The floaters usually settle with time, but sometimes they persist. Patients can be reassured that the floaters are not harmful (once retinal tears and detachment have been excluded). Floaters can be treated by vitrectomy if patients find them especially intrusive, but this is not necessary for the vast majority of patients.
Always provide (and document) a ‘retinal detachment warning’, advising patients to present immediately if they develop new flashes, increasing floaters or, most importantly, an enlarging peripheral visual field defect.
Please refer patients with a few longstanding vitreous floaters routinely. Alternatively, they could see their regular optometrist, with a request to dilate the pupil and check the peripheral retina.
Please refer patients with an acute onset of floaters or photopsia the same day, or first thing next morning if they present late evening.