history and examination (of floaters)

Last reviewed 01/2018

History:

  • duration of floaters
  • any associated visual loss
  • it is important to differentiate a floater (which is slightly dissociated from ocular movement) from a blind spot (scotoma)
  • size and shape of floater(s) may reflect severity
    • a small ring is consistent with a posterior vitreous detachment
    • a vitreous haemorrhage may present with multiple, large floaters
  • multiple floatres suggests presence of the following (1)
    • red blood cells
    • pigment cells
    • pigment granules (of retinal pigment epithelium)
  • other conditions e.g. myopia associated with an increased incidence of retinal tears. If pain occurs then this is suggestive of uveitis.

Examination

  • a thorough eye examination is needed, includung:
    • measurement of visual acuity
    • pupillary light reaction
    • confrontation fields
    • slit lamp biomicroscopy
    • dilated fundoscopy
    • examination of the fundus with indirect ophthalmoscopy and scleral depression (1)
  • red blood cells in the vitreous signify severed retinal vessels.

Reference: