Wen / Dr. Gao Sheng, Department of Ophthalmology, West China Hospital, Sichuan University, ed. / West China Hospital, Sichuan University
[Sohu Health] Those crooked things on the following picture, do you know what they are?
These are a bit like noodles, genetic sequences, twisted things, do you know what it is?
This image of the camera is dirty, a touch of ink lumps of things, do you know what it is?
But anyone who clicked on the brain shell and knew what it was, you guessed it, today we are finally going to talk about floaters!
This topic has always been a relatively high voice in the background message, and it is also asked a lot of questions by our ophthalmologists in the outpatient clinic, because there are really many rumors and misconceptions related to it.
"Doctor, do I have worms in my eyes, oh, it will twist!!"
"Doctor, are you going to be blind with floaters?"
"Doctor, is it not feasible to treat it with a therapeutic instrument, eye drops, surgery, etc."?"
Today, our rumor-busting team invited Dr. Gao Sheng of the Department of Ophthalmology of West China Hospital to talk to you about whether there is a cure for this floater disease that should be carried out.
Floaters refer to the symptom that when you close or open your eyes, you can see translucent or black-gray floating objects similar to mosquitoes or gossamer in front of your eyes, flying around relatively fixed positions.
Especially on a white background, the better the weather, the bluer and brighter, the more obvious the flying mosquitoes.
Asked: "Doctor, I am a little different from them, I have been staring at a slightly bright spot, and the eyes will appear transparent and sink down from the top, is this considered a floater?" ”
A: Floaters is just a feeling, as long as there is something fluttering in front of your eyes, it can be said to be floaters. It's just that some are light and some are heavy, some don't need to be treated, and some need to be treated immediately.
Why do floaters occur?
According to the current research, vitreous liquefaction and retrovital detachment are the main causes of floaters, and a small part of them are caused by diseases such as retinal rifts. Among these reasons, vitreous liquefaction accounts for the largest proportion.
01 Vitreous
Let's first look at what a vitreous is.
The vitreous body is a transparent filling inside the eye, a bit like jelly, which supports the entire eyeball like a pillow core. The vitreous body is composed of 98% water and 2% protein complex, and in the protein complex, it is mainly collagen fibers, hyaluronic acid, and chondroitin sulfate.
(The light green part is the vitreous body.)
02 Vitreous liquefaction
Vitreous liquefaction, mostly the result of natural aging.
With age or the increase in myopia, the moisture in the vitreous slowly separates from the protein complex, resulting in liquefaction of the vitreous, and the collagen fibers that have lost moisture shrink together to form a translucent substance.
This translucent substance will float around in the water, that is, the dots, threads, worms and so on that you see now.
Q: "Doctor, does that mean that the older you get, the more likely you are to develop floaters?" ”
A: If you only look at it from the perspective of vitreous liquefaction, you can say so.
He also asked, "Doctor, you are not right, I have those flying things in my eyes when I was eleven or twelve years old, maybe my vitreous body did not grow old before it was old?" ”
A: Age is only one of the factors that cause vitreous liquefaction, in addition to myopia, trauma or fundus lesions.
For example, we encounter many floaters who have eye trauma caused by exercise or accident, which causes vitreous liquefaction.
You think, the basic function of the vitreous body is to maintain the shape of the eyeball, and play a certain degree of buffering, if you encounter a strong external force, it will destroy the internal structure of the vitreous body and form vitry liquefaction.
1. Physiological floaters
Many people feel that the things that fly with their eyes are very annoying, and when they come to the clinic, they are eager to talk to the doctor about a stomach of bitter water, and even some children's shoes also bring paper and pen, and they have to draw the things that fly with their eyes to the doctor to be assured!
To be honest, whether your eyes are flying dots, lines, or insects, as long as the things that fly in your eyes do not suddenly increase or decrease, nor do they affect your vision, nor do you have organic changes in the eyes, then you belong to physiological floaters, and there is no impact on your eyes and body.
2. Pathological floaters
This type of floater is less loose and is generally caused by serious diseases, such as lesions in the retina, optic nerve, ciliary body and other structures near the vitreous body, resulting in vitreous changes.
Compared with physiological floaters, there are several symptoms:
The things flying in the eyes have obviously increased or decreased, or suddenly formed black lumps to block the line of sight, and there is a sharp flash of light at the head of the eyes, or even suddenly can't see.
If you have these symptoms, you have to cut the hospital quickly!
1. Look at the symptoms:
If it is a simple vitreous liquefaction caused by floaters, it is often from less to more, from light to heavy, and slowly becomes more unconsciously.
If it is caused by the disease, the floating objects in front of the eyes are often suddenly increased, or even suddenly reduced. As long as it is a sudden change, it should be paid attention to and timely medical treatment.
2. Do a check
In order to rule out the causes of organic changes in the eye, we Huaxi doctors recommend that if you find yourself with floaters for the first time, no matter what type of floaters you think you are, you need to go to the hospital to check whether there are lesions in the surrounding retina.
If there is no major obstacle, you only need to follow up regularly in the later stage, or see the doctor again when there is a change.
Since most people belong to physiological floaters, our overall treatment principle is - conservative treatment, to put it bluntly, regardless of it!
Why? There are 3 reasons below
Floaters are generally only noticeable in bright environments, such as looking at white walls or white screens and under strong light, which has a limited impact on daily life.
You think you have a lot of time to hang out every day, besides, wearing sunglasses when shaking is the right three!
There are really a lot of people with floaters, although some people are a little anxious because of this symptom, but to be honest, you come to our eye clinic to sit for a day, listen to the various eye diseases of other patients, you know that this little floater is really not much in eye diseases.
Do you think that vitreous liquefaction is equivalent to the same as an old face with wrinkles and hair loss, is it not a lot more relieved?
Treatments for floaters have not yet been effective and have few side effects, and of course, this is the most important reason.
Q: "No way, doctor, I see a lot of floaters on the Internet that have been cured by eye drops, wearing a treatment device, and eating herbs!" ”
A: These methods are all good cures for floaters before there is a ghost!
After reading this article, you must tell people around you who have floaters, these methods are absolutely unreliable!
He also asked: "So what kind of vitrectomy, laser treatment, these methods are not necessarily unreliable?" ”
A: No, methods such as vitrectomy (FOV), laser or drug are indeed formal medical means of intervention in floaters, but this is only suitable for floaters with large translucent substances that block the field of vision and seriously affect work and life, and must be strictly evaluated by doctors, because these methods have drawbacks.
malpractices
(1) Vitrectomy:
At present, it is very magically publicized by some medical institutions, and only a small operation is needed to solve the problem of floaters. But in fact, this is not the case, the operation itself may cause some postoperative complications, such as infection inflammation, etc., and after removing the original vitreous, it is not an ideal vitreous substitute, which can only make the eyeball full of water.
When your eyeballs are full of water, do you feel like you are walking with diving goggles on at any time, and do you feel like you are not a creature on land?
(2) Laser treatment:
At present, only large collagen fiber clumps can be crushed, and the large ones can be turned into small ones, which does not improve the degree of vitreous liquefaction, and may even accelerate its progress.
(3) Medication:
As for some recommended drug treatments such as iodine products, it seems that the effect of improving floaters is not particularly obvious, and even bring irritation to the patient's eyes and other discomforts.
There is also a type of fibrinolytic enzyme that can be used to treat vitreous-pulling retinal disease, but there is little research on the treatment of floaters.
So, as long as it is not very annoying floaters, all kinds of mosquitoes, you still have to get used to it, and when it flies...
Question 1: Can floaters cause retinal detachment?
A: Floaters itself does not cause the corresponding disease, but vitreous liquefaction carries the risk of retinal detachment.
Because the liquefied glass will be divided into two parts, one part is water, and the other part is a strip-like object formed by collagen fibers and other protein substances. One end of the sliver-like object is tightly attached to the wall of the vitreous capsule, and the other end wanders through the vitreous cavity, like a swing.
And these swinging "swings" will form a certain degree of stretching on the retina, and sometimes even pull through the retina, forming a retinal rift that causes the retina to detach.
When the retina is pulled, it is often accompanied by bleeding, so a sudden increase in floaters occurs. With the absorption of bleeding, the mosquito will be significantly reduced.
In general, sudden increases and decreases are not good things, and retinal detachment often occurs in a few days!
(Either the police are looking for you or the bank is looking for you, paying you back!) ）
If the retina itself has a bad place (denaturation zone), it is easier to break, which is why we repeatedly call everyone to carry out a fundus screening after the discovery of floaters.
Q2: Can I have myopia surgery for floaters?
A: Physiological floaters do not affect myopia surgery, while pathological floaters can not do myopia surgery need to consult a doctor.
Question 3: Is there bound to be floaters in high myopia?
A: High myopia is basically accompanied by floaters. Because the eyeballs of patients with high myopia tend to be much longer than normal people, although the volume has become larger, the vitreous body will not increase again, so the gradually enlarged eyeball pulling the vitreous body slowly forms vitreous liquefaction.
About sports
Patients with severe floaters are not recommended to engage in strenuous confrontational exercises (such as boxing, fighting, etc.) or exercises with drastic position changes (bungee jumping, jumping machines, etc.), but the general daily fitness exercise is OK.
About moving heavy objects
For patients who have already had retinal detachment, care should be taken not to carry overweight items.
Again
Once there is an abnormal flash of light, the number of flying mosquitoes increases or decreases in a short period of time, vision decreases, and the line of sight is blocked, you must go to the hospital quickly.