Ageing of the vitreous: From acute onset floaters and flashes to retinal detachment

• Floaters and flashes are most commonly symptoms of age-related degenerative changes in the vitreous body and posterior vitreous detachment.
• Acute-onset floaters, flashes and defects in their visual field, represent a medical emergency.
• The etiology and pathogenesis of floaters’ formation is complex.
• The molecular and genetic pathogenesis, epidemiology of ageing changes of the vitreous and treatment modalities are summarized here.

Floaters and flashes are most commonly symptoms of age-related degenerative changes in the vitreous body and posterior vitreous detachment. The etiology and pathogenesis of floaters’ formation is still not well understood. Patients with acute-onset floaters, flashes and defects in their visual field, represent a medical emergency with the need for same day referral to an ophthalmologist. Indirect ophthalmoscopy with scleral indentation is needed in order to find possible retinal break(s), on-time treatment and prevention of retinal detachment. The molecular and genetic pathogenesis, as well as the epidemiology of the ageing changes of the vitreous is summarized here, with view on the several treatment modalities in relation to their success rate and side-effects.