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The '''vitreous humour''' is the clear gel that fills the main cavity of the eye between the lens and the [[retina]]. It is also called the '''vitreous body''' or simply the '''vitreous'''. The American spelling is '''vitreous humor'''.
The vitreous helps the eye keep its shape, provides a transparent path for light, and lies close to the retina, macula, optic disc, and lens. It is not the same as aqueous humour, which is the watery fluid in the front part of the eye.
The '''vitreous humour''', also called the '''vitreous body''', is the clear gel that fills most of the inside of the eye between the lens and the retina. It helps the eye keep its shape, lets light pass through to the retina and is involved in several common eye symptoms, especially floaters and flashes.
== Anatomy ==
The vitreous occupies the vitreous chamber, the large space behind the lens. It is bounded at the back by the retina and at the front by structures around the lens and ciliary body.
Some sources spell the term '''vitreous humor'''. British medical writing usually uses '''vitreous humour'''.
Although it looks like a simple clear fluid, the vitreous is a gel. Its structure comes from a fine network of collagen fibres and hyaluronic acid holding water. This arrangement lets light pass through while giving the eye internal support.
== Structure ==
The vitreous occupies the large posterior part of the eye. It lies behind the lens and in front of the retina. In an adult eye it accounts for most of the globe's internal volume.
The vitreous is attached more firmly in some areas than others. Important attachment points include the vitreous base near the front of the retina, the optic disc, blood vessels on the retinal surface, and the macular region. These attachments matter clinically because pulling on the retina can contribute to retinal tears in some circumstances.
The vitreous is transparent and contains no blood vessels in normal adult eyes. That transparency is essential because light must pass through it before reaching the retina.
== Composition ==
== Composition ==
Most of the vitreous is water. The remainder is made up of collagen, hyaluronic acid, salts, proteins, and a small number of cells. The low density of cells and fibres helps keep the gel transparent.
The vitreous is mostly water. NCBI Bookshelf material on vitreous haemorrhage describes the vitreous as about 98 to 99 percent water, with the remainder made up of collagen, hyaluronic acid and electrolytes.
The balance between collagen and hyaluronic acid is important. If collagen fibres clump or the gel becomes more liquid with age, shadows can be cast on the retina and seen as floaters.
The collagen network helps maintain the gel structure. Hyaluronic acid binds water and contributes to the gel's consistency. Together they allow the vitreous to remain clear while still providing some internal support.
== Function ==
== Function ==
The vitreous has several roles:
The vitreous has several roles:
* It helps maintain the shape and internal pressure of the eye.
* It provides a clear optical path between the lens and the retina.
* It supports the retina from inside the eye.
* It helps absorb small mechanical forces inside the globe.
* It contributes to the internal environment of the eye by limiting movement of cells and molecules.
* it helps maintain the shape of the eye;
* it provides a clear path for light to reach the retina;
* it supports the relationship between the lens, retina and other internal eye structures;
* it cushions the retina and lens from ordinary movement and minor mechanical stress;
* it forms part of the environment through which oxygen, nutrients and waste products move.
These functions are usually unnoticed unless the vitreous changes, pulls on the retina, becomes cloudy, bleeds, or is removed during surgery.
The vitreous is not a muscle and does not focus the eye. Focusing mainly depends on the cornea and lens.
== Age-Related Change ==
The vitreous changes gradually with age. It may become more liquid, and the collagen network may shrink or separate. This process can lead to posterior vitreous detachment, where the vitreous pulls away from the retina.
== Ageing ==
The vitreous changes with age. It gradually becomes more liquid and can shrink away from the retina. This process is called posterior vitreous detachment, or PVD.
Posterior vitreous detachment is common in older adults and is often harmless. It may cause new floaters or flashes of light. A sudden increase in floaters, flashing lights, or a shadow across vision needs urgent assessment because these symptoms can also occur with a retinal tear or retinal detachment.
PVD is common and often not sight-threatening by itself. It can cause new floaters and flashes because strands of vitreous cast shadows on the retina or pull on retinal tissue.
== Clinical Significance ==
Vitreous symptoms and disorders include:
== Floaters and Flashes ==
Floaters are small shapes, spots, strands or cobweb-like shadows that appear to move across vision. They are usually caused by tiny clumps or strands within the vitreous casting shadows on the retina.
* '''Floaters''': spots, threads, or cobweb-like shapes caused by shadows from material within the vitreous.
* '''Posterior vitreous detachment''': separation of the vitreous from the retina.
* '''Vitreous haemorrhage''': bleeding into the vitreous cavity, which can cause dark spots, haze, or marked loss of vision.
* '''Vitreous inflammation''': inflammatory cells within the vitreous, often described as vitritis.
* '''Retinal tear or detachment''': sometimes linked to vitreous traction on the retina.
Flashes can occur when the vitreous pulls on the retina. Moorfields Eye Hospital explains that flashing may happen when the outer part of the vitreous pulls on light-sensitive retinal tissue.
Most occasional floaters are not dangerous, but sudden or changing symptoms should be checked by an optometrist or ophthalmologist.
A few long-standing floaters are common. A sudden increase in floaters, new flashes or a curtain-like shadow in vision needs prompt eye assessment because these symptoms can be linked to a retinal tear or retinal detachment.
== Surgery ==
The vitreous may be removed during a vitrectomy. This operation can be used for conditions such as retinal detachment, vitreous haemorrhage, macular hole, epiretinal membrane, severe eye trauma, or complications of diabetic eye disease.
== Posterior Vitreous Detachment ==
Posterior vitreous detachment occurs when the vitreous separates from the retina. The National Eye Institute describes sudden floaters and flashes as common symptoms.
During vitrectomy, the vitreous gel is removed and replaced with fluid, gas, or silicone oil depending on the condition being treated. The eye continues to produce internal fluid, so the vitreous is not replaced by a new gel in the same form.
Most PVD cases settle without major treatment. The important clinical point is checking the retina, because a tear or detachment can occur when the vitreous pulls away.
== Vitreous Haemorrhage ==
Vitreous haemorrhage is bleeding into the vitreous cavity. It can occur after trauma, retinal tears, diabetic retinopathy, retinal vein occlusion or other retinal disease.
Symptoms can include sudden floaters, hazy vision, dark spots or loss of vision. If the view of the retina is blocked by blood, ultrasound may be used to check for retinal detachment or other problems.
== Retinal Detachment Risk ==
The vitreous is closely related to the retina, so sudden vitreous changes can matter. The National Eye Institute lists sudden new floaters, flashes and a curtain or shadow over the field of vision as warning symptoms of retinal detachment.
Retinal detachment is treated as urgent because delayed treatment can lead to permanent sight loss.
== Surgery and Treatment ==
Vitrectomy is surgery to remove some or all of the vitreous gel. It may be used for problems such as non-clearing vitreous haemorrhage, retinal detachment repair, macular hole surgery, severe infection inside the eye or selected cases of disabling floaters.
Vitrectomy can be sight-saving, but it also carries risks. It is not used for ordinary mild floaters.
== See Also ==
* [[Retina]]
* [[Eye]]
* [[Retinal_Detachment]]
* [[Diabetic_Retinopathy]]
== References ==
== References ==
* [https://www.ncbi.nlm.nih.gov/books/NBK559131/ NCBI Bookshelf: Vitreous haemorrhage]
* [https://www.ncbi.nlm.nih.gov/books/NBK563273/ NCBI Bookshelf: Posterior vitreous detachment]
* [https://www.nei.nih.gov/eye-health-information/eye-conditions-and-diseases/vitreous-detachment National Eye Institute: Vitreous detachment]
* [https://www.nei.nih.gov/eye-health-information/eye-conditions-and-diseases/vitreous-detachment National Eye Institute: Vitreous detachment]
* [https://www.moorfields.nhs.uk/private/eye-conditions-and-treatments/flashes-and-floaters/diagnosis-and-treatment Moorfields Eye Hospital: Flashes and floaters diagnosis and treatment]
* [https://www.rnib.org.uk/your-eyes/eye-conditions-az/posterior-vitreous-detachment/ RNIB: Posterior vitreous detachment]
* [https://www.nei.nih.gov/eye-health-information/eye-conditions-and-diseases/retinal-detachment National Eye Institute: Retinal detachment]
* [https://www.moorfields.nhs.uk/private/eye-conditions-and-treatments/flashes-and-floaters/diagnosis-and-treatment Moorfields Eye Hospital: flashes and floaters]
[[Category:Anatomy]]
[[Category:Ophthalmology]]
[[Category:Medicine]]
[[Category:Medicine]]
[[Category:Anatomy]]