What is a posterior vitreous detachment?
Posterior vitreous detachment, or PVD, is a natural change that occurs in the eye with age. While it is not dangerous on its own and usually settles without treatment, it can occasionally lead to more serious conditions that require prompt assessment. At Coastal Eye Surgeons, we assess and diagnose PVD and provide timely intervention when it is needed.
Inside the eye, behind the lens, sits a clear gel-like substance called the vitreous. In younger eyes, this gel is firmly attached to the retina - the “wall paper” of the eye. As we age, the vitreous gradually changes in consistency, shrinks, and pulls away from the retina. When this separation occurs, it is called a posterior vitreous detachment.
For most people, this is a normal part of the ageing process and does not cause lasting harm.
Symptoms of PVD
The most common symptoms of PVD are floaters and flashes of light. These are not painful and typically settle within a few weeks.
Floaters
Floaters are small shadows that drift across your field of vision. They may look like strings, cobwebs, a veil, a fly or mosquito. They are often most noticeable first thing in the morning or when looking at a plain, light-coloured surface.
Flashes
Flashes may appear as brief streaks or arcs of light, like lightning, usually at the side of your vision - similar to a camera flash in the corner of your eye.
Although floaters and flashes are the hallmark of PVD, they can also indicate more serious conditions such as a retinal tear or retinal detachment. For this reason, it is always important to have new floaters or flashes assessed promptly by an optometrist or ophthalmologist.
Healthy vision versus PVD-affected vision.
When does PVD become an eye emergency?
In most cases, the vitreous separates from the retina cleanly and without complication. Occasionally, however, as the vitreous pulls away it can create a tear in the retina. If fluid passes through that tear and gets behind the retina, it can begin to lift the retina away from the back of the eye - a retinal detachment.
Retinal detachment can cause loss of visual field and, if left untreated, loss of vision. It is an ocular emergency that requires surgery.
If you experience a sudden increase in floaters, a new curtain or shadow in your vision, or a significant change in your flashes, seek assessment as soon as possible.
For more information, see Retinal detachment.
How is PVD diagnosed?
PVD can be assessed by an optometrist or by the ophthalmologists at Coastal Eye Surgeons. The vitreous detachment is visible during a dilated examination of the eye - a thorough assessment that also allows the retina to be checked for tears or signs of detachment.
If you are referred to us following an optometrist assessment or if you contact us directly, we will arrange a timely appointment to examine your eye in full.
Who manages PVD at Coastal Eye Surgeons?
Initial assessment and management of PVD is carried out by our ophthalmology team. All three of our FRANZCO-qualified surgeons - Dr Louise Robinson, Dr Khoi Tran, and Dr Liam Turner - assess and manage PVD cases. Depending on what is found at assessment, a patient may be managed conservatively with monitoring, or referred to the most appropriate surgeon if a complication such as a retinal tear or detachment requires further intervention.
Treating PVD
Most cases of PVD do not require treatment. The condition is a natural change associated with ageing, and symptoms typically settle within a few weeks without any lasting consequences.
Where a retinal tear is identified during assessment, it can be treated promptly to reduce the risk of progression to retinal detachment.
In some cases, a floater may be particularly dense and persistent, and may affect vision to a degree that warrants further consideration. Surgical removal of floaters is a separate, specialised procedure performed by Dr Khoi Tran. If this is relevant to your situation, it can be discussed at your appointment.
Ophthalmologist Dr Louise Robinson