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Posterior Vitreous Detachment:

What is a PVD?

Posterior Vitreous DetachmentPosterior Vitreous Detachment (PVD) is a common condition which occurs in about 75 per cent of people over the age of 65. As people get older the vitreous, a jelly-like substance inside the eye, changes: the central part of the vitreous becomes more liquid and the outer part (cortex) peels away from the retina. As it comes away from the retina it can cause the symptoms of posterior vitreous detachment.

What are the symptoms of PVD?

Some people may have no symptoms. However many people notice floaters in their vision or flashing lights. Floaters can take many forms from little dots, circles, lines, to clouds or cobwebs. Sometimes people experience one large floater which can be distracting and make things difficult to read. The flashing lights that occur are also caused by the PVD. As the outer part of the vitreous detaches from the retina it can pull on this light sensitive membrane, especially where the vitreous is attached quite strongly to the retina. The pull of the vitreous in these areas stimulates the retina. This stimulation causes the sensation of flashing lights since the brain interprets all stimulation signals from the retina as light.

Do the floaters go away?

Patients usually find that their symptoms settle down after 3 months or so. The brain tends to adapt to the floaters and eventually is able to ignore them, so they then only become a problem in very bright light. Occasionally patients do have long term problems from their floaters, however fortunately this is uncommon.

Why are floaters important?

Posterior vitreous detachment and the subsequent floaters do not in themselves cause any permanent loss of vision. However, occasionally during the process of vitreous detachment a retinal tear can form which may lead to retinal detachment and visual loss. It is therefore important to have an ophthalmic examination if you do develop symptoms of floaters.

How do retinal tears form?

Sometimes the vitreous is so firmly attached to the surface of the retina that as PVD develops it tugs on the retina, causing a retinal tear. The warning signs of a retinal tear or detachment could be an increase in size and number of your floaters, a change / increase in the flashing lights you experience or a blurring of vision. If you experience any of these symptoms you should seek urgent medical advice within 24 hours. This is particularly important if you notice a dark "curtain" falling across your vision, as this may mean that the retina is detaching. If patients are seen early before the retina detaches laser treatment may stabilise the situation and prevent retinal detachment. If retinal detachment occurs surgery is required (see Retinal Detachment section).

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