What is Posterior Vitreous Separation?
The eye is a very complex functional and anatomic organ. The retina is a thin, delicate and transparent sheet of tissue that lines the inside of the back of the eye. Directly in front of the retina is also a cavity that contains a gel called vitreous, a complex structure consisting of aqueous fluid, macromolecules, and collagen fibrils. In children, the vitreous is an optically clear, transparent, and formed gel. However, as life progresses the vitreous gel naturally and gradually liquifies. By mid to late life, the vitreous has mostly liquified except for a layer of gel up against the retina. At some point, in nearly all people, this layer of gel will spontaneously begin to peel away, or separate, from the retina. We refer to this natural development in the eye as posterior vitreous separation (PVS) or posterior vitreous detachment (PVD).
Posterior Vitreous Detachment Symptoms
Some people have no symptoms from a PVD. However when symptoms do occur they consist of “flashes and floaters”. Flashes occur when the layer of gel pulls mechanically on the retina as it separates. The brain interprets this mechanical irritation of the retina as light. Flashes occur most prominently when PVD initially occurs and then gradually die down over a few weeks.
The floaters occur because the layer of gel up against the retina contains fibers that clump together when PVD occurs, then float around within the liquefied vitreous and are symptomatic in the vision. These floaters gradually diminish in prominence over several weeks or months.
Occasionally people will continue to perceive flashes and floaters for a prolonged period of time. As long as a retinal examination discloses no vision-threatening findings, treatment is not necessary.
Vision-threatening complications can occasionally develop after a PVS. In some cases, the gel separates from the retina may pull on and break a small retinal blood vessel. This can cause vitreous hemorrhage. Although vitreous hemorrhage will usually resolve on its own, it is also important to examine the retina in case the gel has pulled on the retina hard enough to cause a retinal tear to develop. While laser treatment can help treat & stabilize retinal tears, it can also lead to a retinal detachment which is a very serious and potentially blinding complication of a PVS.
Posterior Vitreous Detachment Treatment
The abrupt onset of flashes and floaters should prompt a careful and complete examination of the back of the eye and the retina within a day or two. Since a retinal tear or retinal detachment may not be initially present, one can occasionally occur later. A second examination is often done 3-4 weeks after the onset of PVS. If we identify no complications at that examination, future risk is low.
VitreoRetinal Surgery, P.A. is a group practice of fellowship-trained Retina Specialists. We specialize exclusively in the treatment of retinal diseases. We are actively involved in research into new treatments and are capable of rapidly bringing newly approved treatments to our patients with retinal diseases.
Schedule a Consultation
To learn more about Posterior Vitreous Separation and Posterior Vitreous Detachment, please call (800) VRS-2500 to schedule a consultation. We have at locations in Minneapolis, St. Paul, Blaine, Edina, Oakdale, Plymouth, St. Cloud and Duluth.