One of the most important parts of the eye is the vitreous, or vitreous humor, the fluid or gel in the middle of the eye. This fluid creates pressure that keeps the eye in shape and maintains the health of organs in the eye, such as the lens and the retina.
This gel-like substance usually remains attached to the retina at the back of the eye. But sometimes the vitreous separates from the back, potentially causing visual disturbances or distortions. This tearing away event is called a posterior vitreous detachment (PVD)
The condition sounds dangerous but usually is not. Doctors grow concerned, however, with one circumstance—when the retina is exposed after the detachment.
PVD most often strikes older adults. As we age, the fluid consistency of the vitreous changes and makes retinal detachment more likely.
Symptoms of PVD include flashes of light in the peripheral vision, eye floaters and increasing darkness in a field of vision. In many cases, doctors opt for rest and less eye stress as a treatment option, allowing the eye to repair itself.
Symptoms of PVD
PVD has a small group of symptoms associated with it, and it’s possible that you won’t notice them because they can be difficult to notice.
If you do notice symptoms, they may include:
- Flashes of light, especially in the peripheral vision.
- Floaters, or tiny specks that move around in your field of vision, especially if you did not have these before.
- Decreased or dark vision, like a curtain or shadow moving across your sight. This is less common.
Symptoms will progress slowly over one to three months, then get better. About 85 percent of people who develop PVD never experience any complications.
You may experience more floaters or flashes of light in your vision, but these symptoms are rarely disturbing. If you experience a sudden rise in these symptoms or have a darkening of your vision, you should see an eye doctor immediately.
Your doctor will diagnose PVD following an eye exam where you pupils are dilated. If your vitreous is clear, the doctor may not be able to see if the fluid has detached from the retina. It’s possible other tests are needed, including:
- An optical coherence tomography (OCT)
- An ocular ultrasound
Age is a factor in the diagnostic process. As we get older, the vitreous becomes increasingly less solid, more liquid than gel. This may cause the vitreous to lose shape, shrink and pull back from parts of the eye.
There are millions of microscopic fibers that typically keep the vitreous and the retina attached, but these may break, causing the separation.
Because PVD is so common and rarely causes complications, there are few medical treatments. For the most part, treating PVD means letting the eye heal, and this is what optometrists and ophthalmologists usually recommend—resting your eyes for a day or two. People who develop PVD typically do not need any medical treatment.
In rare cases, if you have so many floaters in your vitreous that you cannot perform routine tasks, you may undergo vitrectomy surgery, which can remove these particles from your vitreous. Even more rarely, a retinal tear or macular hole formed by PVD can lead to vision loss if left untreated.
If the detachment has damaged your retina, you may undergo laser surgery to correct this, but these procedures aim to correct, stop or pre prevent damage to the retina and macula rather than managing the vitreous.
If you are diagnosed with PVD, you will need a follow-up exam so your eye doctor can determine how well the area is healing. Complications from waiting are rare, but there is a small risk that there could be damage to the retina if PVD does not heal. This will be determined at your follow-up exam or if you experience any sudden, new, and severe symptoms of vision loss. Laser surgery to stop or treat retinal detachment may be necessary.
There is no way to prevent PVD because it occurs so routinely in older adults and does not have a specific underlying medical condition.
For most people, PVD is barely noticeable and nothing to fear. This condition is unlikely to cause any harm to your eyes, vision loss, or limitations on your current lifestyle, including activity levels and types of work you perform. While there is essentially no way to mitigate PVD, it is unlikely to harm you if you develop it.
Should You Worry?
You are more at risk for developing PVD if you are older than 60 and fall into one of four categories:
- You are nearsighted
- You had an eye surgery, including cataract surgery
- You have diabetes
- You experienced an eye injury
Mild floaters in the eye are common and aren’t likely to indicate that you have PVD. Particles are also common in the vitreous. However, you will want to schedule an immediate appointment with your eye doctor if:
- You suddenly develop multiple of floaters in your vision
- You observe new floaters alongside flashes in your periphery
- You experience sudden darkness in your vision
If you are at higher risk and are concerned about potential damage to your vision, talk to an optometrist or ophthalmologist. They will ask you questions about floaters or flashes you may experience, and they will examine your eye. They can also inform you of risks in your age group and how other factors like previous eye injuries or surgeries may impact these risks.
What Is a Posterior Vitreous Detachment? (February 21, 2019). American Academy of Ophthalmology (AAO).
What Are Symptoms of PVD? (February 21, 2019). American Academy of Ophthalmology (AAO).
Posterior Vitreous Detachment. (2016). American Society of Retina Specialists (ASRS).
Facts About Vitreous Detachment. (August 2009). National Eye Institute (NEI).
Can a PVD Cause Vision Loss? (February 21, 2019). American Academy of Ophthalmology (AAO).
Posterior Vitreous Detachment: What to Know. (January 28, 2019). Healthline.