Observing punctuation marks appearing as dots, could this be a noteworthy concern?
Relaxing in the sun, perhaps reading a book: that's a great way to unwind, except for those bothersome little black spots that keep dancing across your field of vision. Or the long streaks that appear whenever you move your eyes and are just plain annoying when trying to read.
More than 80% of people are familiar with this situation, often noticed against a bright background like white walls or paper. These vitreous opacities, also known as "Mouches volantes" (French for flying flies or gnats), can certainly be bothersome. But what causes them? And are they harmful?
Changes in the Vitreous Over Time
To understand this, we need to take a closer look at the vitreous, the gel-like substance that fills most of the inside of our eyeball. "It's like a gel-like substance that fills the space between the lens and the retina," explains Prof. Hans Hoerauf, director of the University Eye Clinic in Göttingen. The vitreous is mostly made up of water, with the remaining 2% being collagen fibers and hyalocytes, a certain type of cell.
As we age, the composition of the vitreous changes. The collagen fibers can thicken and clump together, while the gel-like part becomes more fluid. "Then it can happen that these tiny structures within the vitreous cast shadows on the retina that we perceive as opacities," says Hoerauf.
Unfortunately, there's not much that can be done to prevent this: "As we age, usually around the age of 40, the vitreous shrinks and changes structure," says eye doctor Hoerauf. And for those with nearsightedness, there's even more bad news: they have a higher probability of developing vitreous opacities.
Not Every Opacity is Bothersome
These opacities don't necessarily have to be bothersome: "If they hang right on the retina, so to speak on the inner wallpaper of the eye, then the shadows they cast are very intense. If they are further away, they become more blurred," explains Matthias Pollhammer, a specialist in ophthalmology and head of the department of ophthalmochirurgie of the professional association of eye doctors.
However, our brain has a way of ignoring these opacities in most people, thanks to an adaptation effect. In some people, however, this effect doesn't occur.
"There is certainly also a psychological component," says Hoerauf. "One person gets used to the vitreous opacities, while another becomes almost depressed about them." This can be particularly challenging for people in certain professions, such as microscopists or technical draftspersons, who spend a lot of time looking at white paper.
Prevention is Impossible
There is no way to prevent vitreous opacities with home remedies or healthy living habits: "There are no connections with any dietary habits, UV radiation, or other changeable factors," says Pollhammer.
Even the hope that the disturbances could simply disappear like magic is in vain. "Mouches Volantes" can indeed change, but they cannot dissolve.
When to Visit the Doctor
At least: In most cases, one can assume that the floaters are harmless and do not require action. However, if they appear suddenly or frequently, or are accompanied by flashes of light, it is recommended to visit an ophthalmologist. "Then one should definitely clarify or rule out other causes," says Pollhammer. "Inflammatory processes, for example, can release cells and other particles into the vitreous and thus cause floaters."
Other serious diseases also need to be ruled out, such as retinal detachment or diabetic retinopathy, a diabetic eye disease. Regular eye examinations are also recommended from the age of 40 to detect age-related diseases early.
Treatment Options for Severe Floaters
For most people, floaters are a tolerable nuisance. "However, if the floaters are pronounced or significantly impair quality of life, then a surgical procedure may be indicated," says Hoerauf.
In the so-called vitrectomy, the vitreous is surgically removed and replaced with fluid. This reliably eliminates vitreous floaters but carries risks. Infections can occur, or even a rare but very serious complication, namely retinal detachment. In this case, surgery must be performed again very quickly. Depending on the extent of the detachment, reading ability may be lost.
Another problem with vitrectomy: "After a vitreous operation, a cataract always occurs, albeit at a later time, but certainly, a clouding of the lens," says Hoerauf. From a certain age, vitreoretinal surgeons would therefore combine vitrectomy with cataract surgery. The lens is replaced by an artificial lens.
Another, newer option is vitreolysis by laser: The collagen fibers in the vitreous are broken down. "However, it is only suitable for certain types of floaters, if they are not too close to the retina," says ophthalmologist Hoerauf. It does not achieve complete symptom relief, but it can significantly reduce the disturbing lines and points.
Basically put, if other possibilities are eliminitaed, you can deal with the "Fly-like Creatures" as they come. And this, knowing that the majority of people globally have their own bothersome issues bubbling in their line of sight.
The discussion about vitreous opacities, or "Mouches volantes," highlights the importance of understanding their causes and potential harm. Despite common beliefs, changes in the vitreous over time, such as thickening collagen fibers and fluidization, are primarily due to aging and are not influenced by dietary habits or UV radiation. Furthermore, these opacities can sometimes be overlooked by our brains, thanks to an adaptation effect, but in some cases, they can significantly impact quality of life, especially for professionals who spend a lot of time looking at white surfaces.
