New York Times – Ask Well: Floaters in the Eye

What causes floaters in the eye?

Floaters, those small dots or cobweb-shaped patches that move or “float” through the field of vision, can be alarming. Though many are harmless, if you develop a new floater, “you need to be seen pretty quickly” by an eye doctor in order to rule out a retinal tear or detachment, said Dr. Rebecca Taylor, a spokeswoman for the American Academy of Ophthalmology.

Floaters are caused by clumping of the vitreous humor, the gel-like fluid that fills the inside of the eye. Normally, the vitreous gel is anchored to the back of the eye. But as you age, it tends to thin out and may shrink and pull away from the inside surface of the eye, causing clumps or strands of connective tissue to become lodged in the jelly, much as “strands of thread fray when a button comes off on your coat,” Dr. Taylor said. The strands or clumps cast shadows on the retina, appearing as specks, dots, clouds or spider webs in your field of vision.

Such changes may occur at younger ages, too, particularly if you are nearsighted or have had a head injury or eye surgery. There is no treatment for floaters, though they usually fade with time.

But it’s still important to see a doctor if new floaters arise because the detaching vitreous gel can pull on the retina, causing it to tear, which can lead to retinal detachment, a serious condition. The pulling or tugging on the retina may be perceived as lightning-like flashes, “like a strobe light off to the side of your vision,” Dr. Taylor said.

See an eye doctor within 24 to 48 hours if you have a new floater, experience a sudden “storm” of floaters, see a gray curtain or shadow move across your field of vision, or have a sudden decrease in vision.

To learn more please call one of our ophthalmologists in Alexandria at (703) 313-8822

Rabin, Roni Caryn. “Ask Well: Floaters in the Eye.” Well Ask Well Floaters in the Eye Comments. New York TImes, 5 Feb. 2016. Web. 11 Feb. 2016.


RGW Selects Modernizing Medicine, Inc., for EMA

Modernizing Medicine, Inc., the creator of the Electronic Medical Assistant® (EMA™), a cloud-based, iPad native, specialty-specific electronic medical record (EMR) system, announced today that The Retina Group of Washington has selected EMA Ophthalmology to replace its legacy EMR solution. Use of the highly specialized EMR system will help streamline physician workflows and improve patient care across the entire practice.
With 26 physicians working across 14 offices, The Retina Group of Washington is one of the largest and most highly respected retinal and macular practices in the country. The Retina Group of Washington is well known for its extensive experience and sub-specialty expertise of its leading physicians and surgeons. Deeply committed to the advancement of care, the group is constantly conducting cutting-edge research and administers a Fellowship program to train future ophthalmologists.
“As one of the leading retinal practices in the country, we constantly look for ways to make our physicians’ lives easier and improve care,” said Dr. Michael Rivers, current Board member at The Retina Group of Washington and head of their EMR system selection committee.
For more information click here.

Top Retinal Ophthalmologist In Alexandria

Drs.  Reginald J. Sanders and William F. Deegan were selected by their colleagues in the medical field as “Top Doctors” in Ophthalmology as part of the 2015 “Top Doctors” published in the September issue of Washingtonian.  The bi-annual survey,  conducted for the first time online, solicited nominations from more than 12,000 physicians throughout D.C., Maryland and Virginia.  The list is designed to help readers find the best medical care in their communities, including primary care doctors and those specialists whom patients choose for themselves.

Early Vitrectomy for Spontaneous, Fundus-Obscuring Vitreous Hemorrhage.

Melamud A1, Pham H2, Stoumbos Z2.



To examine the visual outcomes of early intervention in the setting of fundus-obscuring vitreous hemorrhage (VH) presumed to be due to posterior vitreous detachment.


Retrospective comparative case series.


All eyes that presented with a fundus-obscuring VH defined as vision of 20/400 or worse, and requiring a B-scan at presentation from 2003 – 2013, were evaluated. Eyes with any history of retinopathy; macular degeneration; recent trauma; presentation greater than two weeks after onset of symptoms; or follow-up of less than two months were excluded. The main outcome measure studied was final best-correct visual acuity (BCVA) as dependent on the time to surgery.


92 eyes met inclusion criteria with a mean follow-up of 490 days. Initial BCVA was logMAR 2.218 (Snellen equivalent 20/3000-20/4000 range 20/400- light perception); final BCVA was 0.318 (Snellen equivalent of 20/40-20/50 range 20/20 – light perception, p < 0.001). 56 patients (60.8%) had either a retinal tear or a retinal detachment. Patients who underwent surgery within 1 week had no significant improvement over all others, however a significant improvement was found when comparing early versus delayed surgery groups (p<0.05). There was a significantly increased risk of developing a macula-off retinal detachment in patients who did not undergo surgery within one week of presentation.


Early surgical intervention results in similar visual outcomes compared to a conservative approach. However, early intervention significantly reduces the incidence of severe vision loss related to macula involving retinal detachment. This study highlights the importance of close follow-up given the high risk of retinal detachment in fundus-obscuring vitreous hemorrhage.
Am J Ophthalmol. 2015 Jul 21. pii: S0002-9394(15)00449-3. doi: 10.1016/j.ajo.2015.07.025. [Epub ahead of print]

Retinal Vein Occlusion in Young Patients

The management of retinal vein occlusion (RVO) has changed dramatically over the last 3 decades since the results of the Branch Vein Occlusion Study (BVOS) and Central Vein Occlusion Study (CVOS) were published in the 1980s and 1990s.

While most patients who present with RVO are 60 years of age or older, young patients can pose particular diagnostic and treatment challenges.

In this installment of Practical Retina, current RGW retina fellow Dr. Luke Lindsell and Dr. Michael Lai from Washington, D.C., address what should be included in an appropriate diagnostic work-up for younger patients who present with RVO, provide pearls for detecting uncommon underlying systemic etiologies, and review their treatment paradigm.

You can read about it in their article entitled “Current concepts in managing retinal vein occlusion in young patients” for the July/August 2015 issue of the journal Ophthalmic Surgery Lasers & Imaging Retina.

Click here to read more.

Source: Ophthalmic Surgery, Lasers and Imaging Retina July 2015 – Volume 46 · Issue 7: 695-701

Diabetic Retinopathy Treatment in Alexandria

Alexandria Diabetic Eye Care

Here at The Retina Group of Washington, our diabetic retinopathy treatment in Alexandria is one of our most important services. If you have diabetes, it is important that you are aware of the severe risks that the condition poses to your eye health and vision quality. One of the most common eye conditions affiliated with diabetes is diabetic retinopathy.

Diabetic retinopathy treatment in Alexandria

Diabetic retinopathy treatment in Alexandria

Diabetic retinopathy can have serious consequences including vision damage and vision loss, and so it is not a condition to be taken lightly. If you are a diabetic patient, you should be visiting us here at The Retina Group of Washington for diabetic eye exams on a regular basis. During these crucial exams, we will check your eyes for signs of diabetes related eye conditions especially, like glaucoma, macular degeneration, and diabetic retinopathy. These frequent diabetic eye exams increase the likelihood that any conditions you do develop will be caught early. Early detection and treatment can make a huge difference in your vision preservation and overall recovery, especially when facing a condition like diabetic retinopathy. If we see signs of developing diabetic retinopathy during an eye exam here at The Retina Group of Washington, we will discuss these signs with you and work to create a plan for diabetic retinopathy treatment in Alexandria that is designed to address your specific needs as a patient. Our goals are to ensure that you are seeing clearly and safely, and that your eyes are kept as healthy as possible as long as possible. As with all other conditions associated with diabetes, keeping your blood sugar levels under control can go a long way in prevention and keeping yourself healthy.

If you would like to learn more about what diabetic retinopathy treatment in Alexandria entails, or if you would like to learn more about any of the other many services available to you here at The Retina Group of Washington, we highly recommend that you visit our main website to browse through the additional information provided there. If you have any specific questions or concerns that we can assist you with in any way, please feel free to contact the staff here at The Retina Group of Washington directly.

6354 Walker Lane, Suite 100
Alexandria, VA 22310

Eye Specialist in Alexandria

Alexandria Macula Doctor

Making sure that you take the best care of your eye health is incredibly important, not just in terms of your vision but in terms of your overall well-being as well. There are plenty of eye conditions that can arise in any individual, it would help to know whether you are at risk for any particular kind of disease or condition in regards to your eyes. If you find that you were prone to diseases related to the macula or were recently diagnosed with any conditions related to the macula, then our eye specialist in Alexandria here at The Retina Group of Washington is here to help.

Eye Specialist in Alexandria

Eye Specialist in Alexandria

Your eyes are incredibly sensitive parts of the body and they’re prone to specific diseases and conditions eye cannot only affect their overall health but could possibly impede on the quality of your vision as well. Whether you have a known eye condition or not, it is imperative that you visit your eye doctor fairly regularly. It is recommended that all individuals, regardless of eye health or family medical history, visit an eye doctor on a regular basis but it is most important for people who already having known eye condition or are at risk for developing one to visit their eye doctor much more frequently. This makes it much easier to catch any conditions as early on as possible. The earlier on a diagnosis is made, the earlier treatment can begin and the more successful is likely to be. There are several eye diseases and conditions that can affect the macula specifically, and it is important to know if you are at risk for developing any of these things. Even if you are not sure, your doctor will be able to give you the information that you need. Our eye specialist in Alexandria here at The Retina Group of Washington can help provide you with a comprehensive eye exam and can refer you to an eye surgeon for treatment if necessary.

If you are in need of an eye exam or if you are at risk for developing any eye conditions, visit us here at The Retina Group of Washington today. Our eye doctor, eye surgeon or eye specialist in Alexandra can provide you with the complete care that you need.

The Retina Group of Washington
6354 Walker Lane, Suite 100
Alexandria, VA 22310

Dr. Johnson quoted in MEDSCAPE Article on Diabetic Retinopathy at the Point of Primary Care

Below is an excerpt from the article quoting Dr. Johnson as a consulting retinal surgeon. Click on the link below to read the full article:


Dr Silva noted, however, that the cost of ultrawide field imaging devices at the present time “is prohibitive,” especially in places with small populations and a limited number of diabetes patients. But prices will come down in time, he added.

Asked to comment, T Mark Johnson, MD, FRCSC, an attending surgeon at the Retina Group of Washington, DC, who was not involved in the study, agreed that the current costs of the cameras used in ultrawide field imaging, are “significant” and could therefore limit their use in screening programs.

And he claims that past studies have suggested that even three-field photography (just taking photos of the posterior pole of the retina) may be as good as ultrawide field imaging for screening for significant diabetic retinopathy. Therefore, more research is needed to justify the added costs of ultrawide field imaging, he pointed out.

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