Posterior Vitreous Detachment

What is a posterior vitreous detachment or PVD?

PVD

The vitreous, or vitreous humor, is a mix of collagen and water. It fills the back of the eye, between the iris and retina.

Early in life, it is adherent to the retina, coating the back surface of the eye. Over time, the vitreous loosens as it undergoes liquefaction, until it separates from the retina in an acute event called PVD, or posterior vitreous detachment.

Is a PVD normal?

Yes, PVD is a natural occurrence in 75% of people over 65 years of age. It is common after the age of 40. However, certain life experiences can cause a PVD to occur before the age of 40. Examples include trauma, eye surgery such as LASIK, intraocular inflammation from underlying autoimmune conditions, infection, or high myopia (a nearsightedness of higher degree than average).

What are the symptoms of PVD?

Some people do not develop any symptoms with their PVD. Most people notice new floaters, dots, lines, or streaks that follow their gaze. Some patients experience quick flashes of light, usually in their peripheral vision.

Is a PVD something to be concerned about?

Retinal detachment

Most patients with a PVD do not have any ocular complications. However, we recommend screening and a consultation for a retinal tear or detachment when any patient develops or experiences new floaters or flashes of light. With an acute symptomatic PVD, the incidence of a retinal tear is 8-10%. In most cases, a retinal tear will occur within 3-4 months of the onset of symptoms. Risk factors for retinal tear or detachment are: high myopia; lattice degeneration (peripheral retinal thinning); family history of retinal tear or detachment; or history of prematurity, ocular surgery or trauma.

When should I be concerned about a problem?

After your first dilated retinal exam, your retinal doctor will best advise you about your level of risk for a retinal tear. In general, for more serious circumstances we advise patients to call our emergency line, which can be accessed through any office number, as soon as they experience any of the following: sudden increase in floaters, particularly darker dots or cobwebs; or sudden increase in flashes of light, blurring of their vision, or dark shadows or “curtains” blocking part of their vision.

Will my floaters eventually go away?

Weiss ring

Floaters are natural “streaks” of collagen within the vitreous humor, and initially worsen with a PVD, due to development of a Weiss ring. This area of fibrosis is caused by separation of the vitreous from the retina. Within the first few months of a PVD, the floaters usually improve substantially, although they do not disappear entirely. A small percentage of patients who are still symptomatic after this healing period may require vitrectomy surgery to treat their floaters.

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