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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

The 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:

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© 2016 by Asia Pacific Academy of Ophthalmology