Mouches volantes - Eye Floaters Explained
Mouches volantes are perceived opacities in the field of vision that appear as floating threads, dots, or cobwebs. They are most commonly caused by changes in the vitreous humor of the eye.
Things worth knowing about "Mouches volantes"
Mouches volantes are perceived opacities in the field of vision that appear as floating threads, dots, or cobwebs. They are most commonly caused by changes in the vitreous humor of the eye.
What are Mouches volantes?
Mouches volantes (French for flying flies, medically also known as floaters or vitreous opacities) are visual phenomena in which individuals perceive floating dots, threads, rings, or shadows in their field of vision. These opacities move along with eye movements and are especially visible against bright backgrounds such as a blue sky or a white wall.
Causes
The most common cause of mouches volantes is an age-related change in the vitreous humor (corpus vitreum), the gel-like substance that fills the interior of the eye. As we age, this gel undergoes changes:
- Vitreous liquefaction: The gel gradually becomes more liquid, and solid components clump together to form opacities.
- Posterior vitreous detachment (PVD): The vitreous humor detaches from the retina, which can cause a sudden onset of floaters.
Other possible causes include:
- Short-sightedness (myopia)
- Eye injuries or eye inflammation (e.g., uveitis)
- Diabetic changes in the eye (diabetic retinopathy)
- Retinal tear or retinal detachment
- Bleeding into the vitreous humor (vitreous hemorrhage)
Symptoms
Typical symptoms of mouches volantes include:
- Floating dots, threads, rings, or shadows in the visual field
- Movement of the opacities when the eyes move
- Increased visibility against bright backgrounds
In most cases, mouches volantes are harmless. Over time, most people notice them less as the brain learns to filter them out.
When to See a Doctor
Certain warning signs require immediate ophthalmological examination:
- Sudden onset of many new floaters
- Flashes of light (photopsia) accompanying the floaters
- A gray shadow or curtain in the visual field
- Rapid deterioration of visual acuity
These symptoms may indicate a retinal detachment, which is a medical emergency and must be treated without delay.
Diagnosis
Diagnosis is made through a comprehensive ophthalmological examination, which typically includes:
- Slit-lamp examination: Assessment of the anterior segment of the eye and the vitreous body
- Fundoscopy (ophthalmoscopy): Examination of the retina and vitreous after pupil dilation
- Optical coherence tomography (OCT): Detailed imaging of retinal layers when needed
- Ocular ultrasound: Assessment of the vitreous when the optical media are opaque
Treatment
In most cases, no treatment is needed, as mouches volantes are usually harmless and symptoms often improve over time. For particularly bothersome floaters, the following treatment options are available:
- Watchful waiting: The most commonly recommended approach for benign, age-related floaters
- YAG laser vitreolysis: A laser procedure in which floaters in the vitreous are fragmented or dissolved using an Nd:YAG laser. Suitable for selected cases.
- Vitrectomy: A surgical procedure in which the vitreous humor is partially or completely removed and replaced with a saline solution or other medium. Only indicated in severe cases, as complications are possible.
References
- American Academy of Ophthalmology (AAO): Floaters and Flashes in the Eyes. www.aao.org (2023)
- Spraul CW, Grossniklaus HE. Vitreous Hemorrhage. Surv Ophthalmol. 1997;42(1):3-39.
- Sebag J. Floaters and the Quality of Life. Am J Ophthalmol. 2011;152(1):3-4.
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