Floaters are caused by opacities
in the vitreous casting a shadow on the retina. The majority results from
vitreous degeneration and is more common amongst the myopic and elderly
population. The condition is benign in most cases but they may be a potentially
serious retinal problem.
They may be a gradual increase in floaters
in both eyes or
Sudden onset of floaters in one eye
with or without flashing light (photopsia, caused by pulling of the retina
by the vitreous)
The visual acuity is normal unless there
is an associated vitreous haemorrhage or retinal detachment.
The vitreous may be visible with direct
ophthalmoscope, but better seen on the slit-lamp.
The history is crucial in deciding on the urgency of referral:
patient with gradual on-set floaters
in both eyes are unlikely to have serious retinal problems, however, refer
the patient within one week
patient with sudden onset floaters with
photopsia may have impending retinal tear. Referred within 24 hours.
This patient presented with a sudden
onset of floater in her right eye.
The picture shows the presence of
Weiss's ring in the vitreous cavity.
The ring is caused by vitreous
detachment from the optic disc edge.
Note the ring shaped opacity corresponding
to the size of the optic disc.
The retina view is blurred because
the camera was focused on the vitreous.
See also retinal
A diagramatic representation of
posterior vitreous detachment. The vitreous
gel is apposed to the retina and
if detachment can sometimes give rise to retinal
tear or hole. If the retinal vessels
were pulled, vitreous haemorrhage can result.
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