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Synchysis Scintillans – The Sparkling Eye Condition

As optometrists, we sometimes encounter rare eye findings that sound unusual but have very specific meanings. One such condition is Synchysis Scintillans. Though it may look alarming to the patient, it is actually a sign of advanced or long-standing eye disease rather than a disease on its own.

What is Synchysis Scintillans?

Synchysis Scintillans refers to the presence of tiny, golden-brown, cholesterol crystals floating in the vitreous cavity of the eye. The vitreous is the clear, jelly-like substance that fills the back part of the eye.

These crystals sparkle and move freely when the eye moves, which is why the condition is called “scintillans” (meaning glittering or sparkling).

Why Does It Happen?

Synchysis scintillans is very rare and usually develops in eyes that already have severe damage. Common causes include:

Long-standing blind or non-functional eyes
Eyes with chronic inflammation or trauma
Eyes with advanced retinal detachment
Severe eye disease leading to degeneration of the vitreous

The cholesterol crystals come from the breakdown of eye tissues inside the globe.

How Does It Appear?

Patients or doctors may notice shimmering, golden crystals moving inside the eye.
It is usually seen when the eye is illuminated with light during examination.
The crystals settle down quickly when the eye stops moving, unlike the floaters of common vitreous degeneration.

Symptoms

Most patients do not have symptoms because the condition occurs in an eye that already has poor or no vision.
Rarely, patients may describe moving “sparkles” if there is still some vision left.

Is It Dangerous?

Synchysis scintillans itself is not harmful, but it is a sign of an already damaged eye. The condition does not cause blindness, but it occurs in eyes that are usually already blind or severely diseased.

Management

There is no treatment required for synchysis scintillans itself.
Management focuses on treating the underlying eye condition, if possible.
In most cases, it is simply observed and documented.

Key Takeaway

Synchysis scintillans is a rare and striking finding – cholesterol crystals glittering inside the eye like “gold dust.” While it may sound fascinating, it usually appears in eyes that have already lost useful vision. If detected, the focus should be on identifying and managing the underlying disease.