Vitreous opacies/floaters/mouches volantes

How did the annoying flies originate in the field of vision?

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 slowly stands out from the retina and components of the collagen fiber framework 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.

In the eye of younger people, the vitreous body is like a transparent, tight rubber ball and fills the entire eyeball. Light rays can fall on the retina without obstruction.

Tangles of collagen fibers form in the vitreous body and cast a shadow on the retina. These balls can move when looking at them in a different direction, i.e. they float in the eye and are therefore called “floaters”, in German suspended particles.

What should be done when “mouches volantes” appear?

A detailed ophthalmological examination is useful when floaters occur, as the causal vitreous detachment can often result in a retinal tear. Retinal tears should be ruled out by an ophthalmologist at regular intervals. If symptoms increase or perceive flashes of light, patients should come to their ophthalmologist as an emergency to rule out new cracks.
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Most people are usually only bothered by the “mouches” at first; over time, these are only noticed in special situations, e.g. when looking at a steel-blue sky.

Are there ways to treat annoying “mouches”?

• Dietary supplement: Supplements such as vitamins, antioxidants and amio acids can delay the degeneration of the vitreous body and improve the current situation or significantly reduce the symptoms caused by floaters (1). Preparations: VitroCap® N capsules contain specially prepared plant ingredients from grape seeds and citrus fruits as well as vitamin C, zinc and the amino acid L-lysine.
• Laser treatment: With a special laser device, vitreous opacities can be torn and thus reduced in size, this is known as vitreolysis. The literature review shows that only a small proportion of those affected achieve an improvement in well-being or visual acuity as a result of the treatment. “Core Vitrectomy” is recommended for patients who are still severely impaired after vitreolysis.
• Core vitrectomy: In vitrectomy, the vitreous body is sucked off via small accesses to the eye and replaced by gas or a liquid. There are risks such as infections, bleeding, and retinal tears. In approximately 45% of patients, the natural eye lens then becomes cloudy so that a cataract surgery becomes necessary (3).

Sources and scientific publications:

1. E. Ankamah et al. Trans Vis Sci Technol. 2021: “Dietary Intervention With a Targeted Micronutrient Formulation Reduces the Visual Discomfort Associated With Vitreous Degeneration”

2. Jan Kokavec et al. Cochrane database system. Rev. 2017: “Nd:YAG laser vitreolysis versus pars plana vitrectomy for vitreous floaters”

3. Ece Özdemir Zeydanli et al. Eye (Bond). 2020: “Management of Vitreous Floaters: An International Survey of the European Vitreo Retinal Society Floaters Study Report”