Diseases of Vitreous

Vhumor is present in posterior 4/5ths of eyeball cavity

• transparent jelly serving optical function, stabilizing the globe volume, supplies nutrients to lens & retina
• made of collagen fibrils & hyaluronic acid

Synchysis / Liquefaction

• absence of fibrillar structure + presence of pockets of liquefaction [coarse material moving freely]
• causes -
  1. degenerations – senile, myopic, retinitis pigmentosa.
  2. post-inflmm [uveitis]
  3. trauma, thermal, radiation

Vitreous hmmrrg

etiology

• retinal breaks from PVD
• retinal vascular disorders
• necrosis in retinoblastoma
• trauma
• bv erosion in uveitis

CFs- sudden dev of

1. floaters – if small hmmrrg [black shadows in red pupil reflex]
2. painless vision loss – if massive hmmrrg [no red pupil reflex]

Diagnosis – ultrasonography with Bscan.
FATE-

1. complete absorption in 4-8wks.
2. Organization with yellow-white debris in recurrent cases.
3. synchisis, khakhi cell glaucoma, retinitis proliferans, tractional retinal detachment.

Rx-

1. conservative to let blood settle down – bedrest, head elevation, bilateral eye patches
2. treat the cause
3. vitrectomy if no absorption after 3mos.

Pars plana Vitrectomy indications:

1. endophthalmitis
2. V.hmmrrg
3. proliferative retinopathy – DM,ROP,Eale’s, retinitis proliferans
4. complicated retinal detachment [giant tears, large anterior dialysis, traction bands]
5. to remove foreign body/ nucleus / IOL fallen into vitreous.
6. persistant hyperplastic primary vitreous.