The myodesopsias, popularly known as “flying flies”.”, are one of the most common consultations in ophthalmology. Although in most cases they are benign and age-related phenomena, their appearance can cause concern in the patient, especially when they appear suddenly or are accompanied by flashes of light.
In this article, from Nebro Ophthalmology Clinic, We explain what myodesopsias are, why they occur, when to be concerned about them and what treatment options are currently available.
What are myodesopsias?
Myodesopsias are small shadows or filaments that the patient perceives in his or her visual field, especially when looking at light backgrounds, such as a white wall or the sky. They move with eye movement and appear to “float” or move slowly before disappearing from the visual focus.
These shadows are, in fact, condensations or irregularities in the vitreous humour, the jelly-like substance that fills the inside of the eyeball and helps to maintain its shape.
Causes of myodesopsias
The most frequent causes of myodesopsias are related to natural changes in the vitreous humour, However, they may also be due to eye diseases that require urgent assessment.
1. Ageing of the vitreous humour
Over the years, the vitreous humour loses some of its gel-like structure and becomes more liquid. This process, known as vitreous syneresis, causes the appearance of collagen fibres that cast shadows on the retina.
For this reason, myodesopsias are especially common from the age of 40 or 50.
2. Posterior vitreous detachment (PVD)
One of the most frequent causes is the posterior vitreous detachment, which occurs when the vitreous separates from the retina.
Although it is usually a physiological and benign process, in some cases it can traction the retina and cause a tear or even a retinal detachment, and therefore should always be assessed by an ophthalmologist..
3. myopia
Myopic people are more prone to develop myodesopsia because their eyeball is more elongated, which favours structural changes in the vitreous.
4. Eye surgery and trauma
Following eye surgery, such as a cataract surgery or partial vitrectomy, After an ocular trauma, or after an ocular trauma, new myodesopsias may appear due to changes in the vitreous structure.
5. Other less frequent causes
In rarer cases, myodesopsias can be due to intraocular inflammations (uveitis) or to vitreous haemorrhages, situations that require immediate diagnosis and treatment.
Symptoms and when to see an ophthalmologist
Classical myodesopsias usually manifest themselves as movable spots, dots, filaments or small cobwebs. They do not usually affect central vision or cause pain.
However, there are certain symptoms that require urgent assessment:
- Appearance sudden of numerous myodesopsias.
- Presence of flashes of light (photopsias).
- Loss of side vision or “black curtain” sensation.
- Progressive worsening of the visual field.
These signs may indicate a tear or retinal detachment, an ophthalmological emergency which, if not treated in time, can irreversibly compromise vision.
Diagnosis of myodesopsias
At Nebro Ophthalmology Clinic in Fuengirola, we carry out a complete examination to determine the origin of the myodesopsias.
Exploration includes:
- Fundus evaluation with pupillary dilation, to observe the state of the vitreous and retina.
- Indirect ophthalmoscopy, The use of a tear, bleeding or signs of detachment can be identified.
- In some cases, it is complemented by ocular ultrasound if direct visualisation is not possible due to vitreous opacities or cataracts.
This study makes it possible to rule out serious pathologies and guide the most appropriate treatment.
Treatment of myodesopsias
In the majority of cases, myodesopsias do not require specific treatment. Over time, the brain gets used to ignoring them and the perception of them naturally decreases.
However, when the myodesopsias are very dense or significantly affect visual quality, There are therapeutic alternatives:
1. Regular observation and monitoring
If there are no signs of complications, it is recommended to have a regular monitoring with fundus examination, especially during the first weeks after onset.
2. Atropine eye drops diluted at 0.01 %
Diluted atropine eye drops, although not approved for this use, can alleviate the discomfort caused by myodesopsias..
3. YAG laser vitreolysis
The laser vitreolysis is an outpatient technique that uses a YAG laser for fragmenting or vaporising vitreous condensation responsible for visual shadows.
It is a painless and safe procedure in selected patients, although it is not indicated in all cases.
4. Vitrectomy
The vitrectomy consists of the surgical removal of the vitreous humour and its replacement with a clear saline solution.
It is reserved only for severe cases, when myodesopsias are very numerous and significantly affect the patient's vision or quality of life.
Like all intraocular surgery, it involves certain risks, so it must be carefully assessed by the specialist.
Prevention and recommendations
Although it is not always possible to prevent the occurrence of myodesopsia, some recommendations can be followed:
- Regular ophthalmological check-ups, especially after the age of 40 or if you are short-sighted.
- Seeing a specialist in the face of any sudden change in the vision.
- Maintain a a balanced diet rich in antioxidants, which promotes eye health.
- Avoid eye shocks or trauma to the eye.
- Control systemic diseases that can affect the retina, such as diabetes.
Conclusion
The myodesopsias are a common and, in most cases, benign phenomenon. However, their sudden onset or appearance accompanied by other symptoms may indicate a more serious pathology such as a retinal tear or detachment.
Therefore, in the presence of “flying flies” or flashes of light, it is essential to seek the advice of a complete eye examination. At Nebro Ophthalmology Clinic, We have the technology and experience necessary to diagnose and treat alterations of the vitreous and retina, always offering personalised attention of the highest quality.