Vitreous opacity

Vitreous opacification: description

Many people suffer from vitreous opacities in the eye and the associated “mouches floaters”. The reason for this is a natural aging process. Therefore, about two-thirds of 65- to 85-year-olds complain about complaints. But even younger people can be affected, especially if they are very short-sighted.

The gelatinous vitreous fills in most of the eyeball inside. In front of him lies the lens, which optically breaks the rays of light coming into the eye. These then pass through the vitreous body to the retina (retina). It lies behind the vitreous body and, as a photosensitive layer of nerve cells, is responsible for converting the optical images into electrical impulses. So the information about the optic nerves can be forwarded to the brain.

The vitreous consists almost entirely of water. Only two percent of its mass are collagen fibers and hyaluronic acid. Normally, all components of the vitreous are strictly arranged. They have a transparent effect and hardly affect the light rays on their way to the retina. Only when the arrangement changes, there is a vitreous opacity with impaired vision.

Vitreous opacification: symptoms

A vitreous opacification manifests itself most often by so-called “mouches floaters”. In German, this means something like “flying flies”, in German, the term “dancing mosquitoes” is used. Because insects dancing in front of the eye usually describe the dark or semi-transparent dots, stripes or streaks that they perceive. This is not a hallucination. The forms actually exist in the vitreous body.

“Flying mosquitoes” do not limit the eyesight and are usually harmless. Nevertheless, many patients complain that the subjective perception of vision deteriorates. As a result, the vitreous opacification is perceived as annoying. On the one hand, the cloudiness and shadow vary in their strength and position. On the other hand, stray light can dazzle patients.

Especially when patients with a glassy opacity on a bright wall or in bright light or are blinded by snow, they perceive the Mouches volantes.

Vitreous opacification: causes and risk factors

The vitreous body that fills the interior of the eye consists mainly of water and a small amount of collagen fibers and hyaluronic acid. In childhood, the fibers are regularly arranged so that they are not perceived. As you age, the vitreous shrinks and the fibers lose their structure. They are now increasingly disorderly and resemble filaments or even form two-dimensional structures.

If the vitreous body continues to shrink in old age, it eventually loses contact with the retina. Then he oscillates lazily with eye movements. This allows the threads and streaks to come into focus. They then cast shadows on the retina, where the patient recognizes the small shadows and shapes.

Over the course of months, the fibers increasingly remove themselves from the retina. They are then perceived fuzzier and weaker, until at some point they are no longer perceptible.

The most important risk factor for the development of vitreous opacity is age, as it is usually an age-related process. Frequently, shortsighted people notice the “flying mosquitoes” slightly earlier than normal or farsighted.

Vitreous opacification: examinations and diagnosis

If for the first time you see something that does not exist outside of your eye, contact your ophthalmologist. It can be a harmless vitreous opacification, but also a different disease. To find out, your ophthalmologist will first ask you in detail about your medical history (anamnesis). Before examining the eye, he asks you the following questions:

• What do you see when you look at a white wall, for example?
• When did you first realize that you are seeing flying mosquitoes or black spots?
• Did the symptoms suddenly start or did they suddenly get worse?
• Are they individual spots and streaks that you see, or are they more sooty and snowstorms?
• Are you aware of flashes of light?
• Are you short-sighted?
• Did you have a retinal detachment on the other eye in the past?

Examination of the eye in suspected vitreous opacity

To better look into your eye, your doctor will first administer eye drops that dilate the pupil. With a bright lamp, the so-called slit lamp, your doctor lights up from the side into your eye and looks at the individual components through a magnifying glass. So he can judge these by their appearance. If you have a vitreous opacity, you may recognize them as dark shadows. This examination is painless and uncomplicated. Due to the eye drops given, vision may be limited for a few hours. Therefore, you should give up until the effect on driving declines.

If the slit lamp examination does not clearly diagnose vitreous opacification or the history of the disease is inconclusive, other investigations may be carried out. These include:

• Ultrasonic
• roentgen
• Computed Tomography
• MRI

Above all, ultrasound is used to detect or rule out retinal detachment. The other methods help to rule out that a foreign body in the eye causes symptoms such as a glassy turbidity.

What else could it be?

In addition to the diagnosis of “vitreous opacification”, other diseases with similar symptoms are also considered. Above all, a retinal detachment or a retinal tear must be differentiated from the opacification of the vitreous, as these require immediate action. In a retinal tear, the symptoms usually appear suddenly. Those affected then perceive flashes of light and often describe the phenomena that they see as soot rain.

In addition, diseases such as inflammation of the middle eye skin (uveitis) or vitreous humor bleeding in question.

Vitreous opacification: treatment

If your doctor has detected a vitreous opacification in your body, usually no further treatment is necessary. Although the “floaters” may be very disturbing for the patient, they are harmless and often disappear on their own.

Nevertheless, there are therapy options in the case of a vitreous opacification, such as a vitreous body removal. This is referred to medically as a vitrectomy. The glass body of the eye is removed and filled the space with a liquid or a gas. However, the majority of ophthalmologists advise against this treatment for vitreous opacification, as the risks are usually greater than the benefits. Vitreous removal may result in blindness, for example, if it causes a retinal tear or infection. The risk of developing retinal holes in vitrectomy is between 12 and 30 percent. In addition, after surgery in many patients to a lens opacity.

In contrast to other eye diseases, laser therapies have not gained acceptance in the treatment of floaters and are not recommended.

These tips can help alleviate the symptoms

Doctors advise patients with vitreous opacification to ignore the symptoms as much as possible. In addition, there are some things you can do yourself to alleviate the discomfort:

• Wear sun glasses with high light protection (85 percent) on bright sunny days or in the snow.
• Avoid white or very bright walls in your own home. Textured wallpaper or muted colors distract the eye more.
• Many decorative elements in the home such as flowers, bookshelves or pictures are useful.
• If you spend a lot of time on the computer, reduce its brightness and choose the contrast as it pleases you.
• Especially short-sighted patients are helped by self-tinting lenses. These darken within seconds when exposed to glaring light.

Vitreous opacification: disease course and prognosis

A vitreous opacification usually does not require further treatment by a doctor, and the symptoms improve over time. The floaters often disappear completely and completely by themselves. However, this can take up to several years. Gradually, the “flying mosquitoes” that the patients see become less, as the fibers as well as the entire vitreous body move away from the retina and thus are less in the field of vision.

Have your eyes checked by an ophthalmologist on a regular basis, as there are some medical conditions that can only be detected by examination and sometimes go unnoticed by the patient. As a general rule, you should consult an ophthalmologist the first time you see floaters. This can tell you whether it is a harmless vitreous opacification or not. In about 15 percent of cases, the first appearance of floaters is a retinal tear. You should also go to the doctor if you suddenly see flying mosquitoes in swarms or dense soot. These can speak as well as flashes of light for a threatening retinal detachment and against a simple one Vitreous opacity.