been active on the Forum, although a few of those on here who have had vitrectomies in the last two years have contacted me because they had seen where I had posted that I had visited him. I have talked with them openly over the phone. I believe I am the first person on here to have had a vitrectomy with Dr. Cohen as I never found anyone when I was looking back in 2014.
I wanted to document this, in some ways, for me. So that I can say it is done and move on. I also wanted to do it to give hope for those who are where I was in 2012 and 2013. I have been there--frantically checking the Forum, going to Doctor after Doctor who act as if floaters are not a big deal. The floaters that they are referring to that “you will learn to accept and ignore” are not our floaters. I can say now that I may pop online and read a few threads every four or five months, but I don’t need to now. This is why a lot of people move on once you have the procedure. I know that I have seen that question posed here before and discussed online.
I’m here to help and offer hope and I am always willing to talk with anyone considering surgery, especially with Dr. Cohen. He is a brilliant Doctor and I don’t believe you could really find fault with his education, credentials and bedside manner. At the end of the day, if you are going to do this; do your research, find a sympathetic Doctor and talk with them. Utilize this forum, PM me if I can ever help—always happy to talk over the phone too.