Sunday 1 December 2013

Muscae Volitantes (Floater) - Treatments In conventional medicine perspective

Muscae volitantes or Floater is defined as a condition of pathol moving black specks or threads seen before the eyes, as results of opaque fragments floating in the vitreous humour or a lens defect due to degeneration of the vitreous humour.  Floater as it suspends in the vitreous humour, it tends to drift  and follows the rapid motions of the eye as a result of damage of the eye that causes material to enter the vitreous humour.
VI. Treatments
A. In conventional medicine perspective
Treatment is not necessary, if the diagnosis indicated that the floater is harmless and will do causes nay damage to the eye vision, but in severe case, the following may be recommended
1. Vitrectomy
In the study to  to evaluate the role of pars plana vitrectomy (PPV) in patients with persistent vitreous floaters (VF) in phakic (56.7 %) or pseudophakic (43.3 %) eyes, Dr. Roth M, and the research team at the Universitätsspital Bern, showed that PPV to be a safe and effective primary treatment for visually disturbing VF. In spite of the small number of cases with a lower PVA (5 eyes/16.7 %), which in the most severe case corresponded to a reduction of VA from 1.0 to 0.6 due to a nuclear sclerosis of the lens, all patients were satisfied. As vitreoretinal complications may occur, a critical patient selection and a careful preoperative assessment of specific risks of vitrectomy are mandatory(28).
2. Laser vitreolysis
Dr. Y M Delaney and the research team at The Department of Ophthalmology Stoke Mandeville Hospital Aylesbury Buckinghamshire, in the study of Nd:YAG vitreolysis and pars plana vitrectomy: surgical treatment for vitreous floaters, indicated that Patients’ symptoms from vitreous floaters are often underestimated resulting in no intervention. This paper shows Nd:YAG vitreolysis to be a safe but only moderately effective primary treatment conferring clinical benefit in one third of patients. Pars plana vitrectomy, while offering superior results, should be reserved for patients who remain markedly symptomatic following vitreolysis, until future studies further clarify its role in the treatment of patients with floaters and posterior vitreous detachment(29).
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