Floaters

Question 1

What causes floaters?

Answer 1

Opacities in field of vision, seen as spots, threads, lines

Two Vs, and R and 2 Us

V: posterior vitreous detachment
V: vitreous haemorrhage
R: retinal detachment
U: uveitis intermediate
U: uveitis posterior

Intraocular malignancy

Question 2

What is posterior vitreous detachment?

Answer 2

Vitreous shrinks with age

It’s like a bag of water next to the retina

A hole in the vitreous means fluid leaks out and around the bag, which means the vitreous pulls away from the retina

Can be partial or incomplete

Question 3

Symptoms of posterior vitreous detachment?

Answer 3

Floaters
Shower of black specks
Photopsia
Painless

Question 4

Investigations of floaters, photopsia?

Answer 4

Visual acuity

Ophthalmoscopy

Slit lamp: to look for retinal breaks

USS of eye

Visual field

Question 5

What does slit lamp test do?

Answer 5

Provides magnified view of structures of eye

Question 6

What is vitreous haemorrhage? What’s the course of the illness?

Answer 6

Bleeding into vitreous humour

Blood clots which is cleared slowly
Rarely results in permanent visual loss

Question 7

Causes of vitreous haemorrhage?

Answer 7

Diabetic retinopathy: new vessels grow into vitreous which are fragile and bleed

Posterior vitreous detachment

Ocular trauma

Question 8

Symptoms of vitreous haemorrhage?

Answer 8

Sudden painless visual loss

Red hue
New onset floaters

Question 9

Management of vitreous haemorrhage?

Answer 9

Urgent referral to ophthalmologist

Observe: will clear over days to weeks

Laser photocoagulation