Posterior Vitreous Detachment Causes Retinal Tears
A posterior vitreous detachment, or PVD, is a common cause of a retinal tear. A PVD is normal physiologic event and eventually happens to everyone. When it occurs, there is a higher than normal chance of forming a retinal tear. A retinal tear may lead to a retinal detachment, a potentially blinding condition.
The Vitreous Separates From the Retinal Surface
When we are born, the vitreous, a watery protein-laden gel, is very homogeneous and optically transparent. It fills the inside of the eye just as air fills a balloon. With time, or aging, the proteins break down forming cavities of water. The situation is very much like Swiss cheese, except there are pockets of water instead of air.
- Posterior Vitreous Detachment “Separates” from the Retinal Surface
At some point the gel collapses on itself and condenses (the same way a cake falls when brought out of the oven). The posterior portion of the vitreous detaches, or separates, from the retina, yet the more anterior portions remain attached. The condensed gel no longer fills the entire eye and now has more room to move back and forth.
Flashes and Floaters Are Common Symptoms of a PVD
When a PVD occurs, the symptoms of flashes and floaters are commonly noted. The flashes develop from the physical tugging of the vitreous on the retina. The floaters can be caused by condensed proteins, blood or cells/debris from underneath the retina.
A posterior vitreous detachment can also be asymptomatic.
Dilated Eye Exam to Look For a Retinal Tear
You should tell your doctor about new flashes and/or new floaters. If caused by a PVD, a dilated eye exam must be performed looking specifically for a retinal tear or retinal detachment.
Your pupils should be dilated when the symptoms first occur and then, again, six weeks after the initial symptoms. It is during the first six weeks following a posterior vitreous detachment that you are at greatest risk of forming a tear or retinal detachment.
At any time, should the symptoms worsen, even in between visits, please alert your eye doctor.
{ 9 comments… read them below or add one }
Thank you for the valuable information…I was diagnosised with this PVD today after first noticing the flashes yesterday and then a floater…I looked visual distrubences up on google and found the floaters/flashes as symptoms of retinal detachment…thank goodness, so far, it is just PVD…again, thank you for the information…helps to put my mind partially at ease.
I am glad you have found this site useful. I am especially happy that you “only” have a PVD and not a tear or retinal detachment. Thanks for taking the time to comment!
Randy
So, this helps describe what a PVD event is and the risks associated with it… does it ever revert back to then normal contacted state?
If relaxation is possible, are there things we can do to assist it?
No, it never “reattaches.” This is a structure separation of tissue from the surface of the retina. I am not aware that relaxation would be helpful.
Thanks for your inquiry,
Randy
Thank you for this information. I have a PVD at 4 weeks post occurence of a floater and cobweb without evidence of a retinal tear at this point but with aberrant flashing. About 20% of the flashes are bright and typical. 80% are a black field in the lateral area arc shaped and very short duration. Infrequently, they are superior and inferior-lateral. They have diminished in frequency and intensity, but the duration of the flashes as well as the character have me concerned. Have you had patients with this complaint?
Dear Barbara,
There is a reason we don’t go into much detail about “flashes.” We (doctors) are not terribly concerned about the quality and specific characteristics. We are most concerned by their mere presence. It is a good thing that someone has checked for a retinal tear.
In my own practice, I do not go into specifics because the presence of any new floater(s) requires a dilated exam, looking for floaters, just as you have had.
In short, sounds like you are in good hands.
All the best,
Randy
I had yag lasar for a large floater in my LEFT eye and five days later had flashes and arching and a huge floater presented itself in my RIGHT eye.. Diagnosis is Vitreous degeneration/ PVD in the right eye..
Could the left eye YAG have triggered the new RIGHT eye problem???
Certainly quite possible. The vitreous starts degenerating sometime during/after our youth. Initially, it is a homogeneous glob of protein and water. Over time, the protein breaks down so that the “vitreous” now has distinct areas of degenerated vitreous/ water (somewhat like Swiss cheese). Most large floaters seems to be associated with a PVD. It isn’t too far fetched to have a PVD in each eye…it is expected.
The topic of using the YAG laser to break of the floaters is another issue altogether.
Hope I helped.
Randy
Thanks Doctor,
The above from me happened just within the past few weeks… it is a so very annoying floater for me…[both eyes now!!]. I had Yag lasar in the lefteye last fall and the ophthamologist here in Rochester, Ny got about 65 % of it in my opinion…So he repeated it a few weeks ago to attempt to get the remaining part.. It was not successful and as I told you within days the RIGHT eye floater appeared.. I am 68 , had cataract surgeries and correction of strabismus as a child..
So my question…….What is your opinion of YAG surgery in the future in my RIGHT eye?? And I guess I would ask if you would recommend another attempt in the left eye..
I am quite sceptical…..
Is there any good information on YAG on line that you can recommend??
Thank you,
Mary Laurer
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