Asteroid hyalosis is a degenerative condition of the eye involving small white opacities in the vitreous humor
Asteroid hyalosis has the striking clinical appearance of glistening, yellowish white, spherical bodies suspended throughout the vitreous.
Although the asteroid bodies can be so dense as to obscure the fundus, the patient is usually completely asymptomatic, with no decrease in visual acuity.
Asteroid hyalosis is unilateral in over 75% of cases. It is common seen in 1 of 200 person

On examination, the asteroids appear as multiple, yellow-white, round, birefringent crystals floating in the vitreous space.
Asteroid hyalosis is a common degenerative process seen in elderly patients over 60 years of age (0.5% of the population) and in patients with diabetes mellitus (30% of diabetics). Most cases are unilateral (75%).
Surprisingly, it is usually asymptomatic, and does not cause floaters or interfere with vision. However, the particles can interfere with the examiner’s view of the retina.
The prognosis is good and in general no treatment is recommended. In rare circumstances, a pars plana vitrectomy is performed if the asteroids become so severe that they affect vision or interfere with the diagnosis or treatment of retinal disorders.(ref 1)
Asteroid hyalosis causes
Doctors are not sure what causes asteroid hyalosis, but they know the risk increases as you age. It typically affects patients aged 55 and older, and men are twice as likely as women to develop the condition.
Some studies suggest a link between asteroid hyalosis and other health issues, such as:
- Diabetes
- Excess alcohol consumption
- Heart disease
- High blood pressure
- Higher body mass index
- High cholesterol
- History of gout
However, other studies have found no significant link between asteroid hyalosis and any of these risk factors. More research is needed on the cause of asteroid hyalosis.
Asteroid hyalosis Vs synchysis scintillans
Benson, in 1894, was the first to describe accurately and to differentiate AH from synchysis scintillans. Because the vitreous particles resembled “stars on a clear night” he termed the condition asteroid hyalitis, but Luxenberg and Sime later suggested the term “asteroid hyalosis” in view of the absence of inflammatory changes
Asteroid hyalosis (AH) is a degenerative eye condition marked by a buildup of calcium and lipids, or fats, in the fluid between your eye’s retina and lens, called the vitreous humor. It’s commonly confused with synchysis scintillans, which looks very similar.
However, synchysis scintillans refers to a buildup of cholesterol instead of calcium.


Asteroid Hyalosis vs Synchisis Scintillans:




•Patients are usually asymptomatic
•Floaters.

•Small, white refractile particles made up of calcium soap;float in the vitreous ;do not settle with gravity.
•Monocular in 75% of cases
•Asteroid hyalosis occurs more often in diabetic patients.





•Past vitreous hemorrhage
•Uveitis
•Pigment floating in the vitreous.


•An innocuous degenerative disease of unknown origin
•Usually diagnosed in patients more than 60years of age.

History of severe, accidental,or surgical trauma associated with a large intraocular hemorrhage.

Synchisis Scintillans: Posterior vitreous detachment; this often allows the crystals to settle inferiorly.




•Asteroid hyalosis has no clinical association, where as synchisis scintillans is often found after vitreous hemorrhage, uveitis or trauma.(ref 2)
Ref 1:Essentials of Ophthalmology-Friedman.
ref 2: Ophthalmic Diagnosis & Treatment 3rd edition https://jamanetwork.com/journals/jamaophthalmology/fullarticle/416959
https://eyewiki.aao.org/Asteroid_Hyalosis_(AH)