Vitreous opacity: Description
Many people suffer from vitreous opacities in the eye and the associated “mouches volantes”. The cause is a natural aging process. About two thirds of the 65- to 85-year-olds complain about corresponding complaints. But younger people can also be affected, especially if they are severely nearsighted.
What is the vitreous body?
The gelatinous vitreous body fills most of the inside of the eyeball. In front of it lies the lens, which optically refracts light rays entering the eye. These then pass through the vitreous body to the retina. It lies behind the vitreous body and, as a light-sensitive layer of nerve cells, is responsible for converting the optical images into electrical impulses. This allows the information to be transmitted to the brain via the optic nerves.
Vitreous opacity: symptoms
“Flying gnats” do not limit visual acuity and are usually harmless. Nevertheless, many patients complain that the subjective visual sensation worsens. As a result, vitreous haze is perceived as a nuisance. On the one hand, the opacities and shadows vary in their intensity and location. On the other hand, stray light can cause severe glare to patients.
Mouches volantes may be most noticeable when patients look at a bright wall or into bright light or are blinded by snow.
Vitreous opacification: causes and risk factors
The vitreous humor, which fills the inside of the eye, is composed mainly of water and, to a lesser extent, collagen fibers and hyaluronic acid. In childhood, the fibers are regularly arranged so that they are not noticed – they hardly influence the light rays on their way to the retina.
Over the course of months, the fibers become more and more distant from the retina. They are then perceived more blurred and weaker, until at some point they are no longer perceptible at all.
Age is considered the most important risk factor for the development of vitreous haze, as it is usually an age-related process. Often nearsighted people notice the “flying gnats” a little earlier than normal or farsighted people.
Vitreous opacity: examinations and diagnosis
If this is the first time you have seen something that does not exist outside your eye, contact your eye doctor. It may be a harmless vitreous clouding, but it may also be another condition. To find out, your eye doctor will first ask you in detail about your medical history (anamnesis). Possible questions are:
- What do you see when you look at a white wall, for example?
- When did you first become aware that you were seeing “flying gnats” (black dots)?
- Did the symptoms appear suddenly or did they suddenly increase?
- Do you perceive flashes of light?
- Are you nearsighted?
- Have you had any injuries, inflammations or operations (cataract surgery, retinal laser treatment) on your eyes?
- Have you had a retinal detachment in the other eye in the past?
Examinations
To get a better look into your eye, your doctor will first give you eye drops that dilate the pupil. Then comes a slit lamp examination: using a bright lamp called a slit lamp, your doctor shines a light into your eye from the side and looks at the individual components through a magnifying glass. If there is vitreous haze, he or she will see dark shadows. The slit lamp examination is painless and uncomplicated.
Due to the pupil-dilating eye drops, your vision may be impaired for a few hours. Therefore, you should refrain from driving until the effect has worn off.
Differential diagnoses
If slit lamp examination does not clearly diagnose vitreous opacification or if the medical history is not completely conclusive, further examinations must clarify whether other causes could be responsible for the symptoms (differential diagnoses):
X-rays, computed tomography (CT) or magnetic resonance imaging (MRI) can be used to determine whether a foreign body in the affected eye may be causing symptoms of vitreous clouding.
Other possible differential diagnoses of vitreous opacification include inflammation of the middle eye skin (uveitis) and vitreous hemorrhage.
Vitreous opacification: Treatment
As a rule, no therapy is necessary for vitreous haze. Although the “mouches volantes” are perceived as disturbing by many affected persons, they are harmless and often disappear on their own. Until then, the symptoms can be alleviated with a few tips (see below).
Laser therapies are also not recommended for mouches volantes treatment.
These tips can help relieve symptoms
Doctors advise patients with vitreous haze to ignore the symptoms as much as possible. In addition, there are things you can do yourself to help alleviate the symptoms.
- Wear sunglasses 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 wall colors are more distracting to the eye.
- Many decorative elements in the home such as flowers, bookshelves or pictures are useful.
- If you spend a lot of time at the computer, reduce its brightness and choose the contrast that is comfortable for you.
- Self-tinting lenses are especially helpful if you have severe nearsightedness. These darken within seconds when exposed to bright light.
Vitreous opacity: course of the disease and prognosis
Nevertheless, if you experience mouches volantes for the first time, you should see an ophthalmologist. The ophthalmologist can determine whether it is actually a harmless vitreous opacity or whether there is a more serious cause behind the symptoms.
Also, if “flying mosquitoes” suddenly appear in swarms or you see dense sooty rain, you should urgently see an ophthalmologist. These symptoms as well as flashes of light can speak for an impending retinal detachment and against a simple vitreous clouding.
