Vitreous Degeneration: Symptoms, Risks, and Expert Insights

Q: Vitreous Degeneration: Symptoms, Risks, and Expert Insights

Hello Sir： "Floaters" are structures within the eye, specifically the vitreous body, which is a gel-like substance that resembles egg white. <br>This vitreous gradually degenerates and liquefies, leading to the formation of some opaque impurities (protein aggregates) that float w

Vitreous degeneration

Hello Doctor, I have approximately 600 degrees of amblyopia in my left eye and about 150 degrees of myopia in my right eye.
I discovered floaters about three and a half years ago, and examinations revealed vitreous degeneration, which has gradually worsened over the past few years.
About a year ago, I experienced my first episode of flashes resembling a meteor shower, and in the last three months, I have had around five more episodes.
Some occurred while lifting heavy objects, and others happened after turning my head.
Occasionally, I have noticed that whenever I look at a bright sky, I see countless spots of light and dark changes outside my central vision.
The contrast of these changes is not significant, but they are clearly present.
They are not as bright as the flash phenomenon, but they include irregular light paths similar to those I mentioned during the flash episodes.
After undergoing a dilated eye examination, the doctor concluded that there were no issues.
I understand that the flash phenomenon may indicate retinal traction, so I asked the doctor about the likelihood of developing holes or even retinal detachment.
The doctor said it was impossible, which made me skeptical, and upon further questioning, the doctor stated that my retina showed no abnormal changes such as lattice degeneration, and the consultation ended abruptly.
I would like to ask you several questions:
1.
What could be the cause of the persistent and noticeable visual phenomena when looking at the sky? I am unsure if the doctor understood my unusual symptoms.
Regardless of the cause, could long-term occurrences like this potentially harm the retina (e.g., lead to degeneration or holes)?
2.
When the doctor said that I could not have retinal holes or detachment, was this based on the current condition of my retina? Or how did the doctor confidently determine that the likelihood of developing holes in the future is very low, thus stating the chance is zero? I know that doctors are usually reluctant to make definitive statements, but this particular doctor seemed very certain, especially since I have indeed experienced around ten flash episodes this year.
Aren't these flashes indicative of retinal traction? If there is traction, why is the doctor so confident that I won't develop holes? I am quite confused.
Although I do not have high myopia, isn't vitreous degeneration itself a potential cause of retinal holes?
3.
If the doctor is saying that, given my current retinal condition, there are no concerns about holes or detachment, then based on my situation, how likely is it that I could experience severe issues leading to holes in the future?
4.
Doctors often mention that vitreous degeneration can be caused by high myopia and aging, but that doesn't seem to apply to me.
Based on your knowledge, is there a more reasonable explanation for vitreous degeneration in someone of my age and medical history?
I am truly distressed about my condition.
Thank you for taking the time to read my lengthy description.
I sincerely hope you can provide me with a detailed explanation.
I am really worried.
Wishing you good health and all the best.

Xiao An, 20~29 year old female. Ask Date: 2007/02/26

Dr. Liu Jingxian reply Ophthalmology

Hello Sir: "Floaters" are structures within the eye, specifically the vitreous body, which is a gel-like substance that resembles egg white.
This vitreous gradually degenerates and liquefies, leading to the formation of some opaque impurities (protein aggregates) that float within the eye.
When you look at a brighter or whiter background, you may sometimes see small dots or strands moving across your field of vision.
This phenomenon is similar to the persistent visual disturbances you might experience when looking at the sky.
Most patients who experience "floaters" do so due to the aforementioned cause (the degeneration of the vitreous body from transparent to opaque, resulting in impurities).
However, a small number of patients may develop "floaters" due to retinal diseases that cause vitreous degeneration, such as retinal tears or other ocular conditions.

The occurrence of "flashes" is due to the adhesion between the vitreous and the retina.
As the vitreous gradually degenerates and liquefies, it begins to separate, causing traction that can lead to flashes, which are usually harmless.
However, special attention should be paid to initial occurrences, as excessive traction between the vitreous and retina may result in retinal tears.

Patients with "myopia" have a higher risk of developing complications such as glaucoma, cataracts, vitreous degeneration, macular degeneration, and retinal detachment compared to the general population.
The higher the degree of myopia, the greater the risk, and it is difficult to predict when these issues may arise.
Regular visits to an ophthalmologist for comprehensive eye examinations (including dilated fundus examinations) are essential, and any identified problems should be addressed immediately.
If you have recently undergone a dilated retinal examination and it was determined to be simple degeneration without retinal tears, you should feel relatively reassured at this stage, as long as you continue to have regular follow-ups (every three to six months).
However, if you experience any new symptoms (such as visual field loss, increased spots, halos, flashes, or a significant increase in luminous objects), you should seek medical attention promptly.

In summary, it is important to take care of your eyes by avoiding excessive strain and fatigue, which is the best way to protect your vision.
Wishing you good health.

Taiwan e-Academy Ophthalmology, Taipei City Hospital, Renai & Zhongxing Branches, Dr.
Liu Jing-Hsiang, Ophthalmologist, 2007.02.27

Reply Date: 2007/02/26

More Info

Understanding vitreous degeneration is crucial, especially for individuals experiencing symptoms like floaters and flashes of light. Vitreous degeneration, or vitreous detachment, is a common condition that occurs as we age, where the gel-like substance in the eye (the vitreous humor) begins to liquefy and separate from the retina. This process can lead to various visual disturbances, including the symptoms you described.

1. Visual Phenomena When Looking at the Sky: The abnormal visual phenomena you experience, particularly when looking at bright backgrounds like the sky, could be attributed to the way light interacts with the vitreous gel and the retina. When the vitreous humor degenerates, it can create shadows on the retina, which may manifest as spots or flashes of light. This is especially noticeable against bright backgrounds, where the contrast enhances the visibility of these phenomena. The presence of floaters and flashes is generally benign, but they can be concerning, especially if they are new or increasing in frequency.

2. Risk of Retinal Tears or Detachment: Your doctor’s assurance that there is no current retinal tear or detachment is likely based on a thorough examination, including a dilated fundus exam. While vitreous degeneration can increase the risk of retinal tears, especially in individuals with high myopia, the absence of any visible abnormalities during your examination suggests that your retina is currently healthy. However, it’s essential to monitor any changes in your symptoms, as new flashes or a sudden increase in floaters can warrant further investigation.

3. Future Risk Assessment: While your doctor may have indicated that the risk of developing a retinal tear or detachment is low based on your current condition, it’s important to understand that this risk can change over time. Factors such as age, the degree of vitreous degeneration, and any changes in your vision should be monitored. If you notice any new symptoms, such as a sudden increase in flashes or floaters, or a shadow or curtain effect in your vision, you should seek immediate medical attention.

4. Causes of Vitreous Degeneration: Vitreous degeneration is often associated with aging, but it can also occur due to other factors. In your case, while you do not have high myopia, other factors such as previous eye trauma, inflammation, or even genetic predispositions can contribute to vitreous changes. It’s also worth noting that some individuals may experience vitreous degeneration earlier than others without any identifiable cause.

In summary, while vitreous degeneration is a common and usually benign condition, it’s essential to remain vigilant about any changes in your vision. Regular eye examinations and open communication with your eye care provider are crucial for monitoring your condition. If you have ongoing concerns or if your symptoms worsen, consider seeking a second opinion or further evaluation from a retinal specialist. Your health and peace of mind are paramount, and understanding your condition can help alleviate some of the anxiety you may be feeling.

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