Posterior Vitreous Detachment
What is Posterior Vitreous Detachment (PVD)?
The inside of the eye, behind the lens, is filled with a clear jelly-like material called the vitreous. With normal ageing, the vitreous jelly becomes more liquid and eventually separates from the retina, the thin layer of light-sensitive tissue that lines the back of the eye. This process is known as posterior vitreous detachment.
Who is at risk of Posterior Vitreous Detachment (PVD)?
PVD is a normal part of aging of the eye and typically occurs over the age 55. It can occur at an earlier age in myopic (short-sighted) eyes, in patients who have undergone cataract surgery or after trauma.
What are the symptoms of Posterior Vitreous Detachment (PVD)?
The two most common symptoms are floaters and flashes, but some patients may experience few or no symptoms.
Floaters
New floaters or an increase in floaters is often the first symptom of PVD and patients commonly describe this as a “cobweb” or “insect” in their vision. Over time the floaters usually become less noticeable but may not always completely disappear. In a very small number of cases surgical treatment is needed to remove the floaters.
Flashes
Flashes are brief bright “sparks” of light seen in the affected eye lasting a split second. They can be compared to seeing lightning during a storm or a camera flash. The flashes typically reduce in frequency over a few weeks and in most patients disappear completely within 3 months. They are triggered by eye movements and best seen in the dark.
Diagnosis of Posterior Vitreous Detachment (PVD)
PVD can be confirmed by a dilated retinal examination. Optical coherence tomography (OCT) is often useful to confirm the presence of PVD.
Complications of Posterior Vitreous Detachment (PVD)
Although PVD is usually uncomplicated, the following complications may occur:
- Vitreous haemorrhage. If the vitreous gel pulls on a blood vessel while it is separating from the retina it can cause a bleed which typically manifests as numerous dark floaters in the vision.
- Retinal tear or detachment
- Epiretinal membrane
Treatment of Posterior Vitreous Detachment (PVD)
No treatment is required for an uncomplicated PVD. Retinal laser or vitreo-retinal surgery may be required if one of the complications occurs.
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