Posterior vitreous detachment is a normal symptom of old age: around three quarters of people over the age of 60 are affected. Very often it remains completely asymptomatic. Sometimes, vitreous detachment can cause dust-like or cobweb-like phenomena, flashes of light or clouding of vision due to small bleedings.
Below you will find further information and specialists for the treatment of vitreous detachment.
Vitreous opacities, flashes of light or clouding of vision are not usually dramatic. In the case of vitreous detachment, the vitreous body separates from the retina. If this causes tears in the retina, the retina can detach. From an ophthalmological point of view, this is an emergency.
A vitreous detachment is usually age-related and often occurs from theage of 65@ Syda Productions / AdobeStock
Increased occurrence of vitreous opacities
In the form of small, semi-transparent dust-like or cobweb-like phenomena (mouches volantes). Larger "lumps" in the visual field are also possible.
As they follow all movements of the eye, they are mobile, and if you try to fixate them, they seem to scurry away. If you focus your gaze on something else, they move closer again.
Opacities that lie directly in the optical axis are particularly annoying because they appear in the center of the visual field. Depending on their size, they affect vision to a greater or lesser extent.
Flashes of light
In most cases, the detached vitreous body is still partially connected to the retina. Eye movements, changes in the position of the head or acceleration/deceleration of the head can then trigger flashes of light.
Opacities due to bleeding
If the connection between the vitreous body and the retina breaks, small blood vessels can burst. These small hemorrhages cloud vision because tiny dark spots ("soot rain") appear.
Larger hemorrhages lead to larger losses in the field of vision. These opacities usually disappear after a few days. Therefore, they are usually not serious.
Nevertheless, if such symptoms occur, you should see a registered doctor as soon as possible. To rule out retinal tears, retinal holes or retinal detachment.
The reason for vitreous detachment is usually age-related shrinkage of the vitreous body. Another reason for vitreous detachment is pathological myopia (rare and severe form of short-sightedness).
As a gel-like substance, the vitreous body (corpus vitreum) fills most of the eyeball. It consists of 98 percent water. Hyaluronic acid, a substance similar to gelatine, is responsible for its gelatinous consistency and can bind extremely large amounts of water. The vitreous body also contains finely distributed connective tissue fibers.
Cross-section of the human eye @ Henrie / AdobeStock
The outer boundary of the vitreous body is formed by a thin layer of connective tissue, the vitreous limiting membrane. Connected to the eyeball in several places, it adheres more or less firmly to some points of the retina.
The fact that the vitreous body shrinks over time is due to localized liquefaction of the hyaluronic acid aqueous gel. A similar shrinkage can be observed with gelatine-containing foods, for example. After the liquid has drained away, the vitreous body volume decreases.
As a result, clumped connective tissue fibers can cast shadows on the retina in bright light (mouches volantes).
With short-sightedness, the eyeball is usually too long. An eyeball that is too long increases the effect of vitreous shrinkage. From around -6 diopters and with progressive short-sightedness, vitreous detachment can also occur at a younger age.
Myopia is increasing at an alarming rate worldwide.
If vitreous detachment is suspected, the first step is to examine the back of the eye to rule out retinal damage. You will be given special eye drops that dilate the pupil. The ophthalmologist then examines the vitreous body and the retina using a slit lamp microscope. The specialist will diagnose opacities, hemorrhages and retinal tears.
Vitreous detachment usually does not require acute treatment. However, you should observe it in any case. We recommend that you make another appointment with your practicing ophthalmologist after about 6 weeks.
You should act quickly in the event of retinal detachment or retinal tears:
Laser treatment
The laser repairs the tear by selectively welding the retina to the underlying choroid. Nowadays, this is not a complex procedure.
Laser eye surgery @ comicsans / AdobeStock
Surgical intervention
Surgery is required for retinal detachment. Specialists reattach the detached retina with the help of sewn-on silicone seals or bands.
Removal of the vitreous body
In more severe cases, removal of the vitreous body (vitrectomy) is necessary. Specialists push the retina back into place. Later, the eyeball fills with the aqueous humor produced by the eye itself, which then replaces the vitreous body.
In most cases, those affected simply have to live with vitreous opacities because the risk of treatment is greater than the benefit. Larger opacities sometimes sink downwards in the vitreous body and are then less troublesome.
There are two treatment options for severe, extremely obstructive opacities:
Laser treatment
Laser treatment removes vitreous opacities and dissolves mouches volantes, but is only suitable for opacities that are at a safe distance from the retina. Only a few specialists carry out laser treatment of mouches volantes.
Removal of the vitreous body
Removal of the vitreous body is an option for severe opacities, hemorrhages or large "clumps". However, this operation is risky. Lens opacification, infections and retinal problems can follow.
Specialists in ophthalmology are responsible for the diagnosis and treatment of vitreous opacities, flashes of light or vitreous detachment .
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