Posterior vitreous detachment

Posterior vitreous detachment (PVD) is a common eye condition that can be a natural part of ageing. It's more common among adults over 50 and can happen in as many as 24% of people aged 50-59 (Source: Clinical Ophthalmology).

Posterior vitreous detachment (PVD) symptoms

The main symptoms of PVD are:

• Suddenly seeing more floaters. These can appear as dark spots, lines or strands, squiggles, or cobweb shapes moving across your vision.
• Starting to see flashes of light (called photopsia) at the side of your vision.

Our eyes contain a jelly-like substance called the vitreous, made of water, hyaluronic acid and collagen. As we age, a natural change happens to this vitreous gel. It becomes thinner and more watery in texture. As this happens, it can start to separate from the retina, the light-sensitive layer at the back of the eye.

The floaters you see are due to clumps of vitreous material that have separated from the retina. These appear as shadows in your vision (floaters). The flashes of light happen when the vitreous gel pulls away and stimulate nerves in the retina. This causes the appearance of flashing lights.

PVD is not a painful condition and doesn't lead to sight loss, although it can lead to complications that may need treatment.

Causes of posterior vitreous detachment

Posterior vitreous detachment is a fairly common eye condition that happens as a natural part of ageing, present in more than 60% of people aged 70 and older (Source: Archives of Ophthalmology).

Other risk factors can lead to PVD in people who have:

• Myopia (nearsightedness)
• Diabetes
• Previous eye surgery
• A family history of retinal detachment
• PVD in one eye, being at greater risk for developing it in the other eye

Rarely, an eye injury or trauma to the head can cause PVD, known in this case as traumatic posterior vitreous detachment.

Getting a posterior vitreous detachment diagnosis

If you notice any symptoms of PVD, see an optometrist or ophthalmologist within 24 hours.

Your optometrist or eye doctor will examine your eye and check for any other eye conditions or complications.

You'll have eye drops to dilate your pupils to allow a detailed eye examination. You might also have optical coherence tomography (OCT), a non-invasive imaging technique that creates a detailed image of the structure of the eye.

Posterior vitreous detachment treatment

There's no treatment for posterior vitreous detachment, and for most people, the symptoms tend to subside after a couple of months. If you have a lot of symptoms and they're troubling you, your optometrist or ophthalmologist may organise a follow-up appointment, especially if you're at higher risk of complications.

If you develop new symptoms that could be a sign of a retinal tear or retinal detachment, you will need to get treatment urgently.

When to get medical advice

We should all have regular eye exams with an optometrist. The NHS recommends visiting your optician every two years, more often for people at greater risk of developing certain eye conditions.

The symptoms of PVD are similar to retinal detachment, which can threaten your sight unless treated urgently. That's why you should see an optometrist or ophthalmologist within 24 hours if you develop the following eye problems:

• A sudden increase in floaters, whether in size or number
• Seeing more flashing lights than usual for you
• A sudden worsening of blurred vision
• A dark curtain or shadow that moves across your vision

Living with posterior vitreous detachment

The symptoms of PVD improve for most people after a few months. That's because the brain learns to ignore them, so they become less noticeable. You may find it helps to wear sunglasses when it's bright outside to reduce the amount of shadow created by floaters on your retina.