TREATMENT OF THE DISEASES OF THE GLASS BODY
Vitreolysis with a YAG laser is a treatment that helps reduce or completely eliminate large floating opacities of the vitreous bodies.
The presence of vitreous opacities is very common, and most of them do not need any treatment.
The condition of the presence of small single fragments in the vitreous cavity is the norm from a medical point of view. However, there are often stronger opacities that cause difficulty in reading, driving, and using a computer. For the most part, the translucent "ghosts" that appear in the field of view when, for example, a sharp fall or a parachute jump, lifting of gravity or against the background of complete well-being and subsequently visible when looking at bright objects carefully, are natural lacunae in the vitreous due to by construction. They sometimes close themselves, move, or form new ones (slow, for months) by themselves.
In general, any noticeable “worms” are something in the vitreous that interferes normally with the light reaching the retina. In English literature, referred to as "floaters" —as the motes on the camera's matrix. This condition is called "destruction of the vitreous body" (DST).
"Flying midges" and "worms" in the eyes, or where do the "broken pixels" come from?
Lift your head and look at something evenly colored on a light background (wall, snow, sky without sun). If you suddenly began to swim before your eyes here are about these things:
Get acquainted, this is the destruction of the vitreous body in your eye. Such “glitches” appear in many people even in childhood and over the years they multiply or gradually change. For most people, their presence is not a cause for concern, but their sudden appearance or a sharp increase is a reason for an urgent visit to an ophthalmologist. Especially if lightning before eyes, dark veil or fine “tobacco dust” are added to this. But let's understand the full situation, let's talk about what kind of phenomenon it is and where it comes from.
The eye is a bulb, most of which is occupied by the vitreous body (as much as 2/3 volume).
It is clearly seen in the diagram above - this is the space between the lens and the retina in the eye cavity. In a normal eye, the vitreous body is so transparent that when translucent eyes appear empty.
The vitreous body is a jelly-like, transparent, viscous and well-stretching structure like jelly or jelly. It consists of “jelly” of water, colloids and trace elements - collagen fibers resembling interwoven ropes impregnated with hyaluronic acid. Unlike the cornea, consisting of the same matrix, the density of the filaments in the vitreous is lower, so the cornea is dense and rigid (by the standards of what is in the eye), and here it is the viscous medium that awaits us. This environment is heterogeneous, there are voids and “tanks” in it, various lacunae. The vitreous body is adjacent to the back surface of the lens, for the rest of its length it comes into contact with the retina. From the optic nerve head to the lens through the vitreous body passes a special hyaloid channel, and the framework of the vitreous body forms a thin network of intertwined fibers of various forms of collagen protein. And the gaps are filled with liquid - this structure gives it the appearance of a gelatinous mass. Due to the vitreous body of the eye, we have the correct spherical shape, it provides incompressibility and eye tone, it is dampened by tremors, nutrients move along the channels. But the light refractive function is very small.
If we need to deliver the medicinal substance to the deep parts of the eye, then we introduce it directly into the vitreous cavity with a micro needle because the eye is sufficiently isolated from the body as a whole, and not everything that enters the blood reaches the inner contents of the eye.
In itself, the vitreous body is not attached to the retina over the main area, but simply very closely adjacent. However, in the macula (the center of the eye, the yellow spot), there are attachments near the optic nerve and at the equator of the retina, which are quite strong. If in the eye with age, with injury or the appearance of another disease of the eye and the organism as a whole, not just destruction (in general, not dangerous), but any blood cells, inflammation appears - this is a very dangerous problem. Everything that gets into such a closed cavity is absorbed for a long time, it is difficult and not always completely with a transparent effect. As a rule, dyed opacities, rough adhesions and cords, reducing visual acuity, remain. Such a terrible picture can be seen with hemorrhage into the vitreous (this is called hemophthalmus).
And if droplets of cholesterol accumulate in the vitreous body, it looks like a “golden rain”.
What happens with age?
Somewhere after 30 years, new “midges” often begin to appear, and after 40 years, hyaluronic acid is gradually lost, the transparency of the vitreous body decreases, and visualization of fibers appears. Still later, the vitreous body generally dries out and begins to exfoliate from the retina (it simply moves away in places where there is no attachment). Vitreous detachment is a normal sign of aging, it is caused by dilution of the vitreous body, leading to tension on the retina in places of strong attachment, which can lead to rupture of the retina. Acute detachment of the vitreous body in 15% of cases leads to retinal breaks.
"Blackflies" in the eye: so what to do with them?
If, after examination, the doctor does not find damage to the retina in the fundus and only notes the presence of micro-inclusions in the vitreous, then there is no need to worry - there are no serious risks to your eyesight.
If the patient sees at the same time “garbage and midges” that bother him, but knows that there is no danger in this, the issue of dynamic observation and habituation to minor defects in the quality of vision are most often discussed. In addition, after a couple of months, these inclusions patients really cease to notice and do not focus their attention on them.
But in some cases, complaints may be due to reduced vision due to "turbidity" floating in front of the eye. Then, together with an ophthalmologist, a specialist in retina (and not just a doctor in the clinic), the treatment of this condition may be discussed.
There are two options: the first one involves the destruction of fragments in the vitreous body using a modern YAG laser (laser vitreolysis), the second is the surgical removal of a part of the vitreous body within the optical axis (vitrectomy operation).
Patients are often told that vitrectomy is the only solution, but it is rarely recommended by its standard method because of the risk of cataract formation, and in 2% of cases of retinal detachment. Therefore, vitreolysis with the help of a Yag laser provides a number of advantages: it is much safer than vitrectomy, affects only the clouded areas, and not the entire vitreous body, an outpatient procedure and lasts only 10-15 minutes, the patient is fully restored within 24 hours.
How basically the body needs this structure - the vitreous body - is very difficult to judge. It seems possible without him, but the need for it in the structure of the eye is not yet fully understood. While it is intuitively clear that the vitreous body is better preserved, if possible.
A large number of doctors of the last century and the current one investigate the structure of the vitreous body - this is evident from the number of names by which its structures are named (channels, ligaments, etc.).
With age, the vitreous body ages, shrinks, and can cause certain problems. You need to keep an eye on your own eyes, when symptoms of vision deterioration in any kind and age appear, contact the specialists of the “Optimed” clinic for help.