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Subjective Grading of Subclinical Vitreous Floaters

Tassignon, Marie-José MD, PhD; Ní Dhubhghaill, Sorcha MB, PhD; Ruiz Hidalgo, Irene MSc; Rozema, Jos J. MSc, PhD

Asia-Pacific Journal of Ophthalmology: March/April 2016 - Volume 5 - Issue 2 - p 104–109
doi: 10.1097/APO.0000000000000189
Original Clinical Study

Purpose: This study aimed to objectively grade the perception of subclinical floaters in an asymptomatic cohort.

Design: A prospective observational cohort study.

Methods: One hundred eighty-two volunteers (49 men, 133 women) with ages ranging from 17.7 to 78.6 years were recruited for floater assessment. Participants were assessed by a light box and by vitreoscope, after which they graded the floaters using a graphic classification system. They also completed a questionnaire to estimate the impact of floaters on daily life. In addition, biometric and refractive data were documented for all participants.

Results: Using the light box method, 67.6% of participants reported seeing transparent floaters, which increased to 84.1% when using the vitreoscope. Opaque floaters were seen by 15.9% (light box) and 6.5% (vitreoscope). Reported levels of floater discomfort varied between participants, with 80.2% of participants reporting no discomfort and 6.6% reporting moderate to manifest discomfort. The perceived discomfort was weakly correlated with the amount of visualized floaters (light box: Pearson r = 0.323, P < 0.001; vitreoscope: r = 0.174, P < 0.001). Both floater perception and discomfort increased with age (r = 0.203, P = 0.006; r = 0.194, P = 0.009, respectively), although neither changed with axial length or refraction (P = 0.131, P = 0.070, respectively).

Conclusions: The light box and the vitreoscope demonstrate that subclinical floaters are very common, even in nonsymptomatic subjects. The amount of perceived floaters in this cohort correlates only weakly with floater-related discomfort.

From the *Department of Ophthalmology, Antwerp University Hospital, Edegem; and †Department of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium.

Received for publication July 17, 2015; accepted December 23, 2015.

The authors have no funding or conflicts of interest to declare.

Reprints: Marie-José Tassignon, MD, PhD, Department of Ophthalmology, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium. E-mail:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

© 2016 by Asia Pacific Academy of Ophthalmology