Posterior Vitreous Detachment
What is posterior vitreous detachment (PVD)?
Posterior vitreous detachment (PVD) occurs when the gel that fills the eyeball separates from the retina. The retina is a thin layer of nerve tissue that lines the back of the eyeball. It’s responsible for detecting light and turning it into visual images.
Following PVD, there’s often an increase in specks or shadows of gray or black in your vision. It also may make you see flashes of light, usually at the side of your vision.
Does posterior vitreous detachment (PVD) lead to vision loss?
PVD isn’t painful, and it usually doesn’t cause vision loss unless you have a complication, such as:
- Retinal tear.
- Retinal detachment.
- Macular hole (the macula is the center of the retina).
- Macular pucker (scar tissue on the macula).
But complications are rare, occurring in fewer than 15% of people with PVD.
Who’s at risk for posterior vitreous detachment (PVD)?
PVD is a natural and common age-related eye problem. It’s rare in people younger than 40, usually occurring after age 60. The chances of developing this condition increase as you get older. If you’ve had PVD in one eye, you’re more likely to develop it in the other eye. Certain factors make posterior vitreous detachment more likely, including:
- Eye injuries.
- Eye surgery.
- Nearsightedness (myopia).
Symptoms and Causes
What causes posterior vitreous detachment (PVD)?
The eyeball is filled with vitreous gel. This gel is made mostly of water and a protein called collagen. As you age, the gel becomes more liquid and the attachment of the back surface of the gel to the retina dissolves, leading to the gel separating from the retina.
What are the symptoms of posterior vitreous detachment (PVD)?
The symptoms of PVD are:
- Floaters: People say they look like bugs, cobwebs, hairs or dust floating in the field of vision. They’re sometimes shaped like a circle or oval, called a Weiss ring.
- Flashes of light: People with PVD report seeing streaks of light, usually at the side of their vision. Flashes may be more noticeable when you’re in darker environments.
The symptoms are usually mild and become less noticeable within a few months, as your brain learns to ignore them. If you experience the symptoms of PVD, reach out to your eye care provider.
Diagnosis and Tests
How is posterior vitreous detachment (PVD) diagnosed?
If you have PVD symptoms, you should visit an eye specialist (ophthalmologist or optometrist) right away. An eye exam can identify any serious problems and reduce the risk of permanent damage and vision loss.
The specialist will conduct a few tests:
- Dilated eye examination: The specialist will put drops in your eye to dilate (widen) the pupil, then look inside with a lighted tool. The test is usually painless, other than maybe feeling a little pressure.
- Ocular ultrasound: This painless test uses high-frequency sound waves to take pictures inside your eye, measure its size and show its structure.
Management and Treatment
What’s the treatment for posterior vitreous detachment (PVD)?
Your healthcare provider will treat the complications of PVD, not the condition itself. You should have an eye exam when your symptoms start and again four to six weeks later. During a follow-up eye exam, your provider will be looking for several things. First, your provider will be checking to make sure nothing was missed during your PVD diagnosis. Second, your provider will look for any complications. There may not have been a retinal tear, for example, during the first exam, but it can be there during a future exam.
Although it isn’t common, some people with long-lasting floaters that bother them could be candidates for a vitrectomy. In this surgery, a specialist makes a tiny opening in the wall of your eye. Then, the surgeon uses suction to remove the vitreous gel from your eye.
How can I prevent posterior vitreous detachment (PVD)?
There’s no way to prevent posterior vitreous detachment. It’s a normal, natural part of aging.
You should report any changes in vision to an eye specialist. They can detect other eye conditions and prevent complications.
Outlook / Prognosis
What is the outlook for people with posterior vitreous detachment (PVD)?
People with PVD can usually go about their normal activities with no restrictions.
Although the condition doesn’t go away, floaters and flashes become less noticeable over time. It’s common to develop PVD in the other eye in the next year or two after your first diagnosis. If you experience symptoms in the other eye, a repeat exam is needed to be sure there isn’t a retinal tear or detachment in your second eye.
Most people don’t develop complications such as a retinal tear. But you should have an eye exam to make sure you don’t have a more serious condition.
Can I do anything at home to reduce floaters and flashes?
Some techniques may help you cope with the floaters and flashes that come with posterior vitreous detachment, such as:
- Move your eyes around gently in circles. This may shift a floater out of your direct line of sight.
- Reduce the brightness on screens, such as smartphones, computers and televisions.
- Wear eyeglasses as prescribed.
- Wear sunglasses in bright environments to make floaters less noticeable.
A note from Cleveland Clinic
Posterior vitreous detachment (PVD) occurs when the gel that fills the eyeball separates from the retina. It’s a natural, normal part of aging. PVD can cause floaters or flashes in your sight, which usually become less noticeable over time. The condition isn’t painful, and it doesn’t cause vision loss on its own. But you should see an eye specialist to make sure you don’t have another problem, such as a retinal tear.
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