It is usually only in the second half of life that the vitreous body stands out from the retina and triggers the vision of flashes and “black dots.” A detailed retinal examination with dilated pupils is of great importance to rule out retinal foramina (retinal holes) and cracks. If left untreated, these can lead to retinal detachment. Emergency laser treatment can close the lesion and thus prevent serious retinal detachment.
The vitreous body is a gel-like mass that fills the space between lens and retina and consists of water, collagen fibers, and hyaluronic acid. In the first half of life, the vitreous body is clear, transparent and is close to the retina.
The natural aging process, usually in the second half of life or more rarely due to eye injuries, causes the vitreous body to liquefy. The back part of the vitreous body stands out from the retina and collagen fibers in the vitreous body condense into connective tissue clusters. These balls are perceived as floating black dots, spider honeycombs or greyish swaths in the field of vision and are particularly annoying when looking at bright, monochrome surfaces.
The vitreous body lift creates tension on the retina at the points where the vitreous body is still in contact. This can lead to nerve cell discharge disorders and thus to the perception of lightning. Furthermore, there may even be a tear in the retina, which, if left untreated, can lead to retinal detachment.
After an average of six to 18 months, the vitreous body is completely lifted off and the risk of retinal detachment decreases again. Until then, regular ophthalmological checks are recommended.
If symptoms such as seeing black spots or lightning intensify abruptly in the meantime, this indicates that vitreous lift has progressed. An emergency ophthalmological check on the same or the following day is indicated to rule out a new retinal hole.
If a tear in the retina is discovered in time, it can be treated with an argon laser. A contact glass is carefully placed on the cornea. In the contact glass, the laser beam is directed by a mirror towards the retinal tear and “burns” the retinal tissue there.
After about a week, the laser foci become scarred and the retina firmly connects to the underlying tissue. Until then, rapid eye movements such as reading should be avoided. If necessary, an inability to work is certified for this period. Watching TV at a distance of four to five meters is no problem, as the eyes barely move.
Retinal cracks or holes that are not discovered or discovered too late pose a high risk of retinal detachment. As a result, fluid from the vitreous space passes behind the retina, which leads to permanent damage to nerve cells.
As long as the central retina with the so-called macula is not affected, there is a good chance that the patient will be able to see clearly again after retinal surgery. Accordingly, retinal detachments where the macula has not yet been removed are treated with priority on the same day or the next morning.
So-called macular-off situations, in which the macula has already been removed, only achieve an average visual acuity of 40-50% after surgical treatment and therefore do not have to be treated as a matter of priority.
The vitreous body is completely removed from the eye (vitrectomy). Gas is then filled into the eye to bring the retina back to normal. Retinal lesions are sealed using icing or with a laser. This operation usually takes place as an inpatient; if necessary, we will refer you to a clinic that has a ward.
The “Mouches Volantes” or “Floaters” are condensed components of the glass body and can each increase or decrease. The treatment of such vitreous opacities is very limited and should only be evaluated when there is appropriate suffering.
