The Floater Doctor

Co-Managing with Dr. Johnson is easy and is a great way improve the quality of vision and quality for your patients and an opportunity to get paid for your time and expertise. That said, most eye care providers have little or no experience evaluating eye floaters a far as candidacy for treatment with the YAG laser. Here is a brief FAQ/Guide to help determine who might be a good candidate for laser vitreolysis:

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Is this a new procedure?

This procedure has been around for over twenty years. We use an FDA-approved laser, although the procedure is an off-label use of the laser. .

 

How does the laser work?

The YAG laser concentrates energy onto the floater itself both breaking up the larger floaters and vaporizing the collagen. The molecules are converted to a gas micro-bubble. The gas is absorbed and the bubbles disappear in about 30 minutes. At the end of a treatment, there will be less vitreous material present. There is a limit to the treatment energy used at any one session, which explains why multiple treatments are often needed.

 

Who can be treated? Young patients (<30-35 years) are RARELY candidates for treatment. I usually discourage them from any treatment. More typically, those >45-50 are candidates for treatment: with or without PVD, and natural lenses or pseudophakes. The most ideal patient is a 'virgin' eye with a prominent weiss ring floater from a completed posterior vitreous detachment. We are very cautious treating glaucoma patients or suspects as post-treatment elevated eye pressures is a known risk.

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Does it hurt?

The vitreous has no nerves or blood supply. The laser itself is painless. There is an awareness of light, movement, bubbles, and some laser 'clicking' sounds. There is no healing, just a period of recovery as it takes a few hours for the pupil dilation to resolve.

 

How long does it take? Are patients sedated?

The patient is fully awake and sitting at a slit-lamp laser biomicroscope. Sedatives are not used. A typical treatment session may take 20-40 minutes with one or two brief breaks if needed.

 

Doesn’t the laser just break up the floater into smaller ones?

Generally, no. The strategy is to vaporize the material so that there is less mass and volume of the floater material. A beneficial side-effect is that if some residual floaters fragments are small enough and far enough from the retina, they will not cast a shadow. Remember, the patient doesn't see the floater, they see the shadows.

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Is Laser Vitreolysis covered by insurance?

Insurers may pay at least a portion of the treatment. Because of the unpredictability of insurance reimbursing this procedure, we require fee for service up front, but as a courtesy, we provide a detailed receipt that the patient can submit to their medical insurer.

 

What is the fee?

$250.00 for initial consultation and examination seen initially at my office. We will waive this fee for patients referred through an affiliate eye care provider if they are a candidate and proceed with treatment.

The treatment fee is $1850 for the initial treatment. The second treatment, if needed is included at no charge. Any additional treatments are $400/eye/ session. I suggest quoting about $2100-2500 per eye for a typical treatment series, maybe more if it is a particularly extensive problem.

 

How many treatments are necessary?

Most people will need between 2-4 total treatments. For extensive conditions I have performed more .

 

Is it dangerous?

It is a relatively low risk and safe procedure with two decades of history. There has never been a retinal detachment or loss of vision in over 10000 treatments which is an acceptably low risk and less than with YAG capsulotomy. A complete explanation of risks is available at our web site (here).

 

What are expectations for results?

I usually quote around 60+ percent improvement which is low and conservative. It is actually more like 80-90+ percent after a few treatments and depending on the type and extent of floater problem.

 

What is Dr. Johnson’s experience with this procedure?

He has treated thousands of patients from all over the country and abroad. Since 2007, he has dedicated his practice exclusively to the treatment of floaters.