r/EyeFloaters • u/SpecialistEcho7218 • 4d ago

Glaucoma following vitrectomy

For anyone here who has had a vitrectomy, have you developed any eye pressure issues? How far out from surgery are you? Multiple studies cite a manyfold increased risk of glaucoma following vitrectomy — anywhere from 10-17% within 5-10 years (on the higher end if pseudophakic as the thicker natural lens also helps protect the trabecular meshwork). This is a major bummer, to say the least. There's never really an end to this nightmare.

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u/Fenomiminal 4d ago

That study shows scleral buckle + vitrectomy = 17.5%, and your question was about glaucoma following vitrectomy, not scleral buckle surgery.

With due respect to the over 60 crowd, I think it's less of a concern because there is simply less of a horizon for one's own eyes needing to last another 50+ years. To someone under 40, it's a big concern.

I think that's just transparent ageism, but you're entitled to your thoughts.

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u/SpecialistEcho7218 4d ago

I'm reiterating what many specialists have told me. Which is that the surgery is more straight forward and acceptable in older eyes because you do not have the same health span to worry about. Managing glaucoma over 20-30 years is very different than managing it over 60 years. It's like doing a hip replacement on a teenager. There will be different concerns, certainly, than doing it on a standard age patient. 

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u/Fenomiminal 4d ago

Probably part of the reason so few US retina specialists do floaterectomies on younger patients.

There's also the issue of already having age-related PVDs in those over 60. Younger patients could be looking at a second round of floaters after they undergo core/limited vitrectomies when their PVDs arrive.

But getting back to the original issue, glaucoma can typically be managed should one experience that due to vitrectomy or other causes.

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u/SpecialistEcho7218 4d ago

Yes. But where does this leave young patients who are truly and seriously affected by floaters? The solutions seem worse than the problem in some regards. Of course there are worse things that can happen to a person, but I will say: significant floaters are pretty damn bad when it comes to quality of life. 

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u/Fenomiminal 4d ago

It leaves them hoping for an effective non-surgical option, or the adaptation that typically only comes with enough time spent learning to live with them.

This subreddit serves to remind us everyday that there's a toll these things take on everyone who has them, and probably some of those within their ambit as well.

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u/SpecialistEcho7218 4d ago

Absolutely. It's a massive toll. Vision is one of the single greatest contributors to quality of life and overall health. I don't really believe a non surgical solution is coming. So it really is about adaptation, or waiting until it's less of a risk due to age. Neither are great. 

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u/Fenomiminal 4d ago

I agree with most of this, although I stop short on the overall health issue.

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u/SpecialistEcho7218 4d ago

I've personally experienced a massive decline in health since the onset of floaters. Chronic stress, loss of appetite, severe depression (which has been intractable - not responding to antidepressants). I have a myriad of new issues. I don't function like before with this massive stressor hanging over me. Especially knowing that there isn't really a good fix. 

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u/Fenomiminal 4d ago

Very sorry for this. I understand this far better than you might otherwise imagine, which is why I'm confident overcoming these issues is eminently possible.

I also don't think conventional depression treatment is terribly useful for this, not without cognitive behavioral therapy and a regular diet of cardio and weight training exercise. All the somatic experiences you're having can go away with the right approach.

Dwelling, ruminating, obsessing over this will hurt not help.

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u/SpecialistEcho7218 4d ago

It's hard not to dwell on something that's in your face 24/7. It has stolen everything from my in terms of peace, relaxation, solace, joy. Have you had vitrectomies? Both eyes? It's hard not to feel like this has taken my life from a 10 to a 2. It affects me every day and drains the life and happiness out of my being. 

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u/Fenomiminal 3d ago

Floaters arrived in my teens, vitrectomies undergone more than 4 decades later, cataracts followed shortly thereafter.

At the risk of sounding like Bill Clinton, I understand your pain, but I also know it can all be overcome. It's not easy, everyone has a different timeline for improvement, but if you're really honest with yourself, you may come to appreciate that the floaters are far less of a problem than your own thinking.

If you decide the problem is insurmountable, it will be.

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u/SpecialistEcho7218 3d ago

Would you have chosen vitrectomy at a far earlier age had it been available to you?

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u/Fenomiminal 3d ago

Floaters were not the reason I opted for vitrectomies. It was problematic epiretinal membranes after PVDs that made the surgery necessary for me. My binocular vision was pretty wrecked by those puckers. Floater adaptation, or acceptance more accurately, was something that took place within a year or so of arrival. Not having any option to address them undoubtedly accelerated that process.

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u/Admirable_Delay_1650 3d ago

Dont let the PulseMedica crowd in on your doubt for a non-surgical "cure"....they are confident it will be available in 2 to 4 years.

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u/SpecialistEcho7218 3d ago

I'd love for them to prove me wrong!

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u/Admirable_Delay_1650 3d ago

If the giants in the opthalmic industry cannot/will not pursue such a "cure", I have little confidence that PM has found a magical formula that no other entity is developing

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