Vitreous Detachment

What is vitreous detachment?

Most of the eye's interior is filled with vitreous, a gel-like substance that helps the eye maintain a round shape. There are millions of fine fibers intertwined within the vitreous that are attached to the surface of the retina, the eye's light-sensitive tissue. As we age, the vitreous slowly shrinks, and these fine fibers pull on the retinal surface. Usually the fibers break, allowing the vitreous to separate and shrink from the retina. This is avitreous detachment.
In most cases, a vitreous detachment, also known as a posterior vitreous detachment, is not sight-threatening and requires no treatment.

Risk Factors

Who is at risk for vitreous detachment?

A vitreous detachment is a common condition that usually affects people over age 50, and is very common after age 80. People who are nearsighted are also at increased risk. Those who have a vitreous detachment in one eye are likely to have one in the other, although it may not happen until years later.

Symptoms and Detection

What are the symptoms of vitreous detachment?

As the vitreous shrinks, it becomes somewhat stringy, and the strands can cast tiny shadows on the retina that you may notice as floaters, which appear as little "cobwebs" or specks that seem to float about in your field of vision. If you try to look at these shadows they appear to quickly dart out of the way.
One symptom of a vitreous detachment is a small but sudden increase in the number of new floaters. This increase in floaters may be accompanied by flashes of light (lightning streaks) in your peripheral, or side, vision. In most cases, either you will not notice a vitreous detachment, or you will find it merely annoying because of the increase in floaters.

How is vitreous detachment detected?

The only way to diagnose the cause of the problem is by a comprehensive dilated eye examination. If the vitreous detachment has led to a macular hole or detached retina, early treatment can help prevent loss of vision.

Treatment

How does vitreous detachment affect vision?

Although a vitreous detachment does not threaten sight, once in a while some of the vitreous fibers pull so hard on the retina that they create amacular hole to or lead to a retinal detachment. Both of these conditions are sight-threatening and should be treated immediately.
If left untreated, a macular hole or detached retina can lead to permanent vision loss in the affected eye. Those who experience a sudden increase in floaters or an increase in flashes of light in peripheral vision should have an eye care professional examine their eyes as soon as possible.

Corneal Refractive Therapy (CRT): Frequently Asked Questions

Dr. Stuart Spind in Glen Burnie, MD is certified to prescribe Paragon CRT.  His careful selection process permits more than 90% of his patients undergoing CRT to leave with their initial therapeutic lenses on their first day rather than needing to to order them. CRT Brand Contact Lenses are FDA approved therapeutic contact lenses used to gently reshape the cornea while you sleep to correct nearsightedness (myopia). Most commonly referred to as “Corneal Reshaping or Orthokeratology”, CRT offers a safe, non-invasive, non-surgical procedure that temporarily corrects nearsightedness and mild amounts of astigmatism.

  Corneal Refractive Therapy (CRT): Frequently Asked Questions

 Why should I choose Dr. Stuart Spind for CRT?

Dr. Stuart Spind uses state-of-the-art technology to measure the change in corneal curvature, along with the change in nearsightedness. Finally, Dr. Spind carefully selects his patients undergoing this procedure, maximizing the likelihood of success. An honest assessment is the first step for obtaining desired treatment outcomes, and that's what Dr. Stuart Spind is known for.

Is there an minimum age requirement for CRT?

There is no lower age limit on the FDA approval for CRT, which makes this treatment available for carefully selected children.  The scientific literature supports contact lens treatment for some children as young as eight years of age.  Any child undergoing CRT must have the aptitude and responsibility to adhere to proper lens care and hygiene, and this requires a careful and honest assessment by both the parents and Dr. Spind.

How much does CRT cost?

CRT is very affordable and the cost includes all progress visits 3 months from the initial prescribing visit, training on contact lens handling and care, and the initial pair of CRT lenses.

Is CRT risky?

No. The FDA has validated the safety and efficacy of CRT. But like all forms of contact lens treatment, eye irritation is possible.  Most cases are minor and resolve on their own if CRT wear is stopped and there is appropriate professional care. Still, there are rare and isolated reports of serious eye infection with overnight corneal reshaping where improper lens care and hygiene were suspected. Dr. Spind's patients receive a complete review of the benefits, risks, and alternatives during their consultation so that it is possible for you to make an educated decision to undergo CRT.

Can I set up a flexible spending account (FSA) for CRT?

Yes, provided that you have access to an FSA through your employer.  An FSA allows you to allocate pre-tax dollars toward qualified healthcare expenses including CRT.

Does CRT prevent myopia for getting worse?

Currently there is no definite proof that CRT prevents or slows myopia progression.  In fact the FDA approval for CRT does not permit the manufacturer from making such a claim.  However there is mounting evidence suggesting that CRT indeed can reduce the natural rate of childhood myopic progression.  Dr. Stuart Spind has provided information about this in an article on myopia control.

How do I find out if I'm a candidate for CRT?

Call Dr. Stuart Spind at (410) 766-1683 and schedule an eye examination.  During your exam, Dr. Spind will provide a complimentary CRT consultation!

What Is Orthokeratology?

What Is Orthokeratology?

In the most basic of terms Accelerated Overnight Orthokeratology or Ortho-k is the science of changing the curvature or shape of the cornea to change how light is focused on the retina at the back of one's eye.

Think of the cornea as the eye's equivalent of a watch crystal. It is a clear, dome shaped structure that overlies the colored iris. Its tissue is most similar to clear, wet skin; and like skin it is very pliable. Because the cornea separates the eye from air and the rest of the outside world and because it has a curvature that bends light towards the back of the eye, it is responsible for most of the eye's corrective power and contributes to various conditions such as nearsightedness (myopia), farsightedness (hyperopia), and the blur of astigmatism.

When you choose Ortho-k a few key tests must be performed. Chief among these tests is the determination that your eyes are healthy. The Orthokeratologist will examine the retina and also the health of the outside of the eye. The other key procedure is the mapping of your cornea. To do this an instrument called a Topographer is used. Just like a topographical map of a camping area show hills, plains, and valleys; the topography of the eye shows your doctor exactly how your cornea is shaped. The information from your corneal mapping plus the size of your cornea and the prescription needed to correct your vision are all used to design the retainer lenses (corneal molds) needed to create the Ortho-k effect.
 

On the day you pick up your Ortho-k retainer lenses you will be instructed in how to insert, remove, and take care your vision retainers. The fit of your retainers will be evaluated and you will be scheduled to be seen after your first night of wear. On day 1, your doctor will re-evaluate your fit and newly corrected vision and another mapping of your cornea will be performed.

Throughout your initial fitting period, your Orthokeratologist will monitor your corneal health and the effectiveness of treatment. At certain times your retainer lens fit may be modified to achieve your goals.

Orthokeratology can produce results in a surprisingly short period of time. The length of treatment to achieve your goals can vary from patient to patient. Factors which can affect the speed of treatment include:

1. your initial prescription
2. corneal rigidity
3. tear quality and quantity
4. your expectations.

We advise patients that they may need to use their retainers every night to maintain their newly corrected vision although some patients are able to vary their wearing time to once every two to four nights. The reason for this is due to the flexibility of your cornea.