Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP Path: utzoo!linus!philabs!cmcl2!seismo!lll-crg!well!ptsfa!ski!dr From: dr@ski.UUCP (David Robins) Newsgroups: net.med Subject: Re: floaters Message-ID: <228@ski.UUCP> Date: Tue, 11-Feb-86 22:53:17 EST Article-I.D.: ski.228 Posted: Tue Feb 11 22:53:17 1986 Date-Received: Fri, 14-Feb-86 05:50:26 EST References: <483@mordred.purdue.UUCP> Organization: Smith-Kettlewell Institute, S.F., CA. Lines: 129 > > Pardon me if this subject has been dealt with before (how > unlikely), or if it's too weird. > > When I look at a light surface, I see small round things > floating by - particles of some kind in the eye fluid (aqueous, > vitreous, something like that?). Anyway, this is probably normal for > most people. The problem is, *I* see big blobs of floaters (whole > collections of round particles). This is usually not very annoying, > except that I happen to be a student, and all the classes I'm in are > taught using projectors with transparencies, so I'm often in the in a > semi-darkened room looking up at a big bright screen with some stuff on > it, and the blobs of floaters are immensely magnified and distracting, > since they don't stand still, and are always running away from your > direct line of vision. > > I remember reading a Scientific American article about this a > long time back (when I didn't have this problem). Apparently the little > round things are red blood vessels let loose into the eye by capillaries > (?) in the retina or whatever. That seems to make sense to me, since > when I see the floaters "magnified," they sure look very similar to red > blood cells. I can see them in rather good detail, even if I can't look > at them directly. > > I'd like to know any or all of the following, if possible: > 1. Why I have so many of these round things floating around Most people have some floaters- they are usually light-gray, and out-of-focus, because they are in the mid-vitreous. They are usually clumps of collagen fibrils. The normally separated fibrils clump up as the vitrous ages and liquifies centrally. (I haven't heard of them being red blood cells- the retinal capillaries usually don't leak ANY cells. What you may have heard is about another phenomenon- referred to as the BLUE FIELD ENTOPTIC Phenomenon. When looking at a bright pure blue light (sometimes the blue sky), one can see dancing, tiny round spots which have a clear surround. These are the white blood cells WITHIN the capillaries of the macula (central) area of the retina. They are seen moving along pathways described by the vessels. Other types of vitreous floaters are due to debris on the back of a separated vitreous posterior face, where it has separated normally from a healthy retina, OR are due to material within the vitreous, other than the collagen mentioned above. Such clumps can be pigment, recent hemorrhages, or pieces of the retina. Anyone who has recent onset of floaters, either solid, fluffy, or cobwebbed in appearance, should be examined to rule out the possibilty of a retinal tear or retinal hole. All vitreous floaters move around because they are either free-floating in the vitreous gel, on the posterior vitreous face, or in the middle of liquified vitreous. Liquification occurs due to aging (40's and up), happens earlier in myopes (nearsighted), or with a history of eye injury or intraocular infection. > 2. If it is an indication of an eye problem Most innocuous vitreous floaters are gradual onset, and long-standing. A new vitreous separation will cause a sudden shower of floaters, associated with FLASHES. Flashes are due to traction on, or bouncing against, the retina. They look like lightning. Flashes can also be due to retina tears, and impending retinal detachment. Non-progressive, long-standing flashes are not dangerous, but new ones MUST be examined. Seriousness cannot always be differentiated by the symptoms. If you have large floaters, and have never been examined, it should be done. > 3. If answer to (2) is "yes," > a. what I could do about it > b. what kind of person I should consult - "doctor" "optician" "optometrist" "opthalmologist" etc. - I don't know how they precisely differ. You should have a DILATED retinal examination by an OPHTHALMOLOGIST. An ophthalmologist (M.D. or O.D.)is a medical physician and surgeon, trained in the specialty of the eyes(3-4 years after internship). An even better person is an ophthalmologist who is a sub-specialist in RETINA. Look up one, or your ophthalmologist can examine you and refer you if necessary. A dilated exam is necessary to examine the periphery of the retina, where most of the pathology and tears occur. (Don't drive after dilation until the pupils return to normal in several hours, and bring dark sunglasses if you have them). An optometrist (D.O.) is someone who has gone to a school of optometry. They are trained in basic eye examination, but especially in measuring the vison and refraction, for correction with glasses, contact lenses, etc. Some also offer eye exercise programs. (I personally feel most eye exercise are nt of great value.) Optometrists are often the primary person consulted by eye patients, partly becasue there are many more of them than ophthalmologists. Although ophthalmologists also do refractions, there main forte is in pathologic conditions and therapy of the eyes. In most states, medications for the yes can only be prescribed by a physician (M.D. or D.O.) An optician is someone trained in making eyeglasses (grinding lenses, fitting frames, etc). Some have extra training to enable them to fit contact lenses under the auspices of an ophthalmologist or optometrist. > 4. Which (Year+Month) SciAm magazine the above-mentioned article on this subject appeared in Don't know > 5. If answer to (5) is "dunno," how I can find out (other than writing to SciAm, I guess), and what other kinds of books/publications (might) deal with this. > 6. Any other information you feel may be remotely helpful, or relevant - respond to me or the net as you find appropriate. I have a handout about floaters, but most of what it covers is mentioned above. In addition, many ophthalmologists have a pamphlet in the office from the American Academy of Ophthalmology on floaters (it was added to the pamphlet list this year). -- ==================================================================== David Robins, M.D. Smith-Kettlewell Institute of Visual Sciences 2232 Webster St; San Francisco CA 94115 415/561-1705 {ihnp4,qantel,dual}!ptsfa!ski!dr The opinions expressed herein do not reflect the opinion of the Institute!