PHARMACOLOGICAL THERAPIES

Before addressing the currently available solutions, we need to make one point clear: we are not aware of any pharmacological methodology which is in some way able to solve the problem of vitreous floaters. This firm statement mainly derives from our direct experience, but also from many months, if not years, of observations in the world of sufferers from floaters. Often the sufferer, so to say "reassured" by one or another ophthalmologist, looks to some medical methods for a solution to his/her problems: eye drops, tablets, cocktails of drugs and integrators, but also alternative therapies, based on the homeopathy or herbal remedies. Soon afterwards, alas, and after having spent much money, he or she will notice that the result is either nil or fairly small, so that it is not any better than the normal process of adaptation. In some cases the mass of floating bodies will get lighter, but it is difficult to say if this is to be attributed to a natural process rather than the effect of the medicine.

It is clear that, lacking serious scientific studies, it is not possible to give a definitive answer; what it certain according to us is that the effects of pharmacological treatments is negligible

Without describing specific products, we will illustrate herewith some of the drugs available for the treatment of floaters.

Eye Drops

Fundamentally the products available in this category are eye drops used as "anti-cataract", that is to say those eye drops that, to some degree, act to slow down the process of cataract formation This function, dubious to say the least and never truly confirmed by scientific experimentation, is supposed to operate by means of iodine-based substances, acting directly in the eye. Such substances would accelerate the metabolic processes, therefore favouring a process of "healing" of the degenerated vitreous. Often available without medical prescription, they sometimes contain other minerals and vitamins with an anti-oxidant action, so as to slow down the formation of free radicals.

Their function as anti-cataracts is debatable, and proof of this is the fact that the only concrete solution to the problem of cataract is still the surgical one, but some producers of these drugs have timidly begun to propose them as also capable of tackling the problem of the vitreous floaters (in a certain sense, floaters and cataract share some common initiation mechanisms). Moreover, even if the effectiveness of iodine-based substances were demonstrated, one would still have to address the problem of how eyedrops deposited externally on the eye surface could penetrate and reach the vitreous. As we have already pointed out, beside the non-toxicity of these eyedrops, studies proving the real effectiveness of such substances are lacking.

Integrators based on anti-oxidants

Another class of medicinal-integrators commercially available are based on the idea that floaters are often associated with aging of the entire organism and that therefore they can be delayed taking anti-oxidants, based on vitamins C and E as well as on beta-carotene, in conjunction with other substances able to limit the harmful effect of free radicals (which are often responsible for the degeneration of the collagen). These integrators are available as tablets and, we believe, it is still to be proven how a substance orally taken can reach the vitreous, practically one of the most isolated areas of the eye. The only possible process must be by osmosis, that is by means of very slow exchanges with the surrounding areas: in this way maybe, pills taken for many months could eventually promote the penetration of these substances in the vitreous. It is then still to be proven that these can really have a positive effect, considering the fact that the vitreous, as well as the crystalline lens, is naturally one of the organs with the most elevated concentrations of anti-oxidants in the entire body.

Moreover, practically none of medicines considered has a curative effect, that is one of restoration of the natural transparency of the degenerated vitreous: the effect of these integrators is often one of prevention.

Integrators based on hydration

This class of integrators act on the state of hydration of the vitreous. Dehydration often produces a degeneration of the vitreous and can even leads to a posterior detachment, both causes of vitreal opacities. For this reason, it is absolutely correct to promote the hydration of the vitreous, especially during summer months and in dry climates. The best hydrating action, though, is performed by water: ophthalmologists often advise to drink large amounts of water during the day. Such drugs are supposed to support the hydrating action of water, even if always in a preventive and never curative function.

Other pharmacological solutions

In this section, we briefly consider other possible solutions, some based on the so-called alternative medicine, without the presumption of being exhaustive.

Chinese medicine attributes the causes of ocular problems in “meridians” that pass through the liver and the colon, assuming that possible states of fatigue of the liver and the colon can be the cause of problems in the eyes: Chinese medicine advises to use medicinal herbs with a depurative function. Among these, the simultaneous ingestion for long periods of time of Marian thistle (also called milk thistle) and taraxacum should restore the correct functionality of the liver. Chinese medicine, moreover, also asserts that the floaters should disappear as a result of extended treatments based on these curative herbs.

Other solutions we have come across in years of observation are based on the combined use of multi-vitamin integrators and multi-minerals integrators, (mainly with vitamin C, vitamin E and beta-carotene, plus other specific minerals), along with substances based on black bilberry (aimed at improving the circulation of the retina), natural apple pectin and anti-oxidants.

Also, we have encountered remedies based on bio-flavonoids, for example extracted from vitis vinifera, or on magnesium-based integrators (being the vitreous rich in magnesium).

Obviously, such solutions are to be carefully evaluated, considering the general status of health of the patient and his/her tolerance to the substances contained in these integrators. What appears certain is that in order to observe any result, these substances should be taken for several months.. We must warn against generic multi-vitamin integrators: many patients have attributed the causes of their own floaters (or their increase) to these very integrators. Indeed, it seems than an excess of vitamin A or vitamin C can lead to the formation of floaters and often in generic multi-vitamin integrators, the doses of these two vitamins is higher than the daily recommended quantity.

conclusion, we once again point out that these notes absolutely do not intend to be definitive. Lacking specific studies, it is impossible to give a clear and precise judgment on what is really effective and what is merely a palliative: what is sure is that the idea we have formed on the subject is discouraging.

Perspectives

The outlook in this field is gloomy: the medical profession does not seem to show any real interest in finding a pharmacological solution to the problem of floaters and therefore, the patient finds himself with those few remedies that ophthalmologists are willing to prescribe, often after being hard pressed by the patients. At this point the patient, deprived of hope and realising the inefficiency of these integrators, often undertakes the search of possible alternative solutions, sometimes helped by the (non medical) experience of many other patients met on the Internet. In this way, do-it-yourself solutions abound: in the above we have only described some of the more common solutions that we have heard (and often tried on ourselves). Only one feature really links all these alternative treatments: their nearly total inefficiency. Faced with this situation, we feel once again the need to promote a change of mentality towards our condition from the medical profession and, equally important, from the patients themselves. There must be an increased awareness towards the inefficiency of pharmacological solutions: it is necessary to foster a critical mind and a greater knowledge towards the use of expensive treatment that are practically always ineffective.

Hence, once again, the task to shift the opinion of the medical profession and the public so that the state of disability caused by vitreous floaters and the absolute necessity of a non-invasive treatment are rightly recognised. In this sense, we wish to quote the studies on enzymes and the pharmacological vitrectomies. For years they have been carried forward by the most important institutes of research, both private and public, and it is not wrong to think that such studies could eventually produce some result also for the specific case of the vitreous floaters, even if it is premature to assert this with any certainty. It remains however a field of research that if supported by the interest of some investigators, could within a few years lead to the discovery of that non-invasive solution we are all waiting for. It is thus our task, now more than ever, to stimulate the interest of medical research, making our voice loud and clear.