Medical Retina & Posterior Segment:
                  Case thirteen


This 72 year-old man was referred by his physician because of diabetic retinopathy. The above picture is the slit-lamp appearance of his right eye.

a. What does the picture show?

There are multiple, tiny, shiny opacities suspended in the vitreous. The features are typical of asteroid hyalosis.

b. What is the histopathology of this condition?

The shiny particles are made up of calcium salts mainly calcium phospate. They are attached to the collagenous framework of the vitreous and moves with movement of the vitreous.
c. What is the significance of this condition?
The condition is a benign degenerative disease of the vitreous and found mainly in people in the sixth and seventh decade of life. It is unilateral in the majority of cases. The visual acuity is not affected and the patient rarely complain of symptoms.

Although some authors believe it has an increased incidence in diabetes mellitus (30% of patients with asteroid hyalosis have diabetes mellitus), the two conditions are generally not thought to be connected. The increased incidence may be due to the fact that the diabetic eyes are looked at more often.

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