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Flashes and Floaters (PVD)

 

What is posterior vitreous detachment?

 

Posterior vitreous detachment (PVD) happens when the transparent vitreous jelly filling in the eye shrinks and separates from the retina. The retina is made up of light-sensitive cells and nerve cells located at the back of the eye.

Posterior Vitreous Detachment (PVD)

 

What causes posterior vitreous detachment?

 

The vitreous is a clear mass of gel made up of protein (collagen) and water, which helps retain the circular shape of the eyes. In PVD the vitreous starts detaching and, from its adjacent retina, strands of this gel start appearing in the vision, hence the term floaters. PVD commonly happens as a result of ageing in both men and women. As we age, the vitreous slowly moves away from the retina and becomes more mobile. However, PVD can also occur in younger age groups who are near-sighted (myopic) or who have experienced eye trauma.

 

Is posterior vitreous detachment painful?

 

At the beginning stage, Posterior Vitreous Detachment is not painful and does not cause loss of eyesight. An indication of having PVD is seeing floaters and occasionally flashes of light. If left untreated, PVD can cause health issues such as bleeding into the eye and retinal tears. A retinal tear can in turn lead to a retinal detachment requiring highly skilled retinal surgery.

 

What are floaters and flashes?

 

Floaters are oddly shaped dots or wavy lines that levitate in your vision. They float up as you look down or side to side. They are commonly more noticeable in light because they cast a shadow on the retina. Flashes appear when the vitreous gel in the eye grazes or pulls on your retina. This causes a flashing light in your eyesight and is usually an on and off light. Both flashes and floaters occur because of the detachment of the vitreous. If the attachment of the vitreous pulls too hard on the retina, it can herald a retinal tear.This in turn can lead to the vision being affected because of a retinal detachment. Catching a retinal tear early before it has led to a retinal detachment can allow laser retinal “welding surgery” to be done by the retina specialist to seal the retinal tear and prevent progression.

 

Is posterior vitreous detachment serious?

 

Although flashes and floaters become progressively less visible as the brain readjusts to the new normal in vision, PVD can lead to permanent loss of vision in the affected eye, due to an untreated retinal detachment.

 

We strongly recommend you visit our ophthalmologists to assess your issues as floaters and flashing lights can be an indication of retinal tear and subsequent retinal detachment which would require vitreo-retinal (VR) surgery by one of our two VR surgeons, Ms Evgenia Anikina and Mr Julian Robins. If the sensitive part of the retina, called the macula, detaches due to a retinal tear, vision can be affected permanently, even with successful surgery. Therefore this is an urgent eye care problem best assessed and treated early in order to obtain the optimal vision outcome.

 

URGENT EYE CARE

Don’t delay in getting your eyes assessed if you have what seems like a sudden onset of simple floaters! It pays to have your retina checked to detect a retinal tear and treat it, and avoid later retinal detachment and vision loss.

 

What are symptoms of posterior vitreous detachment?

 

PVD can often proceed uneventfully without damaging the underlying retina, but can also cause the following symptoms:

 

  • Floaters (dark spots and lines moving across the vision, especially in the daytime)
  • Photopsia (small flashes of light)
  • A cobweb effect across the vision
  • Blurred vision

 

One or all of these symptoms may be present in varying intensity. If you have any of these symptoms, you should book a consultation to have your eyes fully examined by our ophthalmic (or a hospital eye doctor) surgeons. If you have onset of blurred vision this could indicate a retinal detachment which urgently requires specialist retinal surgery. YOU need prompt retina care if you have any of the above symptoms or if your symptoms progress. Our retina care specialists can see you for this urgent eye problem.

 

You should be examined immediately if you begin to experience one of the following symptoms:

 

  • A sudden appearance of new floaters or increase in their size/number
  • Flashes of light/change or increase in flashing lights
  • Blurred vision
  • A dark or blurry curtain permanently obscuring part of your vision

 

These symptoms may be indicative of a more serious condition such as a retinal tear or retinal detachment. With a retinal tear or retinal detachment, early diagnosis and treatment are paramount in ensuring the best visual outcome.

 

 

How long do symptoms of posterior vitreous detachment last? 

 

PVD is known to usually last between a few weeks to six months. The effects of PVD will be less obvious to you as your brain adapts to the floaters and flashes. However, it is important to get your eyes tested as soon as you notice any changes in your vision, early detection of any problems in the retina is key to ensuring a positive outcome and a reduction in possible blindness in the long run.

 

What do I do if I have posterior vitreous detachment?

 

Having PVD does not stop you from your daily activities, and you can carry on with your day-to-day activities as normal. Steer away from heavy-duty exercises during the first six weeks of having PVD. This is because the vitreous may not have fully detached from the retina. Heavy exercises could worsen the risk of retinal tear and subsequent detachment. Book with our ophthalmic retina surgeons to examine the condition of your retina to ensure lack of damage.

 

If you have a blurry curtain in part of your vision, this can indicate a retinal detachment, which is an emergency and you should attend our urgent retina care eye specialist.

 

How is posterior vitreous detachment examined?

 

A full ophthalmological examination is performed by our ophthalmic consultants to check for holes and tears in the retina. This includes applying drops to dilate the pupils (hole in the centre of the eye) to examine your vitreous and the retina. These drops will blur your vision for around four to six hours. A slit lamp (microscope) is used to examine the eye and check for retinal tears/holes. In some cases, due to the vitreous gel being clear, it makes it hard to see the PVD. Additional testing would be required by using optical coherence tomography (OCT), ocular ultrasound and scanning laser ophthalmoscopy (SLO), all of which is available at CLinica London.

 

 

Can posterior vitreous detachment be prevented? 

 

PVD cannot be prevented as it commonly found in older adults due to age. However, PVD can develop at a younger age if you experience eye trauma or are near-sighted. If you are concerned about PVD or potential damage to your vision, speak to our retina ophthalmologists to examine any conditions.

 

How is posterior vitreous detachment treated?

 

Treatment occurs when there is a risk of health to the retina. Clinica’s team of ophthalmic retina surgeons would examine the severity of your condition to give the best guidance. In some cases, Laser Treatment is needed for a retinal tear, or vitreo-retinal surgery with Vitrectomy are recommended. Vitrectomy is a surgical procedure to remove the vitreous from your eye,and flatten the retina if it has detached too. Unfortunately we do not remove the vitreous gel just to remove the troublesome floaters.

 

Retina Care at Clinica

We have five highly qualified ophthalmic surgeons who can look after your retina, Ms Evgenia Anikina, Mr Julian Robins who are both vitreo-retinal surgeons, and Ms Esther Posner, Mr Jaheed Khan and Professor Michel Michaelides who are retina care specialists.

From the Retina Care Ophthalmologists at Clinica London.

Posterior Vitreous Detachment Treatment

Professor Michel Michaelides

Professor of Ophthalmology
Medical Retina & Inherited Retinal Disease Specialist

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Mr Jaheed Khan

Consultant Ophthalmic Surgeon
Medical Retina & Cataract Surgeon

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Ms Esther Posner

Consultant Ophthalmic Surgeon
Medical Retina Specialist

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Ms Evgenia Anikina

Consultant Ophthalmic Surgeon
Cataract, Surgical Vitreoretinal (VR) and Medical Retina Specialist

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Mr Julian Robins

Consultant Ophthalmic Surgeon
Cataract, Vitreoretinal (VR) and Medical Retina Specialist

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Frequently Asked Questions.

Attached to the retina is a “jelly-like” gel that divides the retina and lens. The detachment of this gel can cause flashes or floater patterns which can affect your vison. This occurs naturally usually around the ages of 55-60.

Flashes in your vision will go away over time usually taking up to half a year. Floaters will stay around longer. They will gradually get smaller and become less visible over the weeks and months. However, floaters will never completely disappear.

Seeing-eye flashes are usually harmless. However, the sudden appearance of flashes and floaters and a sudden occurrence of impaired vision can be a sign of more serious eye problems, particularly in an older person.

For most people seeing flashes and floaters is a symptom of vitreous detachment which in most people is something not to worry about. Although, as the vitreous begins to separate from the retina in some cases it may cause a tear. This would cause the sudden appearance flashes/floaters and impaired vision. This potentially is very harmful to a person’s permanent vison and an ophthalmologist should be contacted immediately.

Stress isn’t a direct cause of eye floaters or flashes, but flashes and floaters are caused by deterioration of the vitreous humour. When the human body is stressed it produces a hormone called Epinephrine (also called adrenaline) which causes the pupils to dilate which causes eye-strain. This means that stress isn’t directly linked to floaters and flashes bit can make a pre-existing condition worse.

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