The prevalence of floaters is reported to be 24% in those aged 50 to 59 years, but increases to 87% among those aged 80 to 89 years.1 Floaters can be extremely bothersome and interfere with daily activities, but most importantly, they can be a sign of a retinal tear or detachment especially if acute in onset and accompanied by photopsia.
Twenty years ago, I was pitching Wiffle balls to my younger son, Ryan, and unfortunately, did not follow the advice I give my patients regarding protective eyewear. I did not realize how hard a three-year-old could hit a Wiffle ball with an oversized bat, and I was struck at close range just below the left eye by the batted ball.
The next day, I developed floaters unaccompanied by photopsia in my left eye, but they were subtle, and like a typical physician I ignored them for a few days. I finally saw a dear friend of mine, a retina specialist, and was diagnosed with an inferior horseshoe tear.
I was treated with laser photocoagulation and subsequently developed two more retinal tears which were also treated. My retina specialist and friend told me to call him immediately if I noted any increase in floaters or if I developed photopsia and offered to charter a private plane and fly into see me immediately as he was leaving on a golf trip!
Bruce H. Kaplan, MD
Dr. Kaplan is chairman of the department of ophthalmology, Rosalind Franklin University of Medicine and Science in North Chicago, IL
1. Hollands H, Johnson D, Brox AC, Almeida D, Simel DL, Sharma S. Acute-onset floaters and flashes: Is this patient at risk for retinal detachment? JAMA. 2009;302:2243-2249. doi:10.1001/jama.2009.1714