Eye Floaters: Symptoms, Causes, Diagnosis, And Treatment
Many people suffer from eye floaters (7). Affected patients then often report to the ophthalmologist (3) that they see black dots that seem to dance in front of their eyes (1). The phenomenon is also known as “Mouches volantes” (French for “flying flies”) (2). The vitreous clouding is harmless (5) and it is not a retinal detachment (4), but it disturbs the visual sensation of the affected patient (8). Sometimes it does not require treatment (6) After a while the symptoms often subside on their own (9).
Here you can read everything about the causes and treatment of eye floaters. The ICD code for this condition is H43
Eye Floaters: Description
Many people suffer from vitreous opacities in the eye and the associated eye floaters. This is due to a natural aging process. That is why about two-thirds of the 65 to 85-year-olds complain of such complaints. But younger people can also be affected, especially if they are severely short-sighted.
The gelatinous vitreous body fills most of the interior of the eyeball. In front of it is the lens that optically refracts the rays of light entering the eye. These then pass through the vitreous body to the retina. It lies behind the vitreous body and, as a light-sensitive layer of nerve cells, is responsible for converting optical images into electrical impulses. In this way, the information can be transmitted to the brain via the optic nerves.
The glass body consists almost completely of water. Only two percent of its mass is collagen fibers and hyaluronic acid. Normally all components of the vitreous body are strictly arranged. This makes them appear transparent and hardly influences the light rays on their way to the retina. Only when the arrangement is changed does a clouding of the vitreous humor occur, which impairs vision.
Symptoms Of Eye Floaters
A vitreous opacity most frequently manifests itself through so-called “Mouches volantes” or eye floaters. For as insects dancing in front of the eye, those affected usually describe the dark or semi-transparent spots, stripes or streaks that they perceive. This is not a delusion. The forms actually exist in the vitreous body.
Eye floaters do not restrict vision and are usually harmless. Nevertheless, many patients complain that their subjective visual sensation deteriorates. As a result, the vitreous clouding is perceived as annoying. On the one hand, the cloudiness and shadows vary in strength and position. On the other hand, scattered light can strongly dazzle the patients.
Especially when patients with vitreous opacity look at a bright wall or into bright light or are blinded by snow, they perceive the eye floaters.
Causes and Risk Factors Of Eye Floaters
The vitreous body, which fills the inside of the eye, consists mainly of water and a small number of collagen fibers and hyaluronic acid. In childhood, the fibers are regularly arranged so that they are not perceived. With increasing age the vitreous body shrinks and the fibers lose their structure. They are now increasingly disordered and resemble threads or even form flat structures.
As the vitreous body continues to shrink with age, it eventually loses contact with the retina. Then it swings sluggishly with eye movements. This allows the threads and streaks to come into focus. They then cast shadows on the retina in which the patient can see the small shadows and shapes.
Over the course of months, the fibers increasingly move away from the retina. They are then perceived more blurred and weaker until at some point they are no longer perceptible at all.
The most important risk factor for the development of eye floaters (Mouches volantes) is age, as it is usually an age-related process. Often short-sighted people notice the “flying mosquitoes” somewhat earlier than normal or farsighted people.
Diagnosis Of Eye Floaters
If this is the first time you see something that does not exist outside your eye, consult your eye doctor. This can be a harmless eye floaters but it can also be another disease. To find this out, your ophthalmologist will first ask you in detail about your medical history (anamnesis). Before the examination of the eye, he will ask you the following questions, among others
- What do you see when you look at a white wall, for example?
- When did you first realize that you were seeing flying mosquitoes or black spots?
- Did the symptoms appear suddenly or did they suddenly become worse?
- Are they individual points and streaks that you see, or rather sooty rain and snow flurries?
- Do you notice any flashes of light?
- Are you nearsighted?
- Have you had a retinal detachment in the other eye in the past?
Examination of the eye if this condition is suspected
To help you see inside your eye, your doctor will first give you eye drops that dilate the pupil. With a bright lamp, called a slit lamp, your doctor shines a light into your eye from the side and looks at the individual components through a magnifying glass. So he can judge them by their appearance. If you have a vitreous opacity, he can recognize it as a dark shadow. This examination is painless and uncomplicated. Due to the eye drops that are given, vision may be impaired for a few hours. You should, therefore, refrain from driving until the effect has subsided.
If the slit-lamp examination does not allow a clear diagnosis of vitreous eye floaters (Mouches volantes) or the medical history is not completely conclusive, other examinations can be performed. These include:
- Computer tomography
- Magnetic resonance imaging
The ultrasound is primarily used to detect or rule out retinal detachment. The other methods help to exclude the possibility that a foreign body in the eye causes symptoms similar to eye floaters.
What else could it be about instead of this condition?
In addition to the diagnosis “vitreous opacity”, or eye floaters, other diseases with similar symptoms are also possible. Above all, a retinal detachment or retinal tear must be distinguished from vitreous opacity, because in these cases immediate action is required. With a retinal tear, the signs usually appear suddenly. Those affected then perceive flashes of light and often describe the phenomena they see as sooty rain.
In addition, diseases such as inflammation of the middle skin of the eye (uveitis) or vitreous hemorrhage are also possible.
Treatment For Eye Floaters
If your doctor has diagnosed eye floaters, no further treatment measures are usually necessary. Although the “mouches volantes” can be very annoying for the patient, they are harmless and often disappear on their own.
Nevertheless, there are therapy options for eye floaters, such as vitreous removal. This is also known medically as vitrectomy. The vitreous body of the eye is removed and the resulting space is filled with a liquid or a gas. However, the majority of ophthalmologists advise against this treatment for eye floaters, as the risks are usually greater than the benefits. A vitreous removal can result in blindness, for example if it causes a retinal tear or infection. The risk of developing retinal holes during vitrectomy is between 12 and 30 percent. In addition, many patients experience lens opacity after the operation.
Laser therapies, unlike other eye diseases, have not been widely accepted and are not recommended for eye floaters treatment.
These tips can help relieve the symptoms
Doctors advise patients with vitreous opacity to ignore the symptoms as far as possible. In addition, there is a lot you can do yourself to alleviate the symptoms:
- On bright sunny days or in the snow, wear sunglasses with high light protection (85 percent).
- Avoid white or very bright walls in your own home. Textured wallpaper or muted colors distract the eye more.
- Many decorative elements in the home such as flowers, bookshelves, or pictures are useful.
- If you spend a lot of time at the computer, reduce its brightness and choose the contrast level that is comfortable for you.
- Self-tinting spectacle lenses are particularly helpful for severely short-sighted patients. These darken within seconds when exposed to bright light.
Prognosis For Eye Floaters
Eye floaters usually require no further treatment by a doctor and the symptoms improve over time. The mouches volantes often disappear completely and by themselves. However, this can take up to several years. Little by little, the “flying mosquitoes” that patients see become fewer, as the fibers and the entire vitreous body move away from the retina and are therefore less in the field of vision.
Have your eyes examined regularly by an ophthalmologist, because there are some diseases that can only be detected by examination and sometimes go unnoticed by the patient.
As a general rule, when mouches volantes or eye floaters occur for the first time, you should consult an eye doctor known as an ophthalmologist. This can tell you whether it is a harmless vitreous opacity or not. In about 15 percent of cases, the first occurrence of mouches volantes is a retinal tear. You should also see a doctor if you suddenly see flying mosquitoes in swarms or dense sooty rain. Just like flashes of light, these can indicate an imminent retinal detachment and prevent simple eye floaters.