Like many of you, I am sure, I have developed quite a few floaters over the years. Their onset has been gradual, they do not hinder my vision (except if trying to swat a really small fly), and I have accepted them as a minor distraction as I continue to negotiate the increasingly surprising challenges that life throws at me.
I confess that my own, unremarkable experience of floaters and their impact may have biased my opinion somewhat and, perhaps, been a little too dismissive when patients have mentioned their distress caused by their vitreous degeneration. Obviously, I am talking here of the moving shadows caused by the increasing numbers of collagen strands that precipitate within the increasingly watery vitreous over time.
So, when a work colleague (in her early 50s) asked me last year if there was anything that could be done about her increasingly troublesome floaters, I immediately resorted, automaton-like, to my stock answers of ‘you will get used to them’ and ‘the only treatment involves the complete removal of the vitreous and the risks far outweigh the benefits.’
But perhaps it’s time for a rethink.
First of all, television presenter Phillip Schofield underwent a vitrectomy and publicised how he could now see clearly again. Prior to treatment, he had suffered such an array of floaters that even looking across the TV studio had become difficult.
Then, I heard a presentation from the excellent Wolverhampton surgeon Kam Ballagan and learned that, for some, floaters can become so debilitating that they stop them driving or carrying out their usual tasks. This is now described as vision degrading myodesopsia (VDM). Advances in surgery mean that he is now, in most cases, able to treat these patients successfully and he presented many case examples to illustrate this. In future, we may see positive results from YAG laser vitreolysis, a non-invasive, but still controversial approach.
I will now take floaters more seriously.
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