Warning sign you must not ignore – floaters or flies in your eye

Anyone, my age would remember the popular story of “The boy who cried wolf.” The tale goes like this. A young shepherd boy, alone and out in the fields tending the sheep, got bored. So, to get some kicks, he cried out loud, “Help! Help! Wolf! Wolf!” All the men in the village came out running to help him drive the wolf away to save the sheep.

To their consternation, they found out there was no wolf. They went away disappointed. “The next day, the boy shouted again at the top of his voice, “Help! Help! Wolf! Wolf!” Again, all the men ran out to help.

Alas, once again, there was no wolf! The boy had a good laugh! On the third day, a wolf actually did appear and when the boy again called for help, the villagers ignored his call believing that was it another false alarm and the sheep were eaten by the wolf.

When you notice something odd happening to your eye, would you call for help as soon as possible or would you prefer to wait, for fear of shouting wolf when, perhaps, there was no wolf? Let’s hear Edialo’s story.

My phone rang the first time. I was hesitant picking it. It was 4.30am. Even though wide awake and already at my laptop, it was an unholy hour to disturb anyone. Nevertheless, I picked up my handset after the second ring. “Good morning Dr Ben,” said Edialo at the other end. My heart almost missed a beat as I acknowledged his greetings.

This was about his fifth call in six months about seeing flies in his eye. I had repeatedly assured him they weren’t flies, but floaters. I had told him that in most cases they were harmless, but it was still necessary for him to visit an ophthalmologist for a dilated examination of his eyes. He never did because there was none near him in faraway, Zontiah.

I was surprised to see him the very next day at my office. Visibly worried, he hadn’t slept all night, “Dr Ben, please, go ahead and do all you can to get this fly out of my eye,” he had said. I smiled reassuringly and proceeded to examine him.

What are floaters and why do people worry about them? At a young age, the transparent gel within the eye, called vitreous humour, is uniform in consistency, but as one ages, it liquefies, but often not uniformly, leaving lumps and specks of varying sizes which move all over the place within the gel. These are called floaters and often referred to by some patients as cobwebs or flies depending on their shape or pattern.

Do they pose any danger to the eye? No! But their presence may be a warning sign that something else is happening or about to happen. When the floaters hit the retina (the inner coat of the eye) the retina emits light and the person may say he is seeing flashes of light. A sudden onset of new floaters or flashes of light may herald a retinal tear or detachment which requires immediate evaluation and treatment.

This occurs in only a small percentage of people and our main source of worry or concern is that we don’t always know who can follow with a retinal detachment until after an examination of the dilated pupil. Retina tears and detachment can lead to blindness if not attended to promptly.

Why do we have to dilate the pupil? It is because retinal tears and detachment often begin from the weakest part of the retina which is the periphery of the eye. Thus, without dilatation, these parts cannot be easily viewed with our instruments. To fail to identify the weak areas and treat them is to prepare for an outright detachment which may lead to blindness.

A Yoruba adage say, “When you see a bush rat running in broad daylight, it is either running away from something or there is something chasing it.”

Mr Edialo vision was normal in both eyes. Interestingly, even though he was complaining of floaters in just one eye, he had them in both eyes and the eye he felt at peace with had more trouble! Mr Edialo had a retinal tear and an early retinal detachment in his right eye. At this stage, further deterioration and blindness can be prevented.

The lesson here is, “cry wolf” several times if you suspect something unusual in your eye and leave it to the ophthalmologist to find out if there is indeed a wolf or not. After all, what are medical doctors for? They are there as much to preserve good health as to restore health.