Dr Ben Wild
Overview |
The retina is located at the back surface of the inside of the eye. Its main function is to detect and transmit the sensation of light to the brain for interpretation. Attached to the retina is the vitreous humor. The vitreous humor is a large scaffold of gel that helps keep the eye inflated and extends from the retina all the way to the lens near the front of the eye.
A sagittal view of a healthy eye where the vitreous humor gel represents the pink space between the lens and the retina.
A posterior vitreous detachment (PVD) refers to the separation of the vitreous humor from the retina. This is usually a normal process cause by the liquefaction and shrinking of the gel due to age but can be caused by cataract surgery, trauma, inflammation inside the eye or laser retinopexy surgery. 65% of people have had a PVD by the age of 65. The separation usually starts around the macula (the part of the retina that corresponds to the center of vision) then the peripheral retina then around the optic nerve.
A sagittal view of an eye that has had a PVD. The vitreous gel is seen separated from the retina.
Signs and Symptoms |
Signs
Weiss ring (large circular floater), rare retinal bleeding, rare torn blood vessels, possible pigment granules in the vitreous humor, rare torn retina.
Symptoms
Flashes of light like lightning bolts or arcs associated with head turn or eye movement, floaters (myodesopsia).
Causes and Risk Factors |
Causes
Liquefaction and shrinkage of the vitreous humor.
Risk Factors
Prevention and Treatment |
Prevention
There are no known preventative measures.
Treatments
· Get retinal exam within 48 hours, ideally 24 hours.
· If a retinal tear is also seen, immediate laser retinopexy surgery.
Prognosis |
A PVD is a normal occurrence and usually results in a permanent floater. Often, the floater will settle downwards out of view or the brain will adapt and tune out the floater.
If there is a torn blood vessel, bleeding in the vitreous humor or bleeding in the retina after a PVD, there is a high likelihood of a retinal tear. A tear can be repaired with laser retinal surgery easily without any permanent loss of vision. If not treated in time, a tear can lead to a retinal detachment and cause permanent vision loss.