Vitreous detachment
introduction
A vitreous detachment is a separation of the vitreous from the surrounding structures. A distinction is made between an anterior and a posterior vitreous detachment, with the posterior form occurring much more frequently. In the process, the vitreous becomes detached from the retina. Mostly this is related to a liquefaction of the vitreous body during aging. Symptoms such as sudden flashes of light when the eye moves. With a complete vitreous detachment, therapy is usually not necessary because the symptoms disappear.
Detection of vitreous detachment
What are the symptoms of vitreous detachment?
Symptoms of vitreous detachment are very typical. These depend on whether the vitreous detachment is complete or whether the vitreous is still connected to the retina in some places.
The accompanying symptoms include the so-called floaters. This term means something like "flying mosquitos" and describes optical phenomena that are perceived by those affected. As the vitreous has become detached, those affected will see permanently curved lines and / or points that move. This is due to the liquefaction of the vitreous, which means that the light from the outside enters the eye in a different way.
In some cases, as part of the vitreous detachment, there is also compaction due to collapsing structures, which can also lead to these optical perceptions. Furthermore, flashes of light when the eyes are moved are very typical for a vitreous detachment. These occur in the case of incomplete vitreous detachment and are caused by the pulling of the vitreous on the sections of the retina that are still connected. In some cases, vitreous hemorrhage or retinal tears may also occur. The latter can even lead to a detachment of the retina and associated visual impairment.
How is vitreous detachment diagnosed?
When a vitreous detachment is diagnosed, the first step should be a medical history, i.e. a doctor-patient discussion, and a general examination of both eyes. If vitreous detachment is suspected, an ophthalmoscopy should also be performed. The rear section of the eye is assessed using special examination instruments.
It is important to rule out possible tears in the retina in the event of a vitreous detachment. Therefore, this should always be checked for its intactness. In some cases, the assessment of the back of the eye can also be supplemented by an ultrasound examination.
also read: Intraocular pressure measurement
Treat a vitreous detachment
How is vitreous detachment treated?
The treatment of a vitreous detachment depends on the extent of the detachment of the vitreous body from its surrounding structures and the location of the detachment.
With a complete detachment of the vitreous humor, all accompanying symptoms usually disappear, so there is no need for treatment. However, it is important that regular checkups are carried out by an ophthalmologist in order to rule out possible complications of the vitreous detachment. These can sometimes occur later.
Occasionally the symptoms can last for a very long time and be very annoying to the person concerned. In this case, surgery to remove the vitreous may be considered. However, this procedure, known as "vitrectomy", is very complex and involves some risks.
Vitreous detachment can sometimes lead to complications. These are mostly in need of treatment, which is why the therapy of vitreous detachment focuses on the control and treatment of possible complications. For example, tears and holes can appear in the retina, which, depending on their severity, can be treated with laser therapy. By irradiating with a laser, the retina is reconnected with its surrounding structures. If the retina becomes detached, it may have to be treated surgically.
Read more about surgical removal of the vitreous under: Eye surgery
Which medications can help?
Since vitreous detachment is not treated, there are no drugs that are effective as therapy for vitreous detachment. Various homeopathic remedies can have a supportive effect, but do not have a healing effect. The homeopathic remedies include, for example, Conium, which works against the compaction of the vitreous body when it is detached. Calcium and China can also have a supportive effect.
Preventing vitreous detachment
What are the causes of vitreous detachment?
Vitreous detachment usually occurs as part of natural aging. The substance of the vitreous body liquefies and this leads to a kind of collapse. As a result, the vitreous becomes detached from its base, usually from the retina in the back of the eye.
Another cause, especially in younger people, is severe myopia, or nearsightedness. The eye is longer than that of a person with normal vision, which means that the vitreous body has to fill a larger space. As a result, it is at risk of becoming detached from the surrounding layer at certain points. A trauma to the eye, i.e. an accident with, for example, a collision with the eye, can lead to a detachment of the vitreous body from its front surrounding structures.
Chorioretinitis, i.e. inflammation of the veins and retina in the back of the eye, can also lead to a detachment of the vitreous humor in this area. Furthermore, so-called aphakia, i.e. the lack of a lens, can be a cause of an anterior vitreous detachment. The aphakia usually comes about as a result of an operation, but in rare cases it can also be caused by trauma, i.e. an accident to the eye.
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Course of a vitreous detachment
How long does a vitreous detachment take?
A vitreous detachment can take different lengths of time. The main factor here is the cause of the detachment of the vitreous from its surrounding structures. In the case of the most common vitreous detachment, i.e. the posterior form due to age-related liquefaction of the vitreous, a period of a few days to weeks can be expected. Once the vitreous humor has begun to detach itself from the retina, it becomes increasingly unstable, which means that the vitreous detachment usually proceeds relatively quickly.
In very rare cases, however, the symptoms, i.e. the flashes and optical perceptions, may still be present months to years after the vitreous detachment began. In this case, surgical removal of the vitreous should be considered if the affected person feels severely restricted. In a large number of cases, however, the symptoms are no longer perceived after a certain period of time, as those affected get used to them and the symptoms continue to decrease as the vitreous detachment progresses.
Can a vitreous detachment heal?
A cure with vitreous detachment is not possible as such. A vitreous detachment is a not uncommon phenomenon that can occur in old age. The liquefaction of the glass body leads to a separation from the surrounding structures. Since the vitreous body consists of different materials that flow apart when liquefied and are resorbed over time, i.e. transported away via the vascular system, it is not possible to restore the consistency of the vitreous body. However, this is not absolutely necessary, as vision is still possible despite a complete vitreous detachment. When the vitreous detachment is completely complete, the symptoms are usually completely gone.
It is more important to prevent possible complications. Vitreous detachment can lead to detachment of the retina. This is far more crucial for the affected person than healing the vitreous detachment, as it can cause long-term impairment of vision. Therefore, regular checks should be carried out by an ophthalmologist.
Similar topics: Symptoms of retinal detachment such as Surgery for a retinal detachment
Further questions about vitreous detachment
Why do you see flashes of light in the field of vision?
A very typical symptom of vitreous detachment are flashes of light that the person concerned perceives. These occur mainly when the eye moves. These are based on an incomplete vitreous detachment from the retina. This incomplete posterior detachment of the vitreous body leads to increased tension on the retina at the areas of the vitreous body and retina that are still connected. As a result, the retina is irritated at these points when the eyes are moved and a flash of light is created in front of the patient's eye. These flashes are very characteristic of vitreous detachment.
What role does exercise play in vitreous detachment?
Exercise has different roles in vitreous detachment.
For one, exercise can be a cause of vitreous detachment. A vitreous detachment can be triggered by trauma, i.e. an accident, in the eye, especially in younger people affected, for example when a ball hits the eye directly.
On the other hand, it is important to exercise caution when exercising if a vitreous detachment has already occurred. Especially with incomplete lifting of the vitreous body, jerky eye movements, such as those that often occur in ball games, can tear the retina and thus impair vision. But also other sports, such as weight training and weightlifting, should be practiced with caution in the event of a vitreous detachment. The ophthalmologist will usually advise you to wait before doing such sports until a tear or hole in the retina can be safely ruled out. It is also very important that those affected are aware of possible symptoms of retinal detachment, such as a sudden black haze, in order to recognize them early and, if necessary, to consult an ophthalmologist.