Many people suffer from the phenomenon of mouches volantes, which stands for “flying flies” in French. In this, sufferers see black dots that appear to dance in front of their eyes. Mouches volantes is harmless, but disturbs the visual sensation. The symptoms often subside on their own after a while.
What is mouches volantes?
Mouches volantes is an entoptic phenomenon. This results from the anatomical conditions of the inside of the eye, but is subjectively localized in front of the eye in the outside space. Usually mouches volantes is used synonymously with vitreous haze. In the latter, shadows are cast on the retina. The affected person perceives them as short, long or crooked threads, as streaks floating through his visual field. Visual acuity is not affected.
Causes
There are several triggers of mouches volantes. One cause is thought to be Cloquet’s canal, which is the remnant of the receded hyaloid artery that supplies blood to the lens and vitreous. Eye and facial injuries as well as scratching and touching the eyes are among the other triggers. Here, the pressure on the eyeball that can result plays a crucial role. Blows to the eyes or head, for example, can dislodge particles from the vitreous. Ophthalmic and facial plastic surgeries are another risk factor that opacities of the vitreous can occur, for example, due to swellings that exert pressure on the eyes or release small particles from the vitreous. Oxidative changes in collagen fibers, hyaluronic acid or other components of the vitreous body can also promote mouches volantes. The reason for this are high-energy light rays, resulting in free radicals. If their activities accumulate, we speak of oxidative stress. Unhealthy diet is also associated with vitreous opacities. A healthy diet is very important, as a poor diet such as fast food, unsaturated fats, too much cholesterol, and too few essential vitamins and micronutrients lead to disorders in the eye and throughout the body. Various medications play another role in the development of mouches volantes, because the substances they contain cause changes in the chemical balance in the eye, for example psychotropic drugs and preparations for treating skin problems. Stress, high blood pressure, autoimmune diseases, hemorrhage, and foreign bodies are other possible causes of “flying gnats.”
Symptoms, complaints, and signs
With mouches volantes, sufferers see small threads, dots, worms, or spots in front of the eye, especially when looking at a light-colored background, such as a white wall, computer screen, or sky. Others cannot see them. Nevertheless, the mouches volantes are not imagination or optical illusion. They actually exist. However, they do not fly in the room, but float in the eye. The apparitions move as if they “swim” in front of the visual field. At the same time, the mouches volantes move with you when you change your gaze to another direction. They cannot be fixed in order to look at them more closely, for example. The more attention is paid to the disorder, the more unpleasant it is usually experienced.
Diagnosis and course of the disease
Before the therapy of mouches volantes, the anamnesis, the detailed conversation between the doctor and patient, plays an important role. What is the history of the disease? What does the affected person see when he looks at a white wall? How long have the symptoms been present? Have there already been treatments or operations on the eye? Are there any diseases, for example metabolic disorders or autoimmune diseases? Are medications taken regularly? These questions can give a clue. In addition, visual acuity is determined, intraocular pressure is measured and a retinal scan is performed. With the latter method, the doctor can visualize the vitreous opacity very well. In order to be able to look into the eye better, the doctor administers eye drops in advance, which dilate the pupil. Only rarely are examinations such as X-rays, ultrasound, magnetic resonance imaging or computer tomography used if the vitreous clouding cannot be clearly determined. Mouches volantes are basically harmless. However, those who focus on them or suffer from very many “flying gnats” may be very disturbed by them.The symptoms disappear all by themselves in the course of life, because the fibers move away from the retina, so that sooner or later they are no longer visible to the eye. The appearances become blurrier and fainter over time.
Complications
As a result of mouches volantes, affected individuals see dots and worms in their visual field that do not appear in reality. This significantly reduces and limits the quality of life of those affected. Even everyday activities can no longer be carried out without difficulty, resulting in a reduced ability to cope with stress on the part of the patient. Not infrequently, mouches volantes also lead to disturbances in concentration and coordination. In the worst case, mouches volantes can also cause patients to lose consciousness or to underestimate or misjudge certain dangers. Furthermore, it is not uncommon for patients to experience blurred vision and be unable to perform ordinary tasks. Also the daily work of the affected person is limited by this disease in most cases. The further course of this disease depends strongly on its cause and on possible interventions on the eyes that have taken place before. In most cases, however, self-healing occurs. Only in severe cases eye drops are necessary. Furthermore, without treatment, complete blindness of the affected person may occur. The therapy can take place with the help of a laser and limit the symptoms. In this case, too, there are usually no particular complications.
When should one go to the doctor?
Mouches volantes are not initially a reason to see a doctor. Almost everyone notices them in the course of his life, especially with higher myopia they occur quite regularly. They occur because of the formation of irregularities in the fluid of the vitreous body of the eye. In this fluid there are collagen fibrils, which are mostly dissolved, but they can also combine into small threads and clumps. This results in mouches volantes. They are pathological if they are seen very frequently or constantly as a result of damage to the eye and in particular to the vitreous humour, or if they can be seen even when the eye is closed. A doctor should be consulted if more mouches volantes are noticed than before, their size and shape appear different, they take on different colors or move differently than before. This may indicate vitreous haze and it needs to be investigated where it is coming from. If, in addition to the mouches volantes, more or less large, coarse, dark spots, a foggy haze or streaks like on a dirty window are noticed in the field of vision, or bright flashes, this may indicate bleeding in the eye or retinal detachment. These symptoms indicate an emergency and need medical attention as soon as possible, even if they do not cause pain.
Treatment and therapy
Unfortunately, the best option against mouches volantes is just to get used to them and not to get irritated. To the certain extent, the brain is also able to block out this perception. A specific treatment concept is not yet available to patients. If the mouches volantes lead to a deterioration of visual acuity, which is extremely rare, or if a retinal detachment occurs, surgery can be performed if necessary, the so-called vitrectomy. Detachment can lead to blindness, but this is also extremely rare. During the operation, the central part of the vitreous body is removed together with the opacities. Vitrectomy is a serious procedure that may involve total loss of the eye as a complication. Another option is thermal disruption of the vitreous opacities with a YAG laser. However, the changes may not be close to the lens or retina. This method is gentler compared to surgery, but does not have the same success rates. In addition, new mouche volantes may develop as a result of the blasting.
Outlook and prognosis
The prognosis is very good for mouches volantes. The symptoms associated with vitreous opacification usually improve over time, even without therapeutic measures. The “flying gnats” often disappear completely as the vitreous and fibers gradually move away from the retina over time.As a result, the triggering irregularities in the vitreous fluid also shift out of the visual axis and thus out of the field of vision. However, this can take several months to years. Nevertheless, the eyes and vision should be checked regularly by an ophthalmologist. This is especially true if the “flying gnats” suddenly appear in swarms and in conjunction with lightning. This can be a sign of a retinal defect, which can lead to a retinal detachment via a retinal tear. On the other hand, a surgical procedure such as vitrectomy is associated with possible risks. For example, retinal holes can occur in 12 to 30 percent. Retinal tears and infections with the threat of blindness are also possible in rare cases. In addition, retinal detachment occurs in about 2.5 percent of operated patients. In addition, lens opacities appear in many patients who have undergone surgery.
Prevention
First of all, a healthy and balanced diet is basically indispensable, not only to prevent mouches volantes, but for the whole organism. In addition, to prevent vitreous haze, do not engage in sports that involve a risk of injury to the eyes. Anything that puts pressure on the eyes should be avoided. Excessive eye rubbing is also one of them.
Aftercare
In most cases, very few measures of direct aftercare are available to the affected person in the case of mouches volantes. For this reason, the affected person should contact a physician at an early stage so that complications or other complaints do not arise in the further course. As a rule, self-healing cannot occur with mouches volantes. To prevent complete blindness of the affected person, the patient should consult a doctor at the first symptoms and signs of the disease. In most cases, this disease requires surgical intervention to alleviate and limit the symptoms. In this case, the affected person should take it easy and rest after the operation. Efforts or stressful activities should be avoided in order not to put unnecessary strain on the body. Regular checks by a doctor after the procedure are also very important, and the affected region should be particularly well protected. Further aftercare measures are usually not available to the affected person. The disease does not reduce the life expectancy of the affected person in the process.
What you can do yourself
Mouches volantes cannot be treated causally so far. Mild discomfort decreases on its own after a certain period of habituation. Those affected should consult an ophthalmologist and work out a therapy together. In the best case, the brain is able to fade out the perceptual disturbances on its own. Since no specific treatment concept is available yet, the most important measure is to work through the symptoms and learn to ignore them. In severe cases, the visual disorder can be corrected surgically. After such an operation, the eyes must be spared. Especially in the first days and weeks, the patient must not expose his eyes to major stimuli such as direct sunlight, cold or heat. Contact with harmful substances should also be avoided if possible. A healthy diet can additionally support recovery. The patient should also avoid jerky movements to prevent the suture from tearing. Similar measures apply after laser treatment. Since mouche volantes may recur, the patient should have regular ophthalmologic examinations after treatment is completed. If visual disturbances recur, treatment must be resumed immediately.