The impact of vitreous floaters on quality of life: a qualitative study

In this study we explore the quality-of-life impact of vitreous floaters, and identify all possible issues that may be relevant to a person experiencing floaters, with the aim to define the content of a floaters-specific patient-reported outcome measure, which can help determine the disease burden and benefit of treatment for a patient with floaters. Semi-structured telephone interviews were conducted with patients with floaters. The topic guide was based on an extensive literature review and expert opinion. Interview transcripts were coded into all possible quality-of-life issues that may be relevant to a person experiencing floaters. We grouped these into quality-of-life domains and subdomains, using an earlier framework of quality of life in other ophthalmic diseases. We categorized the patients’ reports (N = 44) into 11 quality-of-life domains: activity limitations, visual symptoms, ocular symptoms, general symptoms, health concerns, emotional well-being, social well-being, mobility issues, economic impact, inconveniences, and the need to use coping strategies. Vitreous floaters result in specific quality-of-life issues that have not been adequately measured with previous patient-reported outcome measures. When compared to other eye conditions, three previously unidentified issues stand out among patients with floaters: the effects of different lighting conditions, intermittent vision impairment caused by eye movements, and the importance of seeking understanding and support from healthcare providers. Eye care clinicians should recognize these issues when evaluating patients with floaters. The present patient-driven determination of relevant quality-of-life issues can guide initiatives in floaters-specific patient-reported outcome measures. Many people perceive moving spots in their vision (vitreous floaters), but not everyone is bothered by them. The impact of floaters is difficult to assess with clinical tests. Previous studies have used questionnaires or a small number of interviews to investigate quality of life, but these studies may not cover all relevant quality-of-life issues. With 44 interviews, we found that vitreous floaters can have a unique and previously unidentified impact on the quality of life of individuals with this eye condition, such as difficulties in daily activities, concerns about work, being bothered by bright light, and wanting their concerns to be taken seriously. Eye care clinicians should recognize these issues when evaluating a person who experiences floaters. To help weigh the quality-of-life impact of floaters and their treatments for each individual, a floater-specific questionnaire is helpful, but only if it is relevant, valid, and developed with patient input. The findings from this study can inform the development of a new floaters-specific questionnaire that covers a more complete range of relevant quality-of-life issues.