Vitreous detachment
introduction
A vitreous detachment is a process in the eye during which the vitreous humor (also called the corpus vitreum) detaches from the adjacent retina and is therefore no longer connected to the back wall of the eye.
The lifting of the device can lead to impaired vision of different degrees, which does not have to be treated in every case. Whether treated or untreated, regular checks of the fundus by an ophthalmologist are essential.
Detection of a vitreous detachment
Is the vitreous detachment perceived by those affected?
The shrinking of the vitreous itself usually has no consequences for the person concerned and often goes unnoticed. Some patients describe "wandering and floating shadows in the eye", which are caused by the connective tissue fibers that sometimes clump together. These obstruct the incidence of light through the eye and are accordingly perceived as annoying, but are otherwise completely harmless. They are also referred to as floaters, French for flying flies (also referred to as "floaters" in English). These typically move with the movement of the eyeball, but with a slight delay due to the gel-like consistency of the vitreous, so that they are sometimes visible in the field of vision.
What are the symptoms of a vitreous detachment?
The following are typical symptoms of vitreous detachment.
"Flying flies" in view
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", which are also known as floaters (French for flying flies).
"Soot rain" in view
There is also increased vitreous opacity and vitreous hemorrhage, which are noticeable as shadows in the field of vision. These are variable in size and range from small dark points to entire shadows of the field of vision. One often speaks of the so-called "soot rain", which, following the force of gravity, swims from top to bottom through the field of vision.
Further information on this topic can be found at: Vitreous opacities and Vitreous hemorrhage
Perceiving flashes of light
The pulling of the shrinking glass body can also lead to the perception of flashes of light in some places where it is connected to the retina. The mechanical stimulus is further processed by the retina as a light stimulus and so the patient has the impression of perceiving small flashes over and over again. They can occur more intensely if the eyeball is moved quickly from one side to the other, thereby increasing the pull of the vitreous humor on the retina. Abrupt acceleration or deceleration, for example in a car, can have the same effect.
Vitreous detachment pain
Pain is seldom associated with a vitreous detachment. Some patients report increased tears in their eyes, an unpleasant foreign body sensation or dizziness and headaches. All these symptoms and complaints are of course uncomfortable, annoying and irritating for the person concerned, but no need to worry, as they disappear on their own in the course of the vitreous detachment, as soon as it has come to rest or to completion.
However, if a patient perceives the described flashes of light more and more frequently, for longer and more intensely, there is a suspicion that the vitreous humor has damaged the retina and that a tear or even an incipient retinal detachment has occurred. In this case, an ophthalmologist should be consulted immediately.
Read more about retinal detachment at: Retinal Detachment - What Are The Symptoms?
Diagnosis of vitreous detachment
If the described floaters, the round or ribbon-shaped shadows whirring around, are increasingly noticeable in the field of vision, you should consult a specialist ophthalmologist. This will first open the pupil with eye drops in order to have a better view of the eye and thus the vitreous body and the fundus. With the help of the slit lamp, the doctor can now look into the patient's eye and assess its condition. Above all, he will want to see the fundus in order to rule out any damage to the retina that can be caused by the vitreous detachment. He can also see cloudiness, bleeding and small tears in the retina. This is usually sufficient to diagnose a vitreous detachment. Once it has been recognized and there are no further complications, such as accompanying retinal detachment, the course of the detachment must be checked by the ophthalmologist at regular intervals.
Therapy of a simple vitreous detachment
A vitreous detachment without complications usually does not need to be treated. In a sense, it is a natural process that takes more time for some and less time for others, but otherwise can be classified as harmless.
Regular checks of the vitreous detachment and the fundus are necessary in order to detect possible complications at an early stage.
How should one behave with a simple vitreous detachment?
In order to minimize the annoying side effects of a vitreous detachment such as floaters ("flying flies" in the field of vision), increased glare sensitivity, lighter flashes of light and sometimes blurred vision, the following things can be observed in everyday life.
Wearing sunglasses with a high sun protection factor can reduce glare. Overly bright colors should also be avoided in the interior design, as these could additionally strain and irritate the eyes. For patients who have to work a lot on the PC, professionally or privately, it is advisable to change and reduce the brightness settings in order to obtain a more pleasant and better-tolerated light. Modern spectacle lenses, which automatically darken when there is brightness, can also be perceived as supportive.
In general, of course, a healthy lifestyle also has a positive effect on the body and the body's own healing processes. So it is advisable to eat a healthy and varied diet, exercise regularly and drink enough. This can support the natural process.
Therapy for a disturbing clouding of the field of vision
The side effects such as floaters (the flying mosquitoes) or cloudiness caused by minor bleeding into the vitreous humor are not dangerous if they can also restrict the field of vision and are annoying and annoying for those affected.
If a patient feels too impaired in everyday vision by the floaters, it is possible to remove the small vitreous opacities with a laser. However, this treatment is only offered by a few specialists and is only suitable for those opacities that are at a sufficiently large distance from the retina behind it.
Further information on this topic can be found at: Vitreous opacity or Treatment of vitreous opacity
Therapy of a complicated vitreous detachment
Follow-up checks after a vitreous detachment are necessary in order to discover possible complications at an early stage.
Therapy for retinal detachment
In the course of a vitreous detachment that is full of complications, the vitreous body with its membrane can damage the underlying retina or even lead to retinal detachment. This must then be treated surgically as soon as possible.
Read more on this topic at: Surgery for a retinal detachment or Symptoms of retinal detachment
Therapy for significant loss of vision
If the vitreous opacities due to the vitreous detachment are to a large extent or the bleeding is so severe that there is a considerable loss of vision, the vitreous can also be surgically removed. This procedure is also known as a vitrectomy. The body's own vitreous body, or its gel-like content and its thin boundary membrane, is suctioned off using fine devices and the interior of the eye is optionally filled with a special gas mixture or a silicone oil. Over time, the eye itself replaces this with an endogenous fluid, the aqueous humor.
But a vitrectomy also harbors serious risks, such as clouding of the lens, damage to the retina or infections of the eye. Therefore, the decision to have a vitrectomy should be carefully considered with the attending ophthalmologist and surgeon. The risks of vitrectomy due to vitreous detachment are rated as slightly higher than those of vitrectomies that are performed due to retinal detachment.
For further information on the subject of vitreous suction, we recommend the following page: Eye surgery
Homeopathy for a vitreous detachment
Since a vitreous body elevation is a basically harmless process, which, as long as it proceeds without complications, only needs to be observed but not treated, no homeopathic remedies are actually necessary.If complications occur, such as retinal detachment (recognizable by increasing strong lightning bolts and a shower of soot), the treating ophthalmologist should be consulted immediately, as an operation is then inevitable.
For more information, we recommend our website to: Surgery for a retinal detachment
However, if you still want to support the body's natural healing process, you can use homeopathic remedies. Euphrasia herbs, also known as eyebright, are particularly popular. These are not only recommended for vitreous detachments, but also for eye problems in general. Even with swollen eyes, Euphrasia can promise slight relief from time to time. However, it should be agreed with the ophthalmologist that the drops are taken, as there can be side effects and interactions with other medications even with homeopathic medicines.
Other active ingredients include: Agaricus and Belladonna (have anti-inflammatory effects), Calcium (helps with structural problems), China (helps with fluid loss), Conium (is recommended for hardening and compression), Phosphorus and Rhus (also have an anti-inflammatory effect) as well Sepia and Silicea (used for structural problems, weakness and compaction).
Read more on this topic at: Euphrasia eye drops - how do they work?
Preventing vitreous detachment
Wishing to prevent vitreous detachment is a similar attempt to trying to prevent the body from aging in general. It goes without saying that it is always advisable to ensure a healthy lifestyle. This includes eating a balanced and varied diet, avoiding fast food products as much as possible, exercising regularly and drinking enough daily (1.5 to 2 liters per day are recommended). All of this helps to keep the body fit and healthy for as long as possible and to postpone the natural aging processes as far back as possible.
Injuries to the face and eyes or eye operations can also increase the likelihood of vitreous detachment. Severely short-sighted people are, due to their anatomical conditions, more prone to vitreous detachments and therefore it might be advisable to have the condition of the eyes and the fundus checked regularly by an ophthalmologist.
Even patients with known autoimmune diseases, diabetes and high blood lipid levels and high blood pressure are more often affected by a vitreous body detachment. Accordingly, it is recommended to deal with the disease consciously and to be in regular contact with the treating physicians in order to be able to recognize and treat sequelae such as vitreous detachment in good time.
Risk factors for vitreous detachment
In addition to the classic causes of a vitreous detachment, which primarily include the natural aging and degradation processes, other factors also play a role.
Injuries to the face and especially the eye area as well as surgical interventions in this area are of course a major risk factor.
Stress as a risk factor for vitreous detachment
But constant stress to which a patient is exposed is not without consequences. Due to the constant tension in the body, the blood pressure values rise, the body releases the stress hormone cortisone, which also influences the chemical composition of the blood and tissue and is therefore more susceptible to diseases in the long term. There are changes in the composition of the vitreous and the breakdown of the hyaluronic lattice may be promoted. This can lead to a vitreous detachment.
Not to be neglected, however, are chronic medication intake and drug abuse, which also put the body under stress and can thus have the same consequences.
Course of a vitreous detachment
Duration of a vitreous detachment
A vitreous detachment is very variable in its duration and can last from a few days to several weeks. In some cases, the process even takes months.
The average duration is between four and twelve weeks. The symptoms can begin at the same time as the vitreous detachment begins, or later when the vitreous membrane begins to pull on the retina. When the vitreous body is lifted off, symptoms such as flashes of light or soot rain also disappear. Most patients get used to the slight visual impairment very quickly and hardly notice them after a while.
However, if those affected feel unduly disturbed and impaired in their everyday life, the natural process of vitreous detachment can be surgically accelerated by performing a vitrectomy, i.e. surgically removing the vitreous body. This can be the case especially with younger patients, as they usually feel more disturbed and handicapped in their everyday life and work due to the visual impairment. However, since this operation is not without its risks, the procedure should be carefully considered with the attending ophthalmologist.
Read more on this topic at: Eye surgery - vitreous suction
A regular check of the fundus is advisable in any case, in order to be able to recognize and treat possible accompanying complications at an early stage.
Can a vitreous detachment be cured?
A vitreous detachment cannot heal. However, a vitreous detachment is not a disease in the classical sense, but rather a natural aging process that is weaker in one person and more noticeable in the other.
The vitreous detachment usually begins insidiously and is only noticeable in the context of the history through its accompanying symptoms such as flashes of light, floaters or distortions. These can then pause as long as the withdrawal has not yet been completed.
However, once the vitreous body has completely detached itself from its subsurface, the retina, the flashes of light normally stop again and the distorted vision also subsides over time and disappears. Once the vitreous detachment is complete, there are no complications, such as retinal detachment, to fear.
Read more about this at: Vitreous detachment
How long is sports banned after a vitreous body ablation?
Normally, a patient with a one-sided or bilateral vitreous detachment does not need to be particularly careful. Nevertheless, some rules of conduct should be observed:
Avoid lifting very heavy weights or engaging in particularly physically demanding activities. Contact sports should also be avoided during this time (for example rugby, boxing or martial arts). Bungee jumping and the like can also have negative effects. Difficult postures, especially overhead, during yoga, Pilates and the like should also be avoided.
It is quite possible that these activities promote the appearance of flashes of light and floaters and, in the worst case, can even lead to a detachment of the retina.
Lighter sports such as swimming, cycling, simple gymnastics or walking, on the other hand, can easily be continued during the vitreous detachment period.
Further questions about a vitreous detachment
What is the vitreous?
The vitreous body (also corpus vitreum) makes up the largest part of the human eyeball and consists of about 98% water. In this there are hyaluronic acid chains, on which the water molecules attach and thus the typical gel-like consistency is created. In addition, the glass body also contains a finely branched network of connective tissue fibers, which give it additional support and stability.
Read more about this at: Vitreous
How does a vitreous detachment occur?
In old age, the vitreous body shrinks, which is quite normal and is primarily caused by small weaknesses and liquefaction of the hyaluronic acid network.
This causes the vitreous humor to lose volume, as the water that is no longer bound comes out of the eye. Since the vitreous body with its outer boundary, the so-called vitreous body boundary membrane, is firmly connected to the underlying retina at several points, the contracting vitreous body covering on the retina is sometimes pulled. Retinal detachment can result.
