The human eye has many parts. These include:
- the lens, the transparent structure located behind the iris
- the cornea, the eye’s outermost layer
- the retina, the tissue lining the back of the eyes
- the vitreous body, a clear gel-like substance that fills the space between the lens and the retina
Microscopic fibers connect the vitreous body to the retina. Posterior vitreous detachment (PVD) occurs when the vitreous shrinks and pulls away from the retina.
PVD is common and occurs naturally. It doesn’t lead to vision loss, and in most cases, you won’t need to seek treatment.
Age is the primary cause of PVD. As you age, it becomes harder for the vitreous to maintain its original shape. The vitreous gel shrinks and becomes more liquid-like, yet the cavity between your lens and retina remains the same size.
The more the gel shrinks or condenses, the easier it is for the vitreous to detach from the retina.
Risk factors for early PVD include:
PVD usually occurs in both eyes. If you have a vitreous detachment in your left eye, you might also experience a detachment in your right eye.
PVD doesn’t cause pain or permanent vision loss, but you might experience other symptoms. They include:
- Flashes. These small flashes of light are comparable to “seeing stars” after hitting your head. They can last a few seconds or minutes and tend to stop, or occur less often, once detachment is complete.
- Floaters. These floating spots in your field of vision can resemble tiny specks, dust, dots, or cobweb-like shadows. They typically occur in the first few weeks of PVD and are most noticeable when looking at a light surface, such as a white wall or the sky.
- Cobweb effect. You may begin to see the outer edge of the vitreous as it separates from the retina. It can feel like you’re looking through a cobweb. This is temporary and goes away once detachment is complete.
Although PVD is common, it’s important to see a doctor if you develop new floaters or flashes. These could be the result of PVD or a retinal detachment. Your doctor may need to perform a diagnostic test in order to determine your condition.
A dilated eye examination can confirm PVD, a retinal detachment, or other eye problem. During the examination, your ophthalmologist or optometrist puts special drops in your eyes. These drops widen your pupils and allow your doctor to see the back of your eyes. Your doctor can then examine the entire retina, the macula, and your optic nerve.
The examination lasts about 30 minutes. It can take a few hours for the dilation to wear off. Bring a pair of sunglasses to put on after your appointment, as sunlight and bright lights may be uncomfortable.
In some cases, additional testing is needed to diagnose PVD.
For example, if your vitreous gel is extremely clear, it might be difficult for your doctor to detect a detachment. In such a scenario, they can use an optical coherence tomography or an ocular ultrasound to diagnose the condition.
An optical coherence tomography uses light to create a three-dimensional picture of your eye, whereas an ocular ultrasound uses high-frequency sound waves to create a picture of your eye.
PVD usually doesn’t require treatment.
Complete detachment typically takes no longer than three months. If you continue to see floaters after detachment is complete, discuss treatment options with your doctor.
You may need further treatment if you begin to experience any of the following issues:
- Continued floaters. If you have a lot of floaters or have difficulty seeing clearly, you might need a vitrectomy procedure. During this outpatient procedure, some or all of the vitreous gel inside of the eye is removed.
- Retinal tears. The underlining tissue can tear in one or more places if the fibers of the vitreous pull too hard on the retina. If fluid enters beneath the retina, retinal detachment can occur. If left untreated, it can lead to vision loss. Surgery can repair both a retinal tear and a retinal detachment.
- Macular holes. These happen when the vitreous is firmly affixed to the retina as it pulls away. They cause distorted, blurry vision. Some macular holes close on their own, but surgery can repair holes that don’t.
As a general rule of thumb, see your doctor if you experience any change in vision, such as a sudden onset of flashes or floaters. This could be a sign of PVD, retinal detachment, or another eye condition.
PVD is a common eye condition that occurs with age, and it typically doesn’t require treatment.
If you do begin to experience eye or vision problems, don’t self-diagnose. The symptoms of PVD can mimic those of other serious eye disorders, so it’s important to see an eye doctor for diagnosis and treatment.
Be sure to schedule a routine eye examination every year. Eye or vision problems can be identified and treated early with a regular check-up.