Vitreous opacities

Published on 02/04/2015 by admin

Filed under Internal Medicine

Last modified 22/04/2025

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210 Vitreous opacities

Instruction

Examine this patient’s fundus.

Salient features

History

• History of diplopia (monocular diplopia)

• Floaters

• History of diabetes, hypertension.

Examination

• Small white opacities that are present in front of the retinal vessels

• The patient may complain of diplopia (monocular diplopia)

• Tell the examiner that you would like to:

• test for monocular diplopia
• check urine for sugar
• check the BP.

Diagnosis

This patient has vitreous opacities (lesions) with monocular diplopia (functional status), and has underlying diabetes mellitus (aetiology).

Questions

What are the causes of vitreous opacities?

• Blood: diabetes, retinal vein occlusion, trauma, subarachnoid haemorrhage, sickle cell retinopathy

• Cholesterolosis bulbi: where free floating, highly refractile crystals are seen in liquified vitreous humour in patients with severe intraocular disease

• Asteroid hyalitis (Benson’s disease): where whitish yellow solid bodies containing calcium palmitate and stearate are suspended in normal vitreous. Prognosis for vision is good

• Synchysis scintillans: gold or yellowish-white particles made up of cholesterol located in the vitreous humour; they settle to the bottom of the eye through gravity. Associated with previous trauma or surgery to the eye

• Other: retinoblastoma, primary amyloidosis.

What are the other causes of monocular diplopia?

• Opacities in the lens

• Corneal opacities

• Retinal detachment.

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