Anatomy
The Vitreous Humor: The Eye's Clear Gel
The vitreous humor is the clear, gel-like substance that fills the large central cavity of the eye (the vitreous chamber), making up about 80% of the eye's volume. It maintains the eye's spherical shape, supports the retina, and allows light to pass through to the retina undistorted.
Anatomy Overview
The Vitreous Humor: The Eye's Clear Gel
Structure & Components
Floaters — shadows of gel clumps drifting across vision (very common with aging)
Sudden shower of new floaters may signal vitreous or retinal tear
Flashes of light (photopsia) when vitreous tugs on the retina
Posterior vitreous detachment (PVD): common after age 50, usually benign
Vitreous haemorrhage causing sudden red or black vision (emergency)
Tractional retinal detachment from vitreous pulling on scarred retina
Functions & Physiology
Composed of 99% water with collagen fibrils and hyaluronic acid
Aging causes vitreous to liquefy and shrink (syneresis)
PVD: vitreous detaches from retina — normal aging process in most adults
Trauma can cause vitreous haemorrhage
Diabetic retinopathy can cause vessels to bleed into the vitreous
High myopia associated with earlier vitreous changes and detachment
Key Points
New floaters: urgent review to rule out retinal tear within 24-48 hours
Most PVD floaters: watchful waiting, they settle below visual axis over months
Vitrectomy: surgical removal of vitreous for haemorrhage, retinal problems
YAG laser vitreolysis for prominent single floater strands (limited evidence)
Treat underlying cause (diabetes, injury) to prevent recurrence
Immediate ophthalmology review if vision curtain or sudden new floaters
Dilated fundus exam is gold standard to assess vitreous-retinal interface
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