Muscae volitantes

Muscae volitantes are extremely common minute fly- or worm-like physiological opacities best seen by the patient against a pale background. They are thought to be predominantly composed of embryological remnants in the vitreous gel.

Vitreous haemorrhage

Vitreous haemorrhage is a relatively common condition with diverse causes ( Table 17.1 ).

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  Presentation: varies according to the severity of the bleed and the underlying cause; mild haemorrhage causes sudden-onset blurring and floaters but may not affect visual acuity, whereas a dense bleed may result in very severe visual loss.

  
  
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  B-scan US: initially shows a uniform appearance; once cellular aggregates develop, small focal echoes become visible; echography is used to exclude an underlying retinal detachment or prominent retinal tear.

Table 17.1

Causes of vitreous haemorrhage

1 Acute posterior vitreous detachment associated either with a retinal tear (see Fig. 16.3c ) or avulsion of a peripheral vessel (see Fig. 16.3d ). 2 Proliferative retinopathies • Diabetic • Following retinal vein occlusion • Sickle cell disease • Eales disease • Vasculitis 3 Miscellaneous retinal disorders • Macroaneurysm • Telangiectasia • Capillary haemangioma 4 Trauma • Blunt • Penetrating • Iatrogenic 5 Systemic • Bleeding disorders • Terson syndrome

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