– pathology of the organ of vision, accompanied by a violation of the physicochemical properties of the colloidal gel of the vitreous body. Clinically, the disease manifests itself as “floaters” and other “floaters” before the eyes. As it progresses, visual acuity may decrease. Diagnosis is based on the results of ophthalmoscopy, biomicroscopy, B-scan ultrasound, optical coherence tomography, tonometry and visometry. Specific treatment methods have not been developed. In the early stages, conservative therapy is carried out. Severe destruction is an indication for surgical intervention (vitreolysis, vitrectomy).
General information
Destruction of the vitreous body is the complete or partial destruction of the structure of this anatomical formation. The pathology is most common among older people. In young people, it usually occurs as a result of mechanical damage to the eye or the progression of myopia. Males and females get sick equally often. Destruction of the vitreous body is statistically more common among residents of economically developed countries, which may be due to increased life expectancy, excessive strain on the eyes during professional activities, and a number of other factors. Modern methods of eye microsurgery can not only eliminate clinical manifestations diseases, but also partially restore visual functions.
Causes
Destruction of the vitreous body occurs when there is a change physical and chemical characteristics its colloidal gel as a result of local inflammation of the eye and surrounding tissues (with endophthalmitis, keratitis, blepharitis, dacryocystitis). The composition of colloids depends on the functional state of the liver, kidneys and endocrine glands. With dysfunction of these organs, the physiological ratio of fluid, proteoglycans, glycosaminoglycans and stromal components is disrupted. Metabolic disorders pathological changes vessels of the retina and brain impair blood circulation and provoke neurocirculatory spasm of the eye muscles, which precedes the development of destructive processes. In old age, the rheological properties of the colloidal gel in the central sections deteriorate, and the colloid becomes denser at the periphery. Under the influence of gravity, deposited crystals or collagen masses in the retinal area peel off and accumulate in the center of the vitreous.
The trigger for this pathology is myopia, in which the round shape eyeball is replaced by an ellipsoidal one, which leads to deformation of intraocular structures. The disease can be provoked by a blow to the orbital area. Mechanical trauma leads to loss of integrity of the gel-like mass, disruption of the primary structure of collagen and the development of hemophthalmos against the background of damage to the vascular bed. The risk group includes patients with decompensated diabetes mellitus, asthenopia and Parkinson's disease. Iatrogenic destruction is possible when the vitreous body is damaged during surgery for cataracts.
Pathogenesis and classification
There are complete and partial destruction of the vitreous body. Most often, destructive processes affect the central sections of the colloidal gel. The first step is the formation of a cavity containing fluid and coagulated collagen masses. Subsequently, more and more fibrillar proteins can be coagulated and go beyond the boundaries of formation, which leads to the liquefaction of the gelatinous substance that fills the space between the lens and the retina. Films and strands of various natures are formed in it, which can be fixed to the fundus of the eye, causing wrinkling and the formation of adhesions. The vitreous body decreases in volume and becomes deformed, which provokes tension of the vitreoretinal joints with subsequent retinal detachment.
According to their form, filamentous, granular and crystalline destruction are distinguished. The trigger for the filamentous form is atherosclerosis or progressive myopia. With the development of inflammatory processes in the inner retinal layer, granular lesions of the vitreous body are formed. In rare cases, the colloidal gel is damaged by deposited cholesterol and tyrosine crystals.
Symptoms and diagnosis
Patients note photopsia, hemophthalmos, “veil” before the eyes and decreased visual acuity. A specific symptom of destruction is “floaters,” which most often appear when looking at the sky or a white monitor. Trying to focus on the flies results in them moving or disappearing. Usually the pathology develops gradually. The sudden appearance of black dots before the eyes is early symptom retinal or vitreous detachment.
To confirm the destruction of the vitreous body, it is necessary to perform ophthalmoscopy, ultrasound of the eyeball, biomicroscopy, optical coherence tomography, visometry and tonometry. The ophthalmoscopy method is used to determine optically empty cavities, which often look like vertical slits. The boundary membrane is without specific changes; gray or white fibrous structures are visualized behind it. Complete destruction is characterized by the formation of a single cavity with fragments of fibrils. Destruction of the limiting membrane is possible, in which there is a lack of retrolental space. When the clouding is localized at the edge of the retina, specific changes are not detected.
Using slit lamp, when performing biomicroscopy, a change in the consistency of the colloidal gel and the presence of flocculent opacities can be detected. With filamentous destruction, collagen fibers acquire a loop-like structure. Granular destruction is manifested by an accumulation of small gray or brown particles. In the later stages of the disease, accumulations of grains in the form of conglomerates are visualized.
Ultrasound examination is a more informative method. The technique is recommended for concomitant vitreous hemorrhages; ultrasound should be performed in B-scan mode. The procedure allows you to identify the source of hemorrhage and echo-negative signals from crystalline structures inside the colloid. Liquefaction of the vitreous is indicated by the detection of mobility of crystals, granular conglomerates or accumulations of collagen fibers.
Optical coherence tomography (OCT) of the eyes is performed when other diagnostic techniques are not informative. During the study, a decrease in the size and change in the shape of the vitreous body, its cloudiness and heterogeneity of structure are detected. A contraindication to optical coherence tomography is massive hemophthalmos. Visometry allows you to assess the degree of decrease in visual acuity. Tonometry determines a slight increase in intraocular pressure.
Treatment
Specific methods for treating vitreous destruction have not been developed. The ophthalmologist's tactics depend on the degree of damage to the colloidal gel and the decrease in visual acuity. In case of minor impairment of eye functions and detection of partial destruction, conservative therapy and lifestyle correction are recommended. Patients should normalize their sleep and wakefulness patterns and perform eye exercises when working at a computer or reading for a long time. Conservative therapy consists of local administration of potassium iodide to provide a resorption effect and antioxidants to improve eye microcirculation (methylethylpyridinol). It is recommended to take vinpocetine and cinnarizine orally, which help improve cerebral circulation. The use of angioprotectors and microcirculation correctors (L-Lysine aescinate) is indicated.
Surgical treatment is required for severe destruction of the vitreous body. In modern ophthalmology, vitreolysis is used for targeted crushing of large fragments of collagen. The operation is performed under local anesthesia. Before using a special YAG laser, the pupils are dilated using mydriatics. short acting(tropicamide). There are no visual impairments after vitreolysis of the collagen structures of the vitreous body. The course of surgical intervention is complicated by high mobility of pathological accumulations inside the colloidal gel.
Total destruction is an indication for vitrectomy under local or general anesthesia. During surgery, the vitreous body is removed using microsurgical techniques. At the first stage, the colloidal gel is divided into small sections, which are subsequently subjected to aspiration. Intraocular pressure is normalized by injecting a balanced salt solution, silicone oil, or gas into the eyeball cavity.
Prognosis and prevention
To prevent destruction of the vitreous body, it is necessary to undergo regular examination by an ophthalmologist with mandatory ophthalmoscopy, visometry and tonometry. It is recommended to reduce visual load, perform therapeutic exercises for the eyes, eat fortified foods, exclude foods with high content animal fat. All patients with myopia should undergo vision correction measures in a timely manner. For diabetic retinopathy, consultation with an ophthalmologist is indicated 2 times a year.
The prognosis for destruction of the vitreous body in case of timely diagnosis and treatment is favorable for life and work capacity. Even in the later stages of the disease, vitrectomy can significantly improve the patient's visual acuity and quality of life.
Floaters, small dots, lightning, darkening, flying spots and flashes before the eyes - all these are symptoms of the appearance of destruction of the vitreous body of the eye. They occur in approximately 60% of people over 60 years of age. The onset of this disease in old age is considered natural. age-related changes. But, as noted by doctors, various opacities can appear at a young age.
Basic functions of the vitreous body
The structure of the vitreous body is an avascular, gelatinous, transparent substance that fills the cavity of the eyeball between the retina and the lens. Its presence ensures the correct shape and preservation of the turgor of the eyeball, carries out light impulses to the retina, and also compensates sharp changes intraocular pressure.
In a healthy person, this substance is absolutely transparent and does not contain any inclusions. It is made up of salts, whey proteins, ascorbic and hyaluronic acid and other substances. It is supported by a framework that consists of protein fibrils. Destruction processes are manifested by liquefaction of the vitreous body, its peeling and wrinkling.
Liquefaction can be partial or complete. Most often, this pathology is observed in the central part of the eyeball, much less often - along its periphery. At the initial stage of the disease, cavities are formed that are filled with gel coagulation products, liquid, and fragments of fibers. The separation of the gelatinous substance into liquid and thick fractions begins due to the breakdown of the hyaluronic acid-collagen complex.
In addition to the “floaters” characteristic of destruction, “flashes” or “lightning” appear in the field of view, this indicates the presence of “optical cavities” in the eyeball. This is how the brain begins to perceive an abnormal reaction of the optic nerve to the presence of voids. Cloudy particles are quite difficult to see because they move with your eye movements.
Opacities are best seen when looking at a bright, clean surface (snow, white ceiling, clear sky) in coherent rays or when squinting your eyes. In poor lighting conditions environment and during its heterogeneity the opacities are usually invisible.
Destruction can be expressed in the form of silver or golden rain. This phenomenon is observed during the presence of crystalline inclusions of cholesterol, tyrosine, magnesium, calcium and phosphorus compounds . Typical for older people who suffer from diabetes or cholesterol metabolism disorders.
The vitreous body is located between the lens and the retina. During certain reasons, the molecules that are located inside the eyeball disintegrate and change color permeability. As a result, the patient seems to see dots, stars, flies, dark spots or cobwebs before his eyes.
Typically, these processes occur due to the aging of the human body. Doctors say that detachment can be observed at a young age under the following circumstances:
At an early age, mechanical injuries to the eye often lead to this pathology. As a result of these injuries, different parts of the eye are destroyed, microscopic ruptured particles form clumps of bodies and begin to float freely in the space of the eyeball, thereby causing destruction.
Symptoms of the disease
The main clinical symptom of the presence of destruction is the floating of all kinds of visual effects directly before the eyes - “cobwebs”, “flies”, “cloudness”, “spots”. These optical elements may vary significantly in effect, appearing when lifting heavy weights, blows to the head, due to a sharp jump in blood pressure.
Main signs of destruction:
- visual effects are observed only under conditions of good lighting (especially on a white surface);
- visual effects always have a constant shape and size;
- the presence of various opacities and “spots” is permanent and not temporary.
The more clearly and thickly the floating elements are visible, the more severe the stage of destruction. When opacities of the filamentous structure appear, the patient may be diagnosed with a severe form of hypertension or atherosclerosis.
The presence of all kinds of “flashes” and “lightning” is the main sign of the disease. When filamentous destruction is diagnosed, the floating fibrils begin to disperse over the entire surface of the eyeball, but in this case they twist and stick together and begin education to be formed, similar to balls of yarn.
In the case of tumor neoplasms, eye injury or as a result of a previous illness, destruction is often expressed in the form of small accumulations of small grains.
If the disease is not treated in a timely manner, ophthalmologists do not rule out partial or complete loss of vision.
Treatment methods
Specific methods of treating this pathology to date have not yet been developed. The main tactics of the ophthalmologist will depend on the degree of vision loss and damage to the colloidal gel. During minor impairment of eye function and partial destruction is diagnosed, lifestyle correction and conservative treatment are recommended. Patients need to normalize their work and rest schedule, and perform eye exercises during prolonged reading or computer work.
The indication for vitrectomy under general or local anesthesia is total destruction. During surgery The vitreous body is removed or replaced using microsurgical techniques. On initial stage The colloidal gel is divided into small sections, which are subsequently aspirated. The pressure inside the eyeball cavity is normalized by introducing gas, silicone oil or balanced salt solution.
Traditional methods of treatment
Treatment folk remedies
during diseases of the posterior ocular segment, it is used quite rarely due to its ineffectiveness and low permeability into the deep layers.
One of these natural remedies is aloe; many people have this plant in their homes. One tablespoon of juice should be drained and mixed with a tablespoon of boiled water. It is necessary to drop it into the eyes three times a day. If these drops cause redness of the eyes, burning, itching after the first use, then the treatment must be completed and consult an ophthalmologist.
Prevention of destruction
There are no special measures to prevent this disease. But first of all, it is necessary not to forget that visual acuity is significantly influenced by the patient’s lifestyle. Thus, alcohol abuse, smoking or the predominance of refined foods in the daily diet inevitably begins to contribute to the deterioration of vascular function, which also affects the function of the visual organs.
In this case, playing sports is not prohibited, but you can resort to them only if there are no dystrophic and dangerous changes on the retina. If a patient with destruction leads an active lifestyle, he should remember to periodically visit an ophthalmologist so that the doctor examines the retina and, if necessary, dilates the pupil.
Compliance with the rules of working in front of a computer is very important, since most professions today involve working behind a monitor screen. You definitely need to give your eyes time to rest, so you need to make it a habit to switch your gaze from the monitor, or just rest for a few minutes with your eyes closed. , experts recommend taking this break when working at a computer every hour.
Patients with obligatory need to periodically visit a doctor to monitor the state of the visual system.
Destruction in a mild form today is increasingly observed among schoolchildren due to increased strain on the eyes: students at school write and read a lot, but at home they are used to playing computer games or watch TV. Therefore, parents are obliged to control the time their children spend near the monitor and, when necessary, limit it.
To prevent destruction, you just need to try to avoid any eye injuries, and also be very attentive to your health.
Prognosis for treatment of destruction
The prognosis for the development of the disease is most often favorable. Destruction, which manifests itself in a mild form, does not have a significant effect on the ability to work and is not the cause of any complications. Severe forms diseases can significantly worsen the patient’s quality of life. Constant floating elements interfere with viewing different objects and performing work duties.
Due to constant visual strain while viewing the environment, it becomes necessary to clear the field of vision from blurring using head and eye movements. This behavior puts strain on the cervical spine and eyes. As a result, a person develops psychological problems and may develop persistent depressive or stressful conditions, manifested in the form of sociopathy and constant anxiety. But not only this destruction is dangerous; in advanced cases there is a high probability of complete loss of vision.
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Destruction of the vitreous body is a pathological condition that results in the destruction of the normal structure of the vitreous body. The process is accompanied by thickening of collagen fibers, liquefaction of the gel-like mass and, in some cases, its wrinkling. To understand the essence of the disease, let us briefly consider the structure of the vitreous body.
Anatomy of the vitreous
The vitreous body is located between the retina and the lens and is a gel-like substance. It consists of 99% water and 1% hyaluronic acid, collagen fibers and other substances. Even though collagen and hyaluronic acid are present in such small quantities, they are very important components. Collagen forms the framework of the vitreous body and gives it elasticity, and hyaluronic acid provides a jelly-like consistency.
The vitreous body performs a number of important functions:
- Compensates for changes in intraocular pressure;
- Provides turgor (elasticity) of the eyeball;
- Participates in transmitting images to the retina.
How does destruction of the vitreous body form?
Normally, the vitreous body is completely transparent. However, under the influence of certain factors, collagen chains are split into small fragments that are no longer transparent. They are the ones that are perceived by the eye as spots, etc.
Violation of the structure of the vitreous body in some cases leads to mechanical damage retina and then a person sees sparks, flashes of light and other light effects before his eyes.
In advanced cases, destruction is severe. At the same time, there are a lot of collagen fragments, they float throughout the vitreous body and form peculiar tangles that interfere with vision. This usually happens in older people who suffer from atherosclerosis or other vascular diseases.
In advanced cases, destruction is severe
One of the types of destruction is destruction in the form of silver or golden rain. It is caused by the deposition of cholesterol crystals inside the vitreous. As the eye moves, these microscopic particles smoothly move and shimmer in the rays of passing light, which creates the picture of a brilliant golden rain.In especially severe cases, destruction leads to wrinkling of the vitreous body and its further detachment. This breaks the thin fibers connecting it to the retina. As a result, a rupture occurs with massive hemorrhages (you can read more about retinal rupture).
Causes of destruction
In elderly people, destruction of the vitreous body is a physiological phenomenon and is caused by the aging process of the body. The emergence The following factors may contribute to destruction at a younger age::
- Intense eye strain (reading, watching TV, etc.).
- Long-term hypoxia is a condition in which the brain does not receive enough oxygen (for example, working in a stuffy room).
- Chronic psycho-emotional stress.
- Effect of radioactive radiation.
- Smoking and alcohol abuse.
- Insufficient amount of minerals and vitamins.
- Atherosclerosis of the vessels of the head and neck.
- Hormonal imbalances caused by pregnancy, age or diseases of internal organs.
Classification of types of destruction
In practice, the following types of vitreous destruction are distinguished:
Symptoms of the disease
The main complaint with destruction of the vitreous body is floating spots before the eyes
The main complaint that is made with the destruction of the vitreous body is floating spots in front of the eyes. In the medical literature they are called myodesopsies.
Cholesterol crystals, blood clots, protein, and short chains of collagen fibers can bind together and cast a shadow on the retina. At this moment the person sees strange floating elements in his field of vision.
At first, when you look away, the front sights move sharply. However, as soon as you fix your gaze on a specific point, they slowly fall down.
The closer the collagen fragments are to the retina, the more clearly the patient distinguishes floaters.
Depending on the type and severity of destruction flies can take on the following shapes:
- Threads. They look like opaque or translucent stripes of brown, gray or black. Their ends are neatly rounded or sharply torn off. Can be long or short. Long threads constantly wriggle: they compress and straighten, twist, stretch, etc. Some people describe them as small moving worms. As for short threads, they practically do not change their shape and look like sticks or hooks. The described structures are an integral part of the filamentous destruction of the vitreous body.
If additionally sparks or flashes of light begin to appear before your eyes, this may indicate a more severe visual impairment (for example, vitreous or retinal detachment).
Diagnostics
Diagnosis of vitreous destruction is usually not difficult and is based for the most part on clinical picture. It is important not to miss accompanying illnesses, which also manifest themselves as spots before the eyes (hypertensive crisis, concussion, diabetes etc.).
When the vitreous body is destroyed, the floaters are constant, do not depend on the position of the body, and are best seen when looking at a light background.
Treatment of destruction of the vitreous body of the eye
Treatment is aimed at eliminating the cause that caused this pathology.
Unfortunately, to date, no treatment methods have been developed that can safely and efficiently eliminate the unpleasant symptoms of vitreous destruction. In this regard, treatment is aimed at eliminating the cause that caused this pathology.
There are several directions in the treatment of vitreous destruction:
- Non-drug methods;
- Drug treatment;
- Surgical methods.
Non-drug methods
Leading a healthy lifestyle
First of all, you need to give up smoking, alcohol, and a sedentary lifestyle. It has long been proven that nicotine is the most terrible enemy for blood vessels, which causes a number of diseases, including destruction of the vitreous body.
If you have to lead a sedentary lifestyle due to work, you should get a massage, especially in the neck area. This is due to the fact that incorrect posture during work can interfere with adequate blood circulation to the organs of the head, including the eyes. An alternative to massage can be yoga.
It is very important to reconsider your attitude towards nutrition. The daily diet should include as much fresh herbs, vegetables and fruits as possible. Foods such as blueberries and carrots are natural sources of retinol (vitamin A), which has a beneficial effect on vision.
Destruction may occur as a result of overwork nervous system. Therefore, we must try to avoid conflicts and stressful situations.
The measures described may seem more preventive than curative. However, normalization of lifestyle often reduces or completely eliminates the symptoms of vitreous destruction, which makes it possible to classify it as a therapeutic approach
Healthy activities for the eyes
The first step is to reduce the amount of strain on your eyes. If your professional activity associated with working at a computer, you need to take at least a five-minute break every half hour. In this case, just close your eyes and try to relax. It is also useful to make a special one.
Currently, the author's eye health systems developed by Dr. Norbekov, Shichko-Bates, Avetisov, are very popular.
Massotherapy
Professional massage of the face and eye area improves blood circulation and lymphatic drainage, which has a beneficial effect on all metabolic processes.
If the massage is performed efficiently, a person will notice a significant improvement in well-being after the first session.
Traditional methods of treatment
The most effective means Treatment of vitreous destruction are drops made from honey and aloe juice:
- 4 tsp aloe juice should be mixed with 1 tsp. natural honey to form a homogeneous substance, and leave for a couple of hours.
- It is necessary to instill three drops into each eye three times a day.
The product described saturates the tissues well nutrients and improves local blood flow.
Medication methods
As prescribed by a doctor, the following medications can be taken for destruction of the vitreous body:
- (has antioxidant activity and normalizes microcirculation processes);
- Cinnarizine, Cavinton(improves intracerebral blood circulation and strengthens the vascular wall);
- Wobenzym(an enzyme preparation that has the ability to dissolve collagen clots);
- Topical application of potassium iodide(has a resolving effect).
Surgical treatment of destruction
There are two methods of surgical treatment of destruction:
Vitrectomy
Removal of all or part of the vitreous. The vacated space is filled with an artificial environment ( saline solution, silicone oil, gas bubble, etc.).
This operation is used only in extreme cases and is quite dangerous, as it can be complicated by retinal detachment, cataracts, and intraocular hemorrhage.
Vitreolysis
Dissolution of opaque vitreous clots using a laser beam. The essence of the intervention is that laser ray splits clots into microscopic particles that can no longer be perceived by the eye.
Unfortunately, vitreolysis is not widely used and is practically not performed on the territory of the Russian Federation. The fact is that it is very difficult technically, since you have to work with moving objects.
Prognosis and prevention
Mild degrees of destruction, which occur in a large number of the population, have virtually no effect on ability to work and quality of life. It should be noted that people quickly get used to such visual effects and very quickly stop paying attention to them.
As for more pronounced destruction, it can cause certain problems (for example, overvoltage visual analyzer and disability). In such cases, it is necessary to decide on surgical intervention.
To prevent changes in the vitreous body, you need to carefully monitor your lifestyle. Unfortunately, it is the “benefits of civilization” that in most cases become the cause of this pathology: a sedentary lifestyle, TV, computer, etc.
Nowadays, destruction of the vitreous body occurs in almost every schoolchild. In this regard, parents should, from the very beginning early age accustom the child to compliance with visual hygiene rules: read only while sitting at a table and in good lighting, walk more in the fresh air, limit time spent in front of the monitor, etc.
In addition, everyone should visit an ophthalmologist at least once a year.
Today in medicine the need to restore vision is becoming increasingly important. Patients complain of decreased visual acuity and clarity of perception. For many, the perceived object doubles, or “floaters” appear before the eyes. In an attempt to figure out what these “floaters” are and where they come from, scientists came to the conclusion that the cause is destruction of the vitreous body of the eye. This is a rather complex disease that is difficult to treat.
Why is destruction of the vitreous dangerous?
The most dangerous are detachments, liquefaction, and wrinkling.
Liquefaction is accompanied by the formation of empty spaces. There is also an accumulation of intraocular fluid and protein compounds. Fibers are formed from fibrils, which stick together and form various configurations in the field of view; they are the ones associated with flies, cobwebs, and octopuses. In this case, threads and balls of yarn are formed.
Even more dangerous looking destruction is represented by wrinkling, the end result of which is retinal detachment. It represents a significant decrease in size of the vitreous body and the formation of folds. Gradually, the structure becomes deformed, the vitreoretinal structures become tense, which can lead to rupture or detachment.
Epidemiology
Based on their form, there are three types of destruction: filamentous, crystalline and granular. In terms of frequency of occurrence, the filamentous form predominates: 52%. Crystalline accounts for 4%, granular – 44%. The trigger factor that triggers the development of the filamentous form of the pathology is predominantly (in 71% of cases) atherosclerotic processes and progressive myopia.
The development of the granular form of the pathology is facilitated by the inflammatory process in the internal retinal layer. It is for this reason that 68% of cases of granular destruction develop.
Causes of destruction of the vitreous body
Destruction can occur due to various reasons. Almost always, the vitreous body undergoes degenerative and dystrophic changes with age. Such changes begin at about 40 years of age, and are finally formed by 60 years of age. Congenital myopia, a weakening of the eye muscle, can lead to similar changes. Often the pathology is a consequence of vascular disorders and occurs against the background of vegetative-vascular dystonia, arterial and venous disorders. Dystrophic changes in blood vessels can also lead to pathology. Cervical osteochondrosis, various hormonal and neuropsychic changes, pregnancy, intake hormonal drugs, can provoke disease.
Various injuries and damage to the head, neck, eyes, and eye surgery are also considered as a cause. Long-term physical exercise, stress, neuropsychic overstrain, exposure to radiation, toxins, and biological objects on the body also act as one of the causes of pathology.
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Risk factors
The risk group includes elderly people, pregnant women, people during hormonal changes(adolescence, menopause). The risk also increases significantly when taking certain medications, in particular hormonal drugs. To avoid risk, the development of osteochondrosis, myopia and weakness of the eye muscles should not be allowed.
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Pathogenesis
The pathogenesis is based on a violation of the normal structure of the transparent substance located between the lens and the retina of the eye. Normally, the vitreous body is transparent and is represented by special threads (fibrils) that are localized in the gel. Various pathological conditions and diseases entail aging fibrils, which quickly break down and lose elasticity. On top of them, various aging products are deposited in the form of grains.
The process is accompanied by clouding and the formation of spots, which are quite clearly visible on a white background or in the daytime, in the light. It is these grains, fragments of fibrils that a person perceives as flies and threads. They can envelop the eye like a film, significantly reducing vision.
Most often, the central sections of the colloidal gel undergo destructive transformations. The process occurs in several stages. At the first stage, a cavity is formed that contains liquid and coagulated collagen masses. Subsequently, an increasing number of fibrillar proteins are involved in the pathological process. They undergo coagulation, go far beyond the boundaries of the formation, as a result, the gelatinous substance turns into liquid and fills the space between the lens and the retina.
Gradually, substances of various configurations are formed, attached to the fundus of the eye and entail wrinkling, starting the adhesive process. There is a decrease in volume of the vitreous body, its deformation, as a result of which the vitreoretinal connections are stretched and subsequently retinal detachment occurs.
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Symptoms of vitreous destruction
Destruction of the vitreous body manifests itself as a defect that occurs in the visual field. These can be structures of various configurations, for example, threads of various thicknesses, balls of yarn, flies that constantly fly before your eyes. The forms can be absolutely any, but for the same person they remain constant. Quite often flashes and lightning appear before your eyes.
These phenomena are especially noticeable against a light background, in the daytime, against the background of any bright surfaces. If the lighting is insufficient, or in the dark, a person, as a rule, does not notice anything like this and does not experience any discomfort. Sometimes such phenomena can occur due to nervousness: after stress, nervous strain, overwork. Some people experience the feeling that objects move with their eyes, making it impossible to focus their eyes.
First signs
The first signs of destruction are the appearance of various small objects before the eyes. They move, less often they stand still. Most often, people compare such objects to spots, spots, and blurred vision. In ophthalmology, such periodically occurring images are usually called optical phenomena. They occur mainly when there is an increase blood pressure, when hit on the head. They can occur as a result of a sudden change in position when lifting heavy objects.
Optical objects are characterized by permanence, stable shape and good visibility against a light background. When these first symptoms appear, you need to consult a doctor as soon as possible in order to diagnose the disease, identify its cause and take the necessary measures.
Forms
Destruction of the filamentous form is characteristic of patients suffering from atherosclerosis. Also, the formation of threads may be a consequence of dystrophic changes in the retina. One of the most common pathologies that occurs in patients with myopia. Such changes may appear in old age.
If you examine the manhole floor using a slit lamp, you can note the presence of fibers that differ significantly in shape and size. Optically empty gaps are clearly visible between them. This is the zone in which the vitreous fluid liquefies. There are different forms of severity of the disease: from minimal to extremely severe.
When conducting a biomicroscopic examination of the eye, a suspension of microparticles of various sizes, shapes and colors is detected. The suspension is represented by the remains of the disintegrated structure of the vitreous body. Also contains cellular elements, components cell membranes. You can detect retinal ciliary cells, leukocytes, lymphocytes, pigment cells that came from defective vessels. A powerful destructive process develops, which is based on inflammation of the inner layer of the retina. Often occurs against the background of chronic or acute uveitis, diabetic retinopathy, hemophthalmos. In hemophthalmia, the grains are red in color.
Like golden shower
Patients often claim that golden sparks appear before their eyes. They become especially pronounced during eye movements. This indicates functional disorders of various organs, in particular: kidneys, liver, glands internal secretion. Often the cause is a metabolic disorder, which only gets worse over time. As a result, the colloidal environments of the body change and their composition changes.
Similar processes occur in the vitreous body. Pathological local changes develop in it, active processes of precipitation and coagulation unfold. Crystals are deposited, consisting mainly of cholesterol and tyrosine. The main accumulation occurs in the vitreous body. When they move, they oscillate in a pendulum manner, and active glow and shimmering begin. It is for this reason that the symptom is called “golden shower”. This form of destruction is quite rare.
Pathology can be diagnosed using ophthalmoscopy, a standard technique that is quite often used in diagnostic practice.
By mixed destruction we mean a type of pathology in which two types of destruction, or all three, develop simultaneously. Most often, both filamentous and granular pathology are observed simultaneously, in which both filamentous elements and granular components can be found in the eye cavity. The combination with crystalline destruction is observed extremely rarely, in approximately 1.5% of cases.
Destruction of the vitreous in both eyes
Destruction can develop in one or both eyes. In most cases, first one eye undergoes destructive changes, then, gradually, the pathological process spreads to the second eye. Most often, granular and filamentous destruction spreads to both eyes. Crystalline is rarely observed.
Destruction of the vitreous body in a child
In children, destruction is observed much less frequently than in adults or the elderly. Most often in children, destruction is a consequence of injuries or damage to the eye or brain. Congenital myopia, myopia, as well as stress, overwork, nervous and mental stress can lead to destruction of the vitreous body. Most often, children experience filamentous destruction, less often granular destruction. Cases of crystalline destruction are little known, and arose mainly against the background of delayed mental and physical development, and metabolic disorders.
Complications and consequences
A consequence of the destruction of the vitreous body should be the formation of voids in which fluid accumulates. Gradually they fill up intraocular fluid. The eye is exposed to necrotic and dystrophic processes. The most dangerous complication is retinal rupture or detachment.
How to stop the destruction of the vitreous?
In order to stop the destruction of the vitreous body, qualified assistance from specialists is required. It is not possible to do this on your own. First of all, you need to contact a retinologist who will conduct an examination of the fundus. In order to identify pathology, the ophthalmoscopy method is used, which is an examination of the eye using a slit lamp.
The main condition is early diagnosis, which makes it possible to promptly identify the cause of the formation of flies. This significantly increases the chances of successful treatment and prevents further progression of the disease. The doctor determines the specifics of therapy, depending on the identified pathologies. May be required surgical intervention or laser correction, since there is no specific conservative treatment.
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Diagnosis of vitreous destruction
The basis of diagnosis is the recognition of pathology mainly based on the clinical picture. Therefore, it is important to carefully study the patient’s life and illness history and obtain the necessary information and information about the patient. Based on the patient’s subjective feelings and objective examination data, a preliminary diagnosis is made. If there is insufficient data, additional laboratory and instrumental studies may be prescribed. Also held differential diagnosis, which allows you to clearly distinguish the signs of one disease from another. At the same time, it is important to pay attention to concomitant diseases, since they can also cause the development of destruction. Often, destruction is not the main disease, but a secondary pathology that develops as a result of another disease.
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Analyzes
Need in laboratory tests occurs rarely, since the main research method is instrumental diagnostics. Rarely, bacteriological examination of tear fluid may be necessary. This need arises mainly in case of bacterial infection of the eye or suspected conjunctivitis.
In case of acute inflammatory process, a clinical blood test is taken. In the case of a crystalline form of destruction, which occurs against the background of metabolic disorders, a biochemical blood test and a detailed immunogram may be required.
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Instrumental diagnostics
At the core instrumental diagnostics There is ophthalmoscopy and biomicroscopy, which allow a detailed study of the eye itself and the fundus of the eye. Additional research methods that can provide the required amount of information are ultrasound, tonometry and visometry.
Using the ophthalmoscopic method, it is possible to identify optically empty cavities, which in most cases are represented by vertical slits. In the presence of complete destruction, a single cavity is found filled with fibril fragments. The limiting membrane may be destroyed, then the retrolental space is absent. If the opacification is localized at the edge of the retina, specific changes will not be detected.
Using a slit lamp, a biomicroscopy examination reveals a colloidal gel, cloudiness in the form of flakes. With filamentous destruction, loop-shaped collagen fibers are detected. Granular destruction manifests itself as an accumulation of small particles. The particles are predominantly gray or brown. At later stages, clusters of grains can be identified as a separate conglomerate.
Also a very informative research method is ultrasonography. It is used most often in the presence of hemorrhages in the retina or vitreous body. Makes it possible to identify the source of hemorrhage. Presence of echo-negative signals from crystal lattices inside the colloid, as well as the mobility of crystals, grains and collagen accumulations indicate liquefaction of the vitreous body.
Optical coherence tomography is performed if other research methods have not provided the required amount of information. Destruction will be indicated by a decrease in size and an atypical shape of the vitreous body, its cloudiness and heterogeneous consistency. In case of massive hemophthalmia, the method is contraindicated.
Visometry can be used to diagnose the degree of vision loss.
Tonometry is used to examine intraocular pressure.
Differential diagnosis
In order to make a final diagnosis, it is necessary to clearly separate the signs of destruction from other diseases that have similar manifestations. So, similar floaters and spots before the eyes can occur with retinal tears, head trauma and neurological disorders.
These diseases can be ruled out by physical examination, vision testing, fundus examination, and examination using a slit lamp and ophthalmoscope.
Treatment of vitreous destruction
The treatment is quite complex and is selected strictly individually for each patient. The intensity and focus of therapy is determined by the nature and extent of the lesions, as well as how much the patient’s vision is impaired. The influence of pathology on performance, physical and mental condition patient.
Specific treatment has not been developed to date. There are still no methods that would effectively remove fibrillary growths without additional risks. Therefore, therapy is based on identifying the underlying disease and further combating it. For example, if the cause of destruction is diabetes, then it is necessary to fight it first, then the destruction will be normalized as a secondary pathology.
The basis of drug therapy is the use of absorbable agents, drugs that improve cerebral circulation. There is no specific treatment aimed directly at restoring destroyed fibrils and preventing destruction.
Currently on the market a large number of biologically active additives, drugs that can indirectly affect tissue restoration, including fibrils. You can try the use of physiotherapeutic methods, folk recipes And homeopathic remedies. Surgical treatment and laser correction are also used.
Is it possible to cure vitreous destruction?
There are no direct methods aimed at treating destruction. But destruction can and should be treated. Today, treatment includes means aimed at resolving deposits and fibrillar formations inside the eye, as well as reducing the load on the visual analyzer. Etiological therapy is used, aimed at eliminating the cause that caused the destruction. Also applies symptomatic therapy, which allows you to eliminate the main symptoms of the pathology. These methods allow you to achieve good results and prevent further development of pathology. If ineffective, surgical methods or laser correction are used.
Medicines
First of all, I would like to note that there are no specific drugs aimed at treating the destruction of the vitreous body. Therefore, at this time, any claims that any drug or supplement is aimed at eliminating destruction are false or erroneous. Any drug will have only an indirect effect, this must be remembered. It is important to take precautions - use the products only as prescribed by a doctor, according to a strictly prescribed regimen. This is due to the fact that the funds are selected for each case individually, and are based on the results of laboratory and instrumental studies. Numerous side effects are possible, in particular, worsening of the pathology or the occurrence of other diseases of the organ of vision.
To improve cerebral circulation, and as a result, improve blood supply to the brain, use 0.4 grams of piracetam 2-3 times a day.
To eliminate hypoxia and normalize metabolic processes in the brain, cinnarizine is used: 25 mg 2-3 times a day.
Mexidol has proven itself well, having a relaxing and antioxidant effect. Eliminates dystrophic and necrotic processes, accelerates the transmission of nerve impulses, and promotes the resorption of compactions. The drug should be taken with a gradual increase in load from minimum to maximum. Start with 200 mg per day, gradually increase to 600 mg. It also needs to be completed gradually. In this case, you need to return to the minimum dosage – 200 mg per day.
Mydocalm is used to stabilize the nervous system, normalize metabolic processes and reduce muscle tone. Take one tablet three times a day.
Drops for destruction of the vitreous body
Used to treat destructive processes eye drops. They are vitamin and absorbable, aimed at resolving deposits and formations inside the eye. Drops such as oftadex, taufon, ciprofloxacin, and chloramphenicol drops have recommended you well. Potassium iodide is also used as a strong absorbent agent. The drops have a local effect. Their use alone will not be enough to eliminate the pathology and alleviate the condition. Therefore, they resort to systemic therapy, taking medicines inside.
- Wobenzym
A drug intended to normalize microcirculation in the tissues of the eye. It has a resolving effect, eliminating the inflammatory process and reducing the amount of deposits and neoplasms in the eye. Restores normal blood circulation. It is an enzyme preparation that resolves collagen fibers and their clots. Use strictly as prescribed by a doctor, in compliance with an individually developed regimen. In this case, the scheme is developed based on the results of laboratory and instrumental studies.
- Emoxipin
The drug is aimed at normalizing microcirculation in the tissues of the eye. Refers to vascular drugs. Restores cerebral circulation, normalizes intraocular pressure. Use strictly as prescribed by a doctor in accordance with the prescribed regimen.
- Taufon
It is an eye drop that stimulates metabolic processes in the cells and tissues of the eye. It contains active vitamin complex. Used for minor impairment of the visual field. For more severe disorders, it is required complex therapy, including systemic drugs. Apply 2-3 drops 3-4 times a day.
- Glycine
Glycine is a drug aimed at stimulating activity and normalizing brain function, improving cerebral circulation, maintaining normal blood supply and metabolism. Normalizes brain function and auditory analyzer. Take 2-3 tablets, 3-4 times a day.
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Vitamins
To maintain the normal functioning of the visual analyzer and prevent destructive and dystrophic processes, it is recommended to take vitamins in the following daily concentrations:
- Vitamin H – 150 mcg
- Vitamin PP – 60 mg
- Vitamin C – 500-1000 mg
- Vitamin E – 45 mg.
Physiotherapeutic treatment
Electrophoresis is used as the main physiotherapeutic procedure. This is a procedure based on the effect of microcurrent on the skin and mucous membranes. Under the influence of microcurrent medicinal substances quickly penetrate deep into tissues, penetrating directly into the tissue that needs treatment. This increases the accuracy and direction of action, reduces the need for the amount of substance. Accordingly, the likelihood of side effects and overdose. Basic medications– absorbable, vascular, vitamins and enzyme complexes.
Traditional treatment
To prepare the decoction, 25 grams of cumin are required. Boil for 5 minutes in boiling water. Then they do not filter, but add a tablespoon of blue cornflower flowers to the resulting decoction. Remove from heat and leave for an hour, wrapped in heat. After this, the decoction is filtered and 1-2 drops are dropped into the eyes when discomfort, burning, floaters, or decreased vision appear.
Toadflax grass has long been used for washing and eye drops. To prepare the decoction, take 15 grams of herb and infuse it in boiling water for 8 hours. Drop 2-3 drops three times a day.], ,
Treatment of destruction of the vitreous body of the eye with an egg
IN folk medicine Destruction of the eye is treated with an egg. To carry out the therapeutic effect, you need to boil a hard-boiled egg. Take out the yolk and grind it with honey until a homogeneous mass is formed. The protein is boiled again. As soon as it has become moderately hot, apply it to the eyes from above, lie down and lie there for 10-15 minutes. After removing the white, apply a mixture of yolk and honey to the area around the eyes and lie there for another 5-10 minutes. Perform the procedure daily for at least 5 days in a row. Promotes the resorption of tumors and deposits, relieves the inflammatory process.
Herbal treatment
Herbs are actively used to treat various inflammatory and destructive processes, including the treatment of eye diseases.
Plantain decoction has proven itself well for the appearance of spots and circles before the eyes. To prepare a decoction, take a tablespoon of herb and pour a glass of boiling water. Infuse for 1-2 hours, use for eye rinsing, washing or lotions.
Also use a decoction of knotweed. To prepare, add 1-2 cups of boiling water to a tablespoon of herb. Use warm for rinsing and lotions.
A decoction of mint is used for the appearance of floaters and other unpleasant sensations before the eyes. As local remedy used for lotions, washing and eye drops. As a systemic drug, the prepared decoction is taken orally.
To prepare, pour a tablespoon of herbs into two glasses of boiling water. Leave for 30 minutes. Then divide into two glasses. Drink one glass throughout the day. It is recommended to drink a third of a glass three times a day. The second glass is used for external use.
Homeopathy
Homeopathic remedies are quite effective and cause minimal side effects. But, despite this, you need to take precautions: take only after prior consultation with your doctor, strictly follow all recommendations and dosage regimen.
Means aimed at eliminating necrotic, dystrophic and destructive processes in body tissues have proven themselves well. These are mainly herbal infusions, which have long been used to activate metabolic processes and stimulate regeneration in tissues.
- Recipe No. 1.
To prepare the infusion, mix 15 grams of white cinquefoil with 10 grams of hop cones, pour in 500 ml of vodka. Drink 50 grams per day.
- Recipe No. 2.
Take 10 grams of burnet, mix with 15 grams of elecampane, pour in 500 ml of vodka. Drink 3-4 tablespoons twice a day.
- Recipe No. 3.
Take burnet herb, black poplar buds in a ratio of 2:1, pour a glass of vodka, leave for a day. Drink 2-3 tablespoons twice a day.
- Recipe No. 4.
Take meadow geranium tincture and hop cone extract, mix in a 2:1 ratio, and infuse for 24 hours. Drink a tablespoon three times a day.
Surgery
The main method of surgical treatment is vitrectomy - a technique aimed at complete or partial removal of the vitreous body. After this, the removed areas must be replaced with a special artificial environment. This is a radical method that is used only as a last resort in the presence of serious indications.
The operation is effective, but it is rarely performed due to high risks. Complications are often observed, such as: hemorrhage into the eye cavity, retinal detachment, cataracts.
Treatment of vitreous destruction with laser
If the destruction is severe enough and cannot be conservative treatment, surgical methods are used. The main technique is vitreolysis, aimed at crushing large fragments of collagen. Local anesthesia is used for the operation.
First, the pupils are dilated using short-acting mydriatics, then the necessary manipulations are performed using a laser. The operation is complicated by the high mobility of pathological accumulations inside the colloidal gel. However, in general, such operations are quite quick and successful, there are practically no complications after them, and vision does not decrease.
Unfortunately, today the operation is not widespread enough. Only a few specialists practice it.
Nutrition for destruction of the vitreous body
During destruction, you need to eat gentle food. It is advisable to use boiled, steamed dishes. It is also important to include in your diet a large amount of foods containing carotenoids, vitamin A, E, B. A must-have product Blueberries should be on the table, since the berries have a restorative effect on the eyes. You need to eat carrots daily, both fresh and as part of various salads. Products such as lettuce, spinach, celery, and turnips are good for vision. Fatty meats, fried, smoked, spicy foods, marinades, and smoked foods should be excluded from the diet.
Prevention
Prevention is based on timely diagnosis. When the first signs of the disease appear, you need to consult a doctor as soon as possible. It is important to undergo preventive examinations in a timely manner, to treat identified diseases of other organs, especially vascular pathologies. This is due to the fact that destruction is often a secondary pathology that occurs as a result of a disease of another organ or system.
Avoid fatigue and eye strain. If poor vision occurs, it is necessary to properly correct it. It is also important to maintain a nutritious diet containing the required amount of nutritional components and vitamins. You need to include more fresh fruits and vegetables in your diet, especially carrots and blueberries.
],“Floaters” are deposits or condensation of small particles in the vitreous . Such opacities, which seem to float before the eyes, can occur either in one eye or in both.
Why do floaters appear?
The main light-refracting structures of the eye - the cornea and lens - concentrate the light beam directly on the retina. This provides us with a clear vision.
But while the light reaches the retina, it passes through another transparent medium of the eye - the vitreous body. It is a jelly-like substance that occupies almost the back 2/3 of the eye.
At the birth of a child and during childhood, the vitreous body is completely transparent. Over time, some deposits and liquid pockets form in it.
Each such deposit casts a shadow on the retina, which is perceived by a person as a floating cloudiness. These opacities become “floating” because with every movement of the eye in the orbit these deposits also move.
Vitreous floaters
People describe floaters as spots, curved stripes, and C- or O-shaped patterns. Some may think they only see one floater, while others may see as many as a hundred.
These floating lines can be either thick or thin, and sometimes branched. In most cases, patients describe them as brown or black. The density of floating particles may vary in each case.
In some situations, these opacities are more clearly visible, and in others, such as when the patient looks at a bright sky, they may become transparent.
Like fingerprints, floaters are unique to each person, that is, identical “spots” cannot be found. Moreover, if these opacities occur in both eyes of a patient, then they may be different in each eye. Additionally, these opacities may change over time. Vitreous floaters always darker than the background and cannot be seen in the dark or with closed eyes.
Causes of floaters in the vitreous body
Any condition in which the transparency of the vitreous humor is impaired can cause the appearance of vitreous floaters.
With age, natural changes occur in the vitreous body. At the same time, small pockets are formed in it, in which the “jelly” of the vitreous body turns into liquid. This is the so-called syneresis (collapse) of the vitreous.
The ligaments between each such fluid pocket and the vitreous jelly may be perceived as a floater. In addition, with age, the collagen fibers contained in the vitreous body become denser and thicker, which also leads to the appearance of floaters. Any person over 50 years old experiences changes in the vitreous substance, but their degree may vary.
As a person ages, the structure of the vitreous body also ages, which is manifested in its shrinking in the space it occupies. This wrinkling leads to displacement back surface vitreous body forward.
Normally, the vitreous is attached to the edges of the optic disc. As the vitreous body shrinks, this connection weakens and it begins to “float” in the eye cavity, which leads to the sensation of opacities, which can sometimes be quite extensive in size. In addition, the very back surface of the vitreous, which “floats” in the eye cavity, also casts a shadow on the retina, which leads to the sensation of opacities.
Wrinkling and detachment of the posterior surface of the vitreous is called posterior vitreous detachment. This is not the same as retinal detachment. Approximately 50% of people over 65 years of age experience posterior vitreous detachment. It is noted that if a patient has developed posterior vitreous detachment in one eye, it will occur within 1.5 years in the other.
In addition to vitreous syneresis and posterior vitreous detachment, which are natural causes floaters, there are many diseases that can lead to the appearance of floaters.
Any cellular material in the vitreous substance can cause opacities. For example, most often such material is erythrocytes during hemorrhage and leukocytes during inflammation.
In this case, hemorrhage into the vitreous body can be a result of eye injury, diabetic retinopathy, retinal rupture through blood vessel or eye surgery. Inflammation in the vitreous can be caused by uveitis, trauma, infection, or surgery.
How common are vitreous opacities?
Floaters in the vitreous body are quite common and are the leading symptom for which people consult an ophthalmologist.
By age 70, nearly everyone will experience floaters, although some people have them more often than others. In children under 16 years of age, floaters are very rare.
Eye diseases with floaters
Vitreous floaters are associated with diseases such as diabetic retinopathy, retinal tears, retinal detachments, and high degrees of myopia.
This condition is more common in people who have undergone eye trauma, cataract surgery, or YAG laser surgery. In addition, opacities can also occur when the eye is damaged by tuberculosis, sarcoidosis, syphilis and toxoplasmosis.
Another cause of floaters is a condition called asteroid hyalosis. Rare reasons Opacities in the vitreous can be primary and secondary tumors such as leukemia and lymphoma.
Risk factors for floaters
The earliest risk factor for the appearance of floaters is myopia. With myopia, vitreous syneresis and posterior vitreous detachment are much more common.
Another risk factor is diabetes mellitus, which can cause diabetic retinopathy. Other risk factors include eye injury.
Are vitreous opacities dangerous?
Floaters may irritate the patient, but in principle they are not dangerous to vision. Most floaters are associated primarily with aging and natural processes occurring in the eye.
However, if you have floaters, you need to undergo regular examination by an ophthalmologist to identify early stage conditions that may be associated with the appearance of these opacities.
The sudden appearance of many opacities or their combination with “flashes” of light can indicate a retinal tear and in this case urgent treatment is needed to avoid retinal detachment. The disappearance of visual fields may be an additional sign of retinal detachment.
Diagnosis of vitreous opacities
When consulting an ophthalmologist about floaters, the doctor will first ask you about them. In addition, he will test your visual acuity, examine your iris at the slit lamp, and then perform an ophthalmoscopy.
Can floaters go away?
Most vitreous floaters decrease in size and become darker over time. In some cases, this occurs due to the natural process of resorption of deposits inside the eye.
In addition, sometimes these deposits can move in such a way that this causes a significant reduction in the shadow they cast on the retina. Also, over time, the brain itself can adapt to these opacities and no longer seem to notice them.
How to get rid of floaters
Currently, in ophthalmology there are no methods for removing vitreous floaters caused by syneresis or posterior vitreous detachment. Most of them will go away on their own over time or simply stop bothering you.
Drugs that can remove opacities
Although some vitamins, herbs, and iodine-containing medications are considered effective in reducing the severity of floaters, there are no clinical studies to prove their effectiveness.
In rare cases where the opacities are caused by an inflammatory reaction in the eye, the use of antibacterial and anti-inflammatory agents may be effective in clearing up the opacities. There are no pills or eye drops that eliminate cloudiness.
