Questions for your doctor

The physician consultation is the patient’s opportunity to learn about their ailment, the treatment(s), and to acquaint themselves with their doctor. The following list of questions are applicable to Floater Only Vitrectomy (FOV) or Laser Vitreolysis consultations and may aid floater sufferers in search of treatment. 

Questions applicable to both FOV and Laser Vitreolysis procedures:

General information

1. Will this procedure get rid of all my floaters? What are the chances of being left with floaters?
2. What are the chances of the floaters returning later in life?
3. What is the recovery time after the procedure?
4. Will my vision be any different afterwards?
5. When could I return to work? Use a computer etc.? Would it affect my recovery? Close up work?
6. How soon after the pre-op examination can I schedule a procedure?
7. Where does the procedure take place? How long do I stay afterward?
8. Will you be performing the procedure yourself?
9. What kind of anesthesia is available for the surgery (general and/or local)?
10. Will my head be solidly strapped on a chair or something to prevent me from moving during the surgery?
11. What do I do if I need to cough/sneeze during the procedure?
12. How long does the operation take?
13. Do I need to be with someone else the day of the procedure?
14. Do I need to do some sort of full physical exam before I go to see you for the procedure? If so, how long before the procedure must this exam take place?

Doctor’s experience

1. How many procedures (FOV / Laser) have you performed in your career?
2. How long have you been doing them?
3. What percentage are successful?
4. How many patients have experienced complications after the operation?

Post-op

1. Can you describe what kind of post-op support you will provide me with if problems occurs?
2. What will be the medication needed after the surgery and what is the approximate cost for it?

Finance questions

1. What kind of health insurance coverage can I expect for the procedure?  (In the US, the health insurance code for laser treatment of eye floaters is 67031.  Doctors should have no reason to charge you before laser treatment of floaters if you are participating with an insurance company.)
2. What is the cost on one eye?
3. What are the methods of payment that you accept?
4. When do I need to pay for the procedure?
5. Does this price include subsequent surgeries/procedures (if required for residual floaters)?
6. What is your appointment cancellation policy?

Laser vitreolysis specific:

Procedure

1. What exactly happens to the floaters when they are lasered?
2. Can you eliminate more than one floater during the procedure?
3. What are the odds of improvement or no improvement?
4. Can I speak with one of your former patients?

Complications

1. What are possible short/long-term complications of the procedure?
2. Are there cures/solutions for these complications?
3. What happens if the laser misses the floater? Will it damage my retina?
4. Is there any danger to my cornea, lens, or retina?

FOV specific:

Procedure

1. Do you always laser the periphery of the retina during an FOV surgery to lower the possibility of retinal tears from occuring during the FOV (and PVD)?
2. Do you use any special techniques (e.g., green dye/triamcinolone) during the surgery to aid in visualization. Are there any complications with the visualization techniques?
3. Do you use 20g, 23g or 25g instruments to perform your vitrectomy?
4. Do you use stitches?
5. How much of the vitreous do you remove/leave (phakic vs aphakic) and where (retina vs lens)?
6. Do you induce a Post Vitreous Detachment if necessary?
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?

Complications

1. What are the risks involved?
   1. Retinal detachment?
2. Cataract?
   1. Taking into account my age, what is the risk of developing cataracts in the operated eye during and after the vitrectomy?
   2. How long until I develop a cataract after surgery?
   3. Do all FOV patients develop cataracts?
   4. What causes the cataract to occur? Oxidation of lens? Is 20g worse for this?
   5. How would I see with a cataract lens?
   6. Which IOL would you recommend if I did develop one?
   7. What would the accommodation be like with this? Would I need glasses?
3. Infection?
4. Other risks?
5. "Shimmering" is possible post-FOV if a patient can see the part of the vitreous that was not taken away move in his eye. What is the percentage of probability that this can occur according to you and your techniques and according to your accumulated vitrectomy statistics and experience as a surgeon?

Suggestions:

It is important to understand your doctor's opinions and the information he/she relates during the consultation. The following suggestions may help with this process:

• If you don't understand your doctor's responses, ask questions until you do understand.
• Take notes or get a friend or family member to take notes for you.
• Ask your doctor for printed material.
• If you still have trouble understanding your doctor, ask where you can go for more information.