Posterior vitreous detachment
One or more floaters suddenly appear in your eye. They may be ring-shaped, strand-like, or large. This is likely a posterior vitreous detachment (PVD). Be aware that this condition, which typically occurs around age 60, is the leading cause of retinal tears and detachments. A fundus examination with an ophthalmologist within 2 to 3 days is essential to assess your retina.
What is vitreous detachment?
The cavity of the eye is filled with a gelatinous substance called vitreous.
The vitreous humor is normally attached to the retina, at the back of the eye.
Posterior vitreous detachment (PVD) occurs when the vitreous detaches from the retina.
What are the causes of posterior vitreous detachment?
With age, the vitreous humor changes. It becomes less solid and more liquid. It liquefies and detaches from the retina at the back of the eye.
The vitreous humor is attached to the retina by millions of microscopic fibers. When a sufficient number of these fibers break, the vitreous humor separates completely from the retina: this is vitreous detachment.
Physical trauma (head trauma, punch to the face, etc.) or acute dehydration can also accelerate vitreous detachment.
Symptoms
Vitreous detachment has affected almost the entire population for the past 60 years. Most affected patients notice no symptoms. Approximately 20% of those affected experience the following symptoms:
Phosphenes – flashes of light perceived in peripheral vision.
Myodesopsia – floaters in the form of flies or vermicelli move across the field of vision with eye movements.
Decreased visual acuity – Rarely, DPV is accompanied by decreased vision, a dark curtain or a moving shadow.
Who is affected?
Vitreous detachment, like presbyopia and wrinkles, is a normal part of aging. Most people experience it around the age of 70. Here are some risk factors that can accelerate the age of posterior vitreous detachment:
Myopia.
Cataract surgery or other eye surgery.
Diabetes.
Eye trauma (physical injuries).
Impact
For most people, DPV is a benign, asymptomatic event with no vision loss. Others may notice a large number of floaters.
Floaters can be bothersome but usually become less noticeable over time.
Complications
For a small number of affected individuals, complications arise when the vitreous humor detaches from the retina.
The vitreous humor pulls too hard on the back of the eye and pulls away a piece of the underlying retina. This is called a retinal tear.
It can lead to vitreous hemorrhage or retinal detachment, which can result in permanent vision loss.
What to do in case of vitreous detachment?
Most patients are unaware that they have a PVP. But if you suddenly notice a large number of floaters, flashes of light, or a sudden decrease in vision, consult your ophthalmologist as soon as possible.
These symptoms can be normal, but they can also mean that you have a retinal tear or detachment.
You will not be able to tell the difference; only an ophthalmologist can.
If a retinal tear or detachment is treated early enough by an ophthalmologist, you can save your eye and vision.
How to treat it?
When posterior vitreous detachment occurs normally, without any damage to the retina, no treatment is necessary. The vitreous does not need to be reattached, lasered, or surgically removed.
Only complications of vitreous detachment are treated:
In the event of a retinal tear, laser treatment is usually necessary. Your ophthalmologist cauterizes the retina to the wall of the eye around the tear using a laser or a cryopexy (freezing treatment).
In the event of vitreous hemorrhage, the ophthalmologist monitors the retina and performs laser treatment or a vitrectomy if the hemorrhage does not dissipate satisfactorily.
In the event of retinal detachment, emergency surgery is performed.
Frequently Asked Questions
How to treat vitreous detachment?
Vitreous detachment heals itself! The brain performs a cortical filtering and treats floaters as unwanted images. You will only see them in the evening when tired (the brain can no longer filter them) or when looking at a bright, well-lit wall (a high-contrast situation where the brain can no longer filter them out).
What to do in case of vitreous detachment?
If floaters suddenly appear, suggesting a vitreous detachment, it is urgent to have a fundus examination to check for a retinal tear. If no retinal tear is found, schedule a follow-up fundus examination one month later and continue with your normal activities.
Does drinking water reduce floaters?
No! Floaters are unfortunately not aspirin tablets. Drinking water won't change anything.