Salah Zuhair Al-Asadi
MB,ChB, FRCS, FIBMS, Lecturer of Ophthalmology, College of Medicine, University of Basrah.

Floaters and photopsia are common eye symptoms. This prospective study aims to detect the relative importance of floaters, photopsia, or both as predictors of vitreo-retinal pathology.
In this study, 202 patients attending the outpatient clinic in Basra General hospital between 2009–2011 complaining of floaters, photopsia, or both were interrogated, starting with inquiry about the mode of presentation, then slit lamp examination of the anterior segment, and dilatation of the pupil by mydriacyl drops 0.5% and phenylphrine drops 10%, followed by 3 mirror examination of the vitreous and peripheral retina.
The results showed that 98 patients were males while 104 patients were females, 104 patients (51.49%) presented with floaters; 24 patients (11.88%) presented with photopsia; and 74 patients (36.63%) presented with both floaters and photopsia, 102 patients (50.50%) had posterior vitreous detachment (PVD) while 52 patients (25.74%) had synchysis, and 48 patients (23.76%) had normal vitreous. The highest percentage of PVD was in the age group 60–69 years and was 40 patients (39.21%). Regarding the mode of presentation, the highest percentage of PVD was in the group of patients presenting with both floaters and photopsia and was 46 patients (62.16%). The total number of retinal tear cases detected was 14, 8 of them were present in patients having PVD and presenting with floaters and photopsia, while 4 cases of retinal tears were detected in patients having PVD and presenting with floaters, and finally 2 retinal tear cases were detected in patients having PVD and presenting with photopsia, 12 eyes (85.71%) who had retinal tears had vitreous pigment granules, while 2 eyes with retinal tears (14.29%) did not have vitreous pigment granules.
In conclusion, the symptoms of floaters, photopsia, or both are an important predictors of vitreo- retinal pathology. A significant number of patients had PVD, and this was associated with retinal tears in a number of patients. Vitreous pigment granules in these patients were closely correlated with the presence of retinal tears. Careful examination of patients including 3 mirror contact lens examination is mandatory.