Dear Dr. Roach: I am a 67-year-old male with generally good vision. I have had a few floaters in my eyes over the years, but they have generally been small and have not significantly affected my vision. However, about six months ago, I suddenly had a large floater appear in one of my eyes that did affect my vision; it is right in the center of my field of vision and is very distracting.

I had a checkup with my optometrist soon after, and she said there were no major issues with my eye. She said that my brain would adjust to the floater so I would not notice it as much. However, six months later, I still find it very distracting. I frequently have to move my eye to try and get it out of my center vision so I can see clearly. Are there any treatments that can be done to remove distracting floaters?

— D.H.

Answer: “Floaters” are bits of cellular debris in the vitreous humor, which is the gel-filled space in between the lens and the retina. Sudden appearance of floaters can represent serious eye disease, such as a detached retina, so it was wise to get an evaluation when you noticed a sudden change.

The eye does not have a way to remove floaters, so you will have them as long as you live unless you do something about it. As your optometrist said, they don’t bother most people; however, several of my readers over the years have been so bothered by floaters that they have undergone surgical vitrectomy. This is the removal of all the gel material from the vitreous cavity, including all (or nearly all) of the vitreous opacities that cause floaters. Published complication rates with this procedure are less than 1% in experienced hands.

I have also read about using a laser to break up large floaters into smaller (and presumably easier-to-ignore) pieces, but I have no personal experience with this. In addition, the literature is mixed.

Dear Dr. Roach: I was diagnosed with sleep apnea decades ago. While I was not obese, I was a little overweight at the time and made a commitment to eat better. I lost 10-20 pounds, and I’m down to under 250 pounds at 6 feet, 1 inch tall. Voila, my sleep apnea was cured! I kept the weight off and never snored since.

While you note the connection between excess weight and sleep apnea, I didn’t see any mention of weight loss as a cure. Is it really this easy, or was I just lucky?

— D.K.

Answer: Weight loss is effective at treating sleep apnea in many people. However, losing and keeping the weight off in the long-term is very hard for most people. The GLP-1 drug tirzepatide (Zepbound) was recently approved for obstructive sleep apnea in people who are obese, in combination with a healthy diet and physical activity. GLP-1 agonists are quite effective at helping people lose weight and keeping the weight off (as long as the person keeps taking the medication).

It’s critical to note that not everyone with obstructive sleep apnea is obese. Some people just have the anatomy in the back of their throats that makes sleep apnea more likely, despite having a normal weight. Weight loss may not help them at all in these cases.

Contact Dr. Roach at ToYourGoodHealth@med.cornell.edu.