Introduction
A vitreous detachment is a process in the eye in the course of which the vitreous body (also called corpus vitreum) detaches itself from the adjacent retina and is thus no longer connected to the back wall of the eye. The detachment can lead to varying degrees of visual impairment, which does not always have to be treated. Whether treated or untreated, regular checks of the ocular fundus by an ophthalmologist are indispensable.
Detection of a vitreous detachment
The shrinking of the vitreous body itself usually has no consequences for the affected person and often goes unnoticed. Some patients describe “wandering and floating shadows in the eye”, which are caused by the partially clumping connective tissue fibers. These hinder the incidence of light through the eye and are therefore perceived as disturbing, but are otherwise completely harmless.
They are also called mouches volantes, French for flying flies (also called “floaters” in English). They typically move along with the movement of the eyeball, but due to the gel-like consistency of the vitreous body they are slightly delayed, so that they sometimes become visible in the field of vision. Typical symptoms of vitreous detachment are listed below.
The classic symptoms by which those affected can often recognize the beginning of a vitreous detachment are, on the one hand, the increased and sudden appearance of “wandering and floating shadows in the eye”, also known as mouches volantes (French for flying flies). There is also an increased occurrence of vitreous opacities and vitreous hemorrhages, which become noticeable as shadows in the field of vision. These are variable in size and range from small dark spots to complete shadows of the visual field.
One also often speaks of the so-called “sooty rain”, which, following gravity, floats through the field of vision from top to bottom. The pull of the shrinking vitreous body can also cause flashes of light to be perceived at some points where it is connected to the retina. The mechanical stimulus is processed by the retina as a light stimulus and thus the patient has the impression of repeatedly perceiving small flashes of light.
These flashes can be intensified if the eyeball is moved quickly from one side to the other, thus increasing the tension of the vitreous body on the retina. The same effect can be caused by an abrupt acceleration or deceleration, for example in a car. Pain occurs rather rarely during a vitreous detachment.
Some patients report increased tearing of the eyes, an unpleasant foreign body sensation or even dizziness and headaches. All these symptoms and complaints are of course unpleasant, disturbing and irritating for the patient, but they are no cause for concern, as they disappear on their own during the course of the vitreous detachment, as soon as it has come to rest or has been completed. However, if a patient perceives the described light flashes more and more frequently, longer and more intensely, there is a suspicion that the vitreous body has damaged the retina and that a tear or even a beginning retinal detachment has occurred.
In this case an ophthalmologist should be consulted immediately. If the described mouches volantes, the round or ribbon-shaped shadows buzzing around, become increasingly noticeable in the field of vision, you should consult an expert ophthalmologist. He or she will first dilate the pupil with eye drops in order to have a better view of the eye and thus the vitreous body and the background of the eye.
With the help of the slit lamp, the doctor can now look into the patient’s eye and assess its condition. He will especially want to look at the fundus of the eye in order to exclude possible damage to the retina, which could be caused by the vitreous detachment. Furthermore, he can detect clouding, bleeding and minor retinal tears. This is usually enough to diagnose a vitreous detachment. Once it has been detected and there are no other secondary diseases, such as an accompanying retinal detachment, the course of the detachment must be checked by the ophthalmologist at regular intervals.
