Myodesopsias or floaters: what they are, why they form, the cures


Look at the blue sky and see it dotted with one or more flying flies is the strange condition that characterizes a rather frequent eye disorder, known as floaters (from the Greek opsisvision, e myōdessimilar to flies), where curious shapes, called flying flies, seem to move together with our eyes.

«In about 95 percent of cases these floaters are not associated with a pathology, but depend on one physiological modification of the vitreous humora gelatinous substance present in the back of the eye,” explains the professor Michael Reibaldidirector of the Ophthalmology Clinic of the City of Health and Science of Turin.
Even if they can appear in all age groups, the two most frequent peaks are concentrated between 20 and 30 years, and then jump between 50 and 60 years.

What are floaters

When we are born and for the first phase of our life, the vitreous humor is completely transparent due to its architecture, made up mostly of water, together with collagen fibers and some proteins. “This structure is made in such a way that it can be completely crossed by light, which can thus stimulate the retina to allow vision,” explains Professor Reibaldi. «Over the years, however, the gelatinous component liquefies and modifies its structure, going to form some accumulations that block at least partially the light rays».

From that moment on, when it passes through those specific points, the light is no longer able to stimulate the retina, but rather projects those images in the form of shadows, which can take the form of small flying flies, precisely, but also of hair, cobwebs and spots of various sizes, more or less dense, which move together with the gaze».

Floaters, what are the causes

We have said that, usually, floaters are due to a natural aging of the vitreous humor, but all those conditions that lead to a acute dehydration. «An example is the abundant sweating that accompanies sports training, if it is not properly replenished with the right fluid intake», explains Professor Reibaldi.

«Only in a small percentage of cases, however, floaters are the initial symptom of a retinal detachment or of ableeding inside the eyeespecially in diabetic patients.

When floaters are dangerous

In general, floaters are completely benign and do not create particular problems, but when they are placed on the central visual axis, i.e. in front of the macula, they can have a heavy impact on the quality of life, to the point – in the most serious cases – of causing considerable difficulty reading, driving or carry out normal daily activities.

«Be especially careful when floaters are accompanied by other symptoms, in particular a intense light stimuli, similar to flashes, mainly in the peripheral portion of the eye: these flashes, called photopsies, can indicate a traction that the vitreous exerts on the retina, laying the foundations for its possible detachment», warns Professor Reibaldi. «To turn on an alarm bell it must also be a worsening change of the phenomenonFloaters usually don’t change overnight. If, on the other hand, a rapid deterioration or a sudden increase in the spots is observed, it could be an eye hemorrhage or, in any case, a pathological condition to be treated promptly ».

How floaters are diagnosed

A fundus examination, with a dilated pupil, is enough to confirm the presence of floaters. “This examination allows not only to visualize and characterize these floaters, but also to exclude the possible pathologies associated with them”, reports the expert.

How floaters are treated

At present, there is no drug therapy that can solve the problem. “The only valid remedies are one proper hydration in order not to make the problem worse and give space to the brain’s ability to adapt, avoiding obsessive concentration on the moving body», suggests the expert.

In the most serious and impactful situations, on the other hand, special treatments can be evaluated: «La vitreolysis “disintegrates” these floaters with the laser, breaking them into smaller aggregates or moving them away from the central visual area, so that they do not disturb vision. There is also a more radical approach, the vitrectomy, which involves the partial or total removal of the vitreous humor and its replacement with a saline solution. However, these are complex interventions and not without risks, to be reserved only for exceptional cases and of real need”, concludes Professor Reibaldi.

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