Eye Floaters or Degenerative Vitreous Syndrome or DVS?

The correct medical term for the condition is “Degenerative Vitreous Syndrome” (abbreviated to DVS) but in common parlance the condition is more often referred to as “floaters” or “eye floaters”.  At One Clear Vision we’re trying to raise the profile of the condition and its sometimes debilitating symptoms so we like to use terminology that resonates and is medically correct. The term “floater” is not especially helpful in this respect as it has connotations of something gentle and harmless. If you are a sufferer you’ll be aware that this in not the case. As we know people with the condition use “eye floaters” when searching online for help and resources we have tried our best to optimise this website so people who need help find us.

About the Condition

The vitreous humour is the gel-like substance which fills the space in the eye between the lens and the retina. It is primarily composed of water with the remainder being hyaluronic acid and collagen fibers. It is transparent which enables light to pass through while the gel form provides support to the retina and helps the eye hold its shape, essentially acting as a shock absorber.

However, if the vitreous gel begins to degenerate it loses its form and liquefies – a process referred to as syneresis. Eventually the vitreous can peel away from the retina entirely in what is known as a Posterior Vitreous Detachment (PVD). Without the stable gel form, the collagen fibers can collapse upon themselves, bind together to condense into clumps and knots, and become mobile. These fibers cast shadows on the retina and appear as spots, strings, or cobwebs in the visual field and are commonly referred to as eye floaters or mouches volantes.

Cross sections of eye showing progressive liquefaction of the vitreous

Cross sections of eye showing progressive liquefaction of the vitreous

Vitreous syneresis in itself is not thought to be physically harmful, although it can reduce the shock-absorbing capability of the eye. In most cases, where PVDs occur, they happen safely, with no side-effects. PVD may be associated with retinal tears in about 14% of cases.

There is a spectrum of the side effects of vitreous syneresis covering at one end, mild and sparse eye floaters that many people in the population experience, through to dense, numerous and opaque eye floaters that can cause significant practical and emotional difficulties for sufferers, called DVS. DVS should be considered both for its physical and its quality of life implications.

Causes

Vitreous syneresis is caused by depolymerization. The precise reason that this occurs is a little researched area. There seem to be congenital causes such as genetic disorders as well as anecdotal reports of environmental causes. Vitreous degeneration is usually associated with middle-age, but children and teens have also reported vitreous opacities. Floaters and are also believed to be more common in nearsighted eyes. Most people who have the problem in one eye will also have it in the other.

References

  • Wagle, Ajeet M et al. “Utility Values Associated with Vitreous Floaters.” American journal of ophthalmology 152 (2011): 60–65.e1. Print.
  • Scott, J.E. “Secondary and Tertiary Structures of Hyaluronan in Aqueous Solution. Some Biological Consequences.” 1998.
  • Bishop, P N et al. “The Role of the Posterior Ciliary Body in the Biosynthesis of Vitreous Humour.” Eye (London, England) 16 (2002): 454–60.
  • Suri, S., and R Banerjee. “Biophysical Evaluation of Vitreous Humor, Its Constituents and Substitutes.” Trends in Biomaterials and Artificial Organs 20 (2006): 72–77. Print.
  • Hoerauf, Hans. “Vitrectomy Against Floaters.” Vitreo-retinal Surgery. Ed.
  • Günther K. Krieglstein et al. Springer Berlin Heidelberg, 2007. 115–124. Essentials in Ophthalmology.
  • Alwitry, A, H Chen, and S Wigfall. “Optometrists’ Examination and Referral Practices for Patients Presenting with Flashes and Floaters.” Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) 22 (2002): 183–8. Print.
  • Facts About Floaters. Bethesda: National Eye Institute, 2009.
  • Floaters. London: Moorfields Eye Hospital, 2006.