Here are some tips for getting the most out of your eye floaters consultation

The physician consultation is the patient’s opportunity to learn about their ailment, treatment and their doctor.  It can be quite an overwhelming experience when you are in unfamiliar surroundings, receiving alot of information which may be complex, worrying or distressing so it is worth giving some thought to your goals from the meeting in advance.

The lists of diagnostic and treatment questions below may give you some ideas of the types of things to find out.

  • Don’t be embarrassed of appearing ignorant, you are not a medical professional and you are not expected to be, if you are unsure about something, this is the time to ask.
  • Take notes or get a friend or family member to take notes for you.
  • Ask your doctor to draw pictures and explain or spell unfamiliar words.
  • Ask your doctor for printed material that you can refer to later.
  • Ask your doctor to provide you with a written summary of your diagnosis, prognosis and his or her recommendations for management and treatment that you will be able to discuss with your GP later.
  • Ask where you can go for more information.
  • If you still have trouble understanding your doctor, make a second appointment.

  1. What is my diagnosis?
  2. Is there any underlying pathology? (e.g. genetic syndrome, injury, retinal damage, uveitis, other disease)
  3. What do you think caused this to happen in my particular case?  (e.g. have your eyes aged prematurely, is there a possible underlying genetic syndrome?) Can I do anything to prevent the situation deteriorating further?
  4. Can you actually see my eye floaters/PVD?
  5. Are there any other diagnostic tests I could have to clarify my diagnosis? (e.g. B-Scan, different type of lens)?
  6. What is my prognosis if I do nothing (ie. How will my condition change in the future)?
  7. What are the conservative management options for dealing with this condition?
  8. What are the treatment options for dealing with this condition?  What are their relative risks and benefits?
  9. Do you have any experience of treating floaters with laser or vitrectomy?
  10. What course of action would you recommend?
  11. What kind of follow-up is required (e.g. annual retests)?
  12. Would another doctor give me the same answer or can I seek a second opinion?
  13. Can you recommend any support organisations/advice lines for this condition in my area?

  1. What happens during this procedure?
  2. Do you use any special techniques for this procedure that might differ to another doctor’s?
  3. What are the theoretical risks and complications, both short and longer term, of this procedure (e.g. anaesthesia, infection, cataract formation, retinal damage, eye floaters remaining after treatment, eye floaters returning after treatment, changes to vision such as visual acuity, shimmering and halos)?
  4. What is the follow-up procedure (e.g. recovery time, follow-up appointments, medication)?
  5. Will you be performing the procedure yourself?
  6. How many of this type of procedure have you/this clinic carried out?
  7. What is your complication rate/the complication rate of the clinic for this procedure?
  8. How do you evaluate the success of the procedure for a particular patient?  How does a patient report that they feel the operation has not been successful?
  9. Are there cures/solutions for these complications? What kind of post-operative support does the clinic provide if problems occur?
  10. Why do you believe more doctors do not offer this procedure for eye floater patients?
  11. Would it be possible to speak to a past patient of yours who has had this procedure?

Questions for specific types of eye floater treatment

Laser vitreolysis

  1. What type of laser and equipment do you use?
  2. What are the odds of improvement or no improvement?  How do you evaluate this and take account of a possible placebo effect?
  3. Is there any danger to the cornea, lens, or retina?
  4. Can you eliminate more than one floater during the procedure?  How many procedures will be needed?
  5. Are my floaters difficult or easy to treat with laser?
Floaters only Vitrectomy

  1. Do you use 20g, 23g or 25g instruments to perform a vitrectomy?
  2. Do you use stitches?
  3. How much of the vitreous do you remove/leave (phakic vs aphakic) and where (retina vs lens)?
  4. Do you induce a Posterior Vitreous Detachment (PVD) if necessary?  How do you do this?
  5. Do you always laser the periphery of the retina during the surgery to lower the possibility of retinal tears from occurring?
  6. Do you use dyes/triamcinolone during the surgery to aid in visualization. Are there any complications with the visualization techniques?
  7. What do you replace the vitreous fluid in the eye with? Is this replaced naturally?
  8. Would I need a gas bubble? Does this cause more chance of cataract forming?
  9. Which IOL would you recommend if I developed cataracts as a result of surgery?
Pharmacological

  1. What substance are you using and what is it derived from?
  2. How does it work?
  3. What is the evidence for its safety and effectiveness?
  4. What are my odds of improvement or no improvement? How do you evaluate this and take account of a possible placebo effect?
  5. Is there any danger to the cornea, lens, or retina?
  6. How many procedures will be needed?

Finance questions

  1. What is the total cost of treatment, post-operative care, medications, hospital stay?
  2. What kind of health insurance coverage can I expect for the procedure?
  3. When do I need to pay for the procedure?
  4. Does this price include subsequent surgeries/procedures, e.g. to deal with complications or if required for residual floaters?