In the outpatient clinic, we often encounter many patients who are troubled by flying mosquitoes and are usually diagnosed with vitreous turbidity after ophthalmologic examination. This article summarizes some of the common problems of vitreous turbidity, hope to help the majority of patients.
What is vitreous clouding?
Do you sometimes feel little black dots, tiny filaments or light gray cloud-like shadows floating around in front of your eyes? This becomes more noticeable especially when you look into bright places, such as a white wall or blue sky. Then you may have developed what is often referred to as flying mosquitoes, also known as vitreous turbidity.
Vitreous humor is the clear gel that fills our eyes and gradually liquefies as we age. Vitreous turbidity is actually small clumps of gel or small clumps of cells within the vitreous that appear to be floating in front of our eyes, but they are actually floating inside the eye. The flying mosquitoes you see are actually projections of these substances on the retina, and they can take on various forms, such as fine dots, rings, lines, clouds, spider webs, etc.
What is posterior vitreous detachment?
As we reach middle age, the vitreous begins to coalesce and concentrate, forming a gel mass or cords that gradually detach from the posterior wall of the eye, forming a posterior vitreous detachment.
The following people are more likely to develop post-vitreous detachment: nearsighted patients, post-cataract surgery patients, post-YAG laser patients, patients with intraocular inflammatory disease. If you have sudden onset or worsening of the eye, you need to pay attention to it, especially if you are over 45 years old.
Is vitreous opacity and retrovitreous detachment a serious eye disease?
When the concentrated vitreous gel detaches from the wall of the eye, the pulling force may cause retinal fissures and sometimes a small amount of hemorrhage, which can also manifest as new onset miosis. In severe cases, retinal tears caused by pulling can lead to retinal detachment. Therefore, it is important to see an ophthalmologist as soon as possible if you experience any of the following: a sudden new appearance of a dark shadow in front of your eyes, even if it is only one; a sudden sensation of a flash in front of your eyes.
If there are other symptoms, such as darkening and blackening in a certain direction, or a feeling of curtain blockage, then a retinal detachment may have occurred and you need to see an ophthalmologist immediately.
Can vitreous clouding be eliminated?
Flying mosquitoes in front of the eyes may be a symptom of retinal tears, which can lead to retinal detachment if left untreated. Once a retinal detachment occurs, surgery is required.
Other causes of flying mosquitoes are relatively harmless and may diminish over time. Or, because you have grown accustomed to the symptoms and they no longer bother you, no special treatment is needed. Patients often ask: Is it possible to surgically remove these clouding? It is not necessary. Vitamin therapy will not make the vitreous clouding disappear.
It is also important to note that even if you have had a vitreous cloud for many years, if a new cloud suddenly appears, or if it suddenly becomes larger and more numerous, you need to see an ophthalmologist as soon as possible.
What causes a flashing sensation in front of the eyes?
When the vitreous gel rubs against the retina, or pulls on the retina, you may feel a flash in front of your eyes. This sensation is similar to the “starburst” that occurs when the eye is struck by an external force.
The flashing sensation can continue intermittently for weeks or months and becomes more common as you age. Sudden flashes of light in front of the eyes should also be seen immediately because of the possibility of a retinal fracture. If examination reveals only a posterior vitreous detachment, continued observation and regular fundus review is sufficient.
Migraine Some patients may experience a jagged flash or bright dotted line in front of both eyes, often lasting 10-20 minutes. This type of flash is usually due to cerebral vascular spasm and is an aura manifestation of migraine, and the flash is usually followed by a headache. If there is only a flash of light without a headache, then it is an ocular migraine. If these symptoms are present, a neurological consultation is required.
How to check for vitreous opacities?
When you come to the hospital because of flying mosquitoes in front of your eyes, your doctor will dilate your pupils with dilating eye drops so that every part of the vitreous and retina can be fully examined and cracks and hemorrhages in the peripheral retina can be detected in time. Most people’s pupils will be dilated 20-30 minutes after the eye drops are given, and the fundus can be checked at this time. However, it usually takes 5-6 hours for the pupil to recover, so you will need to arrange your daily routine and mode of transportation in advance. Some patients will also need an ultrasound of the eye to fully understand the extent of vitreous clouding and posterior vitreous detachment.