In that we see new spots, cobweb like shapes, or brief flashes of light which are alarming. In most adults what we are seeing is related to posterior vitreous detachment (PVD) which is a common age related change in the eye. Although in the great majority of cases this does not lead to permanent vision problems what is important is to recognize posterior vitreous detachment symptoms because similar changes may also retinal tear or retinal detachment.
At Vasan Eye Care we see many patients present with sudden floaters and flashes which is why we recommend a comprehensive eye examination as soon as possible when these symptoms break out of the blue or worsen.
What Is Posterior Vitreous Detachment?
The vitreous is a see-through gel which fills the space between the lens and retina. As we age this gel changes to a more watery consistency and begins to pull away. This natural process of vitreous degeneration may eventually cause the vitreous to separate from the retina which is known as posterior vitreous detachment.
The National Library of Medicine reports that PVD is a separation of the posterior vitreous cortex from the retina’s internal limiting membrane. Age related changes are by far the most important causes of it. PVD is also different from retinal detachment. That said the vitreous when in the process of separating may at times pull with great force on the retina which in turn may produce a retinal tear.
Common Posterior Vitreous Detachment Symptoms
The most reported signs of posterior vitreous detachment symptoms are new floaters and brief flashes of light. PVD symptoms may appear all at once, especially when the vitreous has finished it’s separation from the retina. Floaters may present as dots, threads, rings, cobwebs, or small moving shadows. They tend to move when the eyes do. Flashes can present as flickering lights or short arcs, also they are more noticed at the periphery of the visual field tear.
| Symptom | What a Person May Notice |
| Floaters | Moving dots, threads, cobwebs, rings, or shadows |
| Flashes | Brief flickers or streaks of light, often in peripheral vision |
| Mild visual disturbance | Temporary awareness of moving vitreous shadows |
| Warning changes | Sudden increase in floaters, worsening flashes, shadow or curtain over vision |
Most simple cases of posterior vitreous detachment report that symptoms tend to diminish as the brain adjusts and the vitreous stabilizes. But a sudden onset of many floaters and flashes is a reason for a medical evaluation which in turn may require a retina exam for posterior vitreous detachment symptoms.
Can Posterior Vitreous Detachment Cause a Retinal Tear?
During the process of vitreous degeneration the vitreous may instead remain fixed to certain parts of the retina. As it detaches from the rest of the eye the traction may in some cases cause a retinal tear. If fluid gets into that retinal tear the retina may start to pull away from the back of the eye.
This is what we often see in sudden PVD eye symptoms which we may tend to put off. According to the NHS guidelines if you experience an increase in flashes, a growth in the number or size of floaters, a curtain like shadow, or a sudden drop in vision that is when you should go in for that immediate assessment.
| Usually Associated With Uncomplicated PVD | Symptoms Needing Prompt Eye Assessment |
| Stable floaters | Sudden shower or significant increase in floaters |
| Occasional flashes that improve | Increasing or persistent flashing lights |
| Vision otherwise remains stable | Sudden reduction or blurring of vision |
| No missing area of vision | Dark curtain, shadow, or missing peripheral vision |
How Is PVD Diagnosed?
An ophthalmologist typically reports on posterior vitreous detachment symptoms from a comprehensive history and a dilated retinal examination. Dilation of the pupil which in turn allows the doctor to look at the peripheral retina for tears, bleeding, or early retinal detachment. When needed we may order in investigations like optical coherence tomography (OCT) or ocular ultrasound which will provide more info on the health of the vitreous and retina.
Posterior Vitreous Detachment Treatment
In simple terms in most cases of posterior vitreous detachment treatment does not include surgery or medication. If the doctor rules out retinal tear or detachment other methods of treatment may be put on hold and just regular follow up will be recommended.
In fact the goal of vitreous detachment treatment is usually to monitor rather than to cause reattachment of the vitreous. Floaters tend to diminish over time, also flash symptoms may go away as traction on the retina decreases.
If there is a retinal tear diagnosed through examination that which treatment is put forward by the retina specialist to. Retreatment to reduce the risk of the retina detaching may be recommended. What is done is based on what is seen in the retina, not just the presence of PVD.
When Should You Visit an Eye Doctor?
New onset of posterior vitreous detachment symptoms, in particular sudden floaters and flashes, should be had rather than self diagnosed. Timely assessment is very important if floaters suddenly multiply, flashes intensify, vision becomes blurred, or a dark curtain or shadow appears.
At Vasan Eye Care we see that a detailed retina examination can identify if symptoms are from simple PVD or a more serious issue that requires more in depth care. Also at the very early stages of any retinal disease prompt medical care is key.
Frequently Asked Questions
1. What are the most common posterior vitreous detachment symptoms?
The typical posterior vitreous detachment symptoms are new floaters and flashing lights which present suddenly in one eye.
2. Does posterior vitreous detachment require treatment?
In most easy cases no specific vitreous detachment treatment is required but it is important to have an eye exam to rule out retinal tears.
3. Are floaters and flashes always caused by PVD?
No. Floaters and flashes are a few different things which may present for many reasons that include retinal issues, in which case of sudden or progressive symptoms you should see a professional.
4. Can PVD cause permanent vision loss?
For the most part PVD which is uncomplicated does not lead to permanent loss of vision. However vision may be affected if a retinal tear or retinal detachment happens and is not treated early.
5. How long do PVD eye symptoms last?
PVD eye symptoms often improve within weeks or months’ time which some patients report to still have floaters present at a later date.
References link
- NCBI Bookshelf – Posterior Vitreous Detachment
https://www.ncbi.nlm.nih.gov/books/NBK563273/ - Guy’s and St Thomas’ NHS Foundation Trust – Posterior Vitreous Detachment
https://www.guysandstthomas.nhs.uk/health-information/posterior-vitreous-detachment