Posterior Vitreous Detachment

What is Posterior Vitreous Detachment?

If you often experience floating lines across your vision, it could be a symptom of posterior vitreous detachment (PVD). This is a natural condition that many people experience as they get older and is not usually something to worry about. It is not painful and should not affect your vision. In most cases symptoms go away without treatment.

While PVD is common, floaters can sometimes be a symptom of a much rarer but more serious condition called retinal detachment. This can cause permanent vision loss without treatment. It’s important to seek urgent medical treatment if you suddenly experience the appearance or increase of floaters combined with blurred vision, flashes of light, or a dark shadow that appears to sweep across field of vision.

Posterior Vitreous Detachment Causes

The gel-like substance that fills your eye between the lens and the retina (the light-sensitive tissue at the back of the eye) is called vitreous gel. It is filled with tiny fibres that hold the gel to your eye. As you age, this gel can become more liquid and shrink. As this happens, the fibres start to break and the gel starts to pull away from the retina.

It tends to affect people over 60 and becomes more common with advanced age but it can occur earlier. You are at a higher risk from PVD and early PVD if you are nearsighted, suffer from cataracts, have had a recent injury to your eye or eye surgery, or you have diabetes.¹

Retinol detachment

Posterior Vitreous Detachment Symptoms

PVD tends to affect both eyes. If you experience it in one eye, it is likely that you will develop it in the other eye within a year.² PVD eye symptoms aren’t usually serious and don’t cause pain or permanent vision damage.

The main symptom is something commonly known as ‘floaters’. These are lines, dots, rings or cobweb-like shadows that float across your field of vision. You may notice them more when you look up at the sky or at a light surface. You may also see ‘stars’ or small flashes of light. As the vitreous separates from the retina it can seem like you’re looking through a cobweb pattern. All of these symptoms will reduce or go away once the vitreous is fully detached. This usually takes between one to three months.³

In 90% of cases PVD does not cause any damage to the retina.⁴ In rare cases however, as the fluid pulls away from the retina, it can cause a retinal tear or hole. This can lead to retinal detachment, as the vitreous fluid can leak between the layers of the retina and separate them. If you have retinal detachment you may need urgent surgery.

Although PVD is not generally serious, the overlap in symptoms with retinal detachment, and the chance of complications mean it’s always best to consult with your optometrist immediately if you have an increase in floaters, flashes or any changes in vision.

Posterior Vitreous Detachment Diagnosis

Your ophthalmologist or optometrist will check your eye for signs of PVD and any other potential causes for your symptoms. This will involve using special eye drops that dilate (open up) your pupils. This enables your doctor to see into the back of your eye with a microscope. It’s a good idea to bring sunglasses to your appointment as the drops will cause sensitivity to light for around three to four hours as well as blurry vision so you will be unable to drive.⁵

If the vitreous gel in your eye is very clear, it may be difficult for your doctor to easily spot the signs of PVD. In this case they may perform other tests to diagnose PVD including optical coherence tomography (a 3D picture of your eye using light) or an ocular ultrasound (a picture of your eye using sound waves).

In general it’s best to get regular annual eye check ups so we can spot problems like PVD early on. If we detect PVD we may ask you to come in for more frequent check ups to monitor the condition.

Posterior Vitreous Detachment Treatment

PVD cannot be prevented and is a natural part of ageing. Most of the time you won’t need treatment. The floaters and flashes will reduce and eventually stop after a few months once the process of detachment is complete. If the floaters bother you, it may help to wear sunglasses when you’re out in bright light.

In the rare case that PVD causes a retinal tear, you will need urgent laser treatment or cryotherapy treatment. If posterior vitreous detachment causes full retinal detachment, then you will need urgent surgery to preserve your eyesight.

If you think you have vitreous or posterior vitreous detachment, please contact your optometrist for emergency advice.

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