Vitreous Detachment
As time passes, the vitreous body—the jelly-like substance inside the eye—becomes more watery. The microscopic collagen fibers within the gel tend to clump together. These fiber clumps cast tiny shadows on the retina, which patients perceive as black spots (“floaters”). These are the primary symptom of vitreous detachment.
In vitreous detachment, most often patients may appear as black or gray spots, strings/threads or spider tissues that move when patients move their eyes, and appear to be removed when they try to look directly at them.
If you notice a sudden increase in myopsies, contact Dr. Nikolaos Trakos immediately – especially if they are accompanied by flashes of light (“flash”) or perceive a curtain or veil covering part of your peripheral visual field. These may be symptoms of retinal detachment rather than vitreous detachment, and require immediate ophthalmological examination and possible surgery.
What are the Symptoms of Vitreous Detachment?
The symptoms of vitreous detachment can include:
- Spots that are more noticeable when looking at a bright area, such as the blue sky, a white wall, or a white light screen.
- Small areas in the visual field that appear as dark spots or floaters, transparent threads, or fibers.
- Spots that move when the eyes move and disappear from the visual field when trying to refocus on them.
What are the Causes of Vitreous Detachment?
– Changes that come with age: Over time, the vitreous gel, which fills the eyes and helps them maintain their round shape, changes texture. The vitreous is partially liquefied, thus it is removed from the inner surface of the bulb. As the vitreous shrinks, the small clumps enter the path of light that passes through the eye, creating tiny shadows on the retina that perceives them as spots in vision
In this case, there is a accumulation of fluid behind the retina, which makes it separate from the back of the eye.
– Inflammation in the back of the eye: Posterior uveitis is an inflammation of the layers of the uvea at the bottom of the eye. This condition can cause the release of inflammatory substances in the vitreous, suspended, and patients perceive them as floaters or specks. Posterior uveitis may be due to infection, inflammatory diseases or other causes
– Bleeding in the eye: Bleeding in the vitreous can have many causes, such as diabetes, hypertension, clogged blood vessels and injury. The blood cells released into the eye appear to patients as specks within their visual field
– Retinal tear: when the vitreous is detached, because the patient may have dehydrated, it pulls the retina with enough force to cause a tear in the retina, something like a small tear, which can lead to retinal detachment.
The fracture can be treated with laser, while if it is not prevented and develops into retinal detachment is needed (vitrectomy). If left untreated it can cause permanent vision loss.
Surgeries and ophthalmological drugs: Some vitreous surgeries add gas or silicone bubbles to the vitreous that can also be perceived as spots (“floaters”) in vision. Certain medications injected into the vitreous, anti-angiogenic agents (Avastin, Eylea, Lucentis) to treat wet maculopathy can cause the formation of floaters or shadows until they are naturally absorbed after a few days.
An essential element of any surgical procedure, especially cosmetic surgery, is providing the patient with sufficient time for information.
What are the risk factors – for vitreous detachment?
Factors that can increase the risk of vitreous detachment include:
– Age over 50 years
– Presence of myopia
– Trauma to the eyes
– Cleaning of the posterior lens capsule after cataract surgery (YAG Laser Capsulotomy). The tiny pieces of the cloudy lens, which have been fragmented by laser, hover inside the vitreous cavity of the eye for a few days, until they are precipitated and no longer visible.
– Diabetic retinopathy
– Eye inflammation
– Complications from cataract surgery.
Usually, however, the densities of the vitreous pre-exist, but are not visible to the patient due to the cloudy lens that has cataracts, and after surgery may occur, so the patient should not be concerned.
How is vitreous detachment diagnosed?
The diagnosis of vitreous detachment can be made with a simple ophthalmological examination and fundoscopy. The ophthalmologist will use eye drops to dilate their pupils and to better see the back of the eyes and the vitreous to determine its cause, in order to first rule out a tear or retinal detachment or other pathological causes.
Why choose Dr. Trakos?
Dr. Trakos’ contribution to the field of anterior segment and cataract surgery, as well as to the treatment of vision problems, has changed the lives of many people by improving their sight and quality of life
What is the treatment of vitreous detachment?
Causes of vitreous detachment, such as inflammation or bleeding from diabetes can be treated.
But most vitreous detachments do not need treatment. Spots (“floaters”) in the field of vision can be a concern for patients and adapting to them may take time. Usually, once Dr. Trakos assures the patient that this kind of vitreous detachment will not cause other problems, it becomes easier for the patient to ignore or observe them less often.
If these “floaters” significantly disturb vision, which rarely happens, the patient and together with his ophthalmologist can discuss possible treatments. Treatment options may include:
– Vitrectomy (vitrectomy): During the vitrectomy process, the vitreous is removed through small incisions in the eye. Surgery may not remove all stigmas and new “floaters” may be created after surgery. The risks of a vitrectomy include bleeding and retinal cracks
– Laser use: In this case an ophthalmologist targets with a special laser (YAG Laser) and breaks the accumulated detached vitreous. The result is that the “floaters” become less noticeable. Some people who have done this treatment report improved vision. Others, however, notice little or no difference. The risks of laser therapy include damage to the retina. Laser surgery to treat vitreous detachment is rarely used.
In any case, Dr. Nikolaos Trakos and the Ophthalmology Center EYD are at your disposal for examination and diagnosis of the problem that concerns you.
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