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Thursday, December 25, 2014

Floaters - Vitreous Opacities

Floater or myodesopsie is a rather common phenomenon entoptisch characterized by shadowy forms that occur singly or in groups in the visual field, which have the form of dots, wires or fabric webs and slow tracking eye movements. The term is derived from the Greek myioeides.

Description

Vitreous opacities are small protein structures and cellular waste materials that are more or less free-floating in the vitreous (also called "vitreous"), the jelly-like fluid that fills the eye, located; making them follow rapid eye movements slowed. The shadows they cast therefore not always fall on the exact same position on the retina, making the brains not get a chance to remove them from the conscious perception (as in the shadows of the blood vessels of the eye is the case).

Having vitreous opacities is very normal. However, some people have so much that visibility is seriously hampered by here. In these cases, also referred DVS (Degenerative Vitreous Syndrome)

Causes

Myodesopsie can have several causes, some of the common described briefly below.

Aging process
Aging is often accompanied by thickening of the vitreous, myopia have a greater predisposition. This compaction process is vitreous opacities by the breakdown of collagen. In many people, this occurs at a young age.

Glasvochtcollaps
In addition to the compaction of the vitreous with increasing age, the amount of glass is also less moisture, which usually leads to a glasvochtcollaps in the elderly, in which the vitreous separates from the retina. This often occurs in or around the 6th decade of life. Here also arise vitreous opacities, usually noticeable as large rings in the visual field. Because the vitreous to the retina at different places is adhered, it may cause various complications. An innocent complication that occurs is a mechanical stimulation of the retina, resulting in addition to vitreous opacities also temporarily flashes of light are observable. More serious complications can arise when there are so creates a tear in the retina and there is a small hemorrhage, which again is observable as vitreous opacities and sustained flashes of light. So the resulting hole in the retina can lead to retinal detachment and permanent blindness. In the sudden onset of flashes or the appearance of large numbers of small shadow form is always advisable as soon as possible to visit a doctor or ophthalmologist.

Diabetes mellitus
Diabetes (diabetes mellitus) can also cause blood in the vitreous, which is perceived as vitreous opacities, sometimes suddenly. Regular monitoring by an ophthalmologist for diabetics important.

Trauma
Another common cause of eye trauma myodesopsie is, for example after cataract extraction.

Uveitis
Also, uveitis, inflammation of the eye, causing in many cases myodesopsie.

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Research and treatment

In research, an ophthalmologist should pupilverwijdend agent, and then checks the retina with a slit lamp and / or ophthalmoscope. If no cracks are found in the retina no further treatment is urgently needed. If the opacities are so annoying that they impede the functioning (eg, computer work, reading, driving) surgery (vitrectomy) or laser treatment may be considered.

Interfering floaters can be removed with a laser treatment. This is a technique which is only a global plan has by some ophthalmologists. The risks are very low. In people over 45, the success rate of around 70-95%. People under 35 are often not help with laser. Because there are no study results published in scientific journals, many people assume that laser so can not help.

In addition, the vitreous humor can be removed by means of a vitrectomy. With the advent of advanced surgical instruments the cloudy vitreous under local or general anesthesia may be removed. The surgery has a number of significant risks, including retinal detachment (0.5-1%) or permanent impairment / blindness by other complications (1 patient in a study of 116). In addition, the patient is expected to receive a result of the operation of early cataract. The older you are, the sooner the cataracts will develop.

Looks like a good eye, he can see most floaters. Some other hand, are so small that they are not visible. In those cases, only case history (by questioning the patient) can be determined that a patient suffers from myodesopsie.

View vitreous opacities


Most people discover their vitreous opacities when lying on their backs looking at the sky. Many vitreous opacities tend to slowly sink into the vitreous, so they are at the back of the collection period near the macula and be clearly visible; the bright blue background helps here again at. The effect can be further enhanced by narrowing the pupil, for example, by looking through a speldenprikgat to heaven. (When the speldenprikgat in small circles for the eye moves, it is also possible to take the shadows of the blood vessels in the retina where. This is called the Purkinje phenomenon)

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