Eye Care Blog

In another case that came to my attention, a man returning from Europe was looking at some white clouds one day when eye floating specks appeared before his eyes. He consulted the ship’s doctor, who told him that the symptom was very serious and might be the forerunner of blindness. It might also indicate incipient insanity, as well as other nervous or organic diseases. He was advised to consult his family physician and an eye specialist as soon as he landed, which he did.

This was twenty-five years ago, but I shall never forget the terrible state of nervousness and terror into which the man had worked himself by the time he came to me. It was even worse than that of the clergyman, who was always ready to admit that his fears were unreasonable. I examined this man’s eyes very carefully and found them absolutely normal. The vision was perfect for both the near-point and the distance. The color perception, the fields, and the tension were normal, and under a strong magnifying glass I could find no opacities in the vitreous. In short, there were absolutely no symptoms of any disease.

I told the man there was nothing wrong with his eyes, and I also showed him an advertisement for a quack medicine in a newspaper, which gave a great deal of space to describing the dreadful things likely to follow the appearance of eye floating specks before the eyes unless one began betimes to take the medicine in question at one dollar a bottle. I pointed out that the advertisement, which was appearing in all the big newspapers of the city every day, and probably in other cities, must have cost a lot of money and must therefore be bringing in a lot of money. Evidently there must be a great many people suffering from this symptom, and if it were as serious as was generally believed, there would be a great many more blind and insane people in the community than there actually were.

My patient went away somewhat comforted, but at eleven o’clock—his first visit had been at nine—he was back again. He still saw the eye floating specks, and was still worried about them. I examined his eyes again as carefully as before, and again was able to assure him that there was nothing wrong with them. In the afternoon I was not in my office, but I was told that he was there at three o’clock and at five. At seven he came again, bringing with him his family physician, an old friend of mine. I said to the latter:

“Please make this man stay at home. I have to charge him for his visits, because he is taking up so much of my time, but it is a shame to take his money when there is nothing wrong with him.”

What my friend said to him I don’t know, but he did not come back again.

I did not know as much about muscae volitantes then as I know now, or I might have saved both of the men just described a great deal of uneasiness. I could tell them that their eyes were normal, but I did not know how to relieve them of the symptom, which is simply an illusion resulting from mental strain. The specks are associated •to a considerable extent with markedly imperfect eyesight, because persons whose eyesight is imperfect always strain to see; but persons whose eyesight is ordinarily normal may see them at times, because no eye has normal sight all the time. Most people can see muscae volitantes when they look at the sun or any uniformly bright surface, such as a sheet of white paper upon which the sun is shining. This is because most people strain when they look at surfaces of this kind.

The specks are never seen, in other words, except when the eyes and mind are under a strain, and they always disappear when the strain is relieved. If one can remember a small letter on a test card by central fixation, the specks will immediately disappear or cease to move, but if one tries to remember two or more letters equally well at one time, they will reappear and move.

Usually the strain that causes muscae volitantes is very easily relieved. A schoolteacher who had been annoyed by these appearances for years once came to me because the condition had recently grown much worse. In half an hour I was able to improve her sight, which had been slightly myopic, to normal, whereupon the specks disappeared. Next day they came back, but another visit to the office brought relief. After that the teacher was able to carry out the treatment at home, and had no more trouble.

A physician who suffered constantly from headaches and muscae volitantes was able to read only 20/70 when he looked at the test card, while the retinoscope showed mixed astigmatism and he saw the specks. When he looked at a blank wall, or a blank white card, the retinoscope still showed mixed astigmatism and he still saw the specks. But when he remembered a black spot as well as he could see it, when looking at these surfaces, there were no specks, and the retinoscope indicated no error of refraction. In a few days he obtained complete relief from the astigmatism, the muscae volitantes, and the headaches, as well as from chronic conjunctivitis (inflammation of the conjunctiva of the eye). His eyes, which had been partly closed, opened wide, and the sclera became white and clear. He became able to read in trains with no inconvenience, and—what impressed him more than anything else—he also became able to sit up all night with patients without having any trouble with his eyes the next day.

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