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Posterior Vitreous Detachments (PVD): A description of the anatomy & risks to retina & new floaters.

This video describes the anatomy of the vitreous and its composition of collagen proteins and water. A common event occurring in mostly aging eyes is what is called a posterior vitreous detachment (PVD). This is not to be confused with a much more concerning retinal detachment. The PVD is essentially a shift of fluids as separation of the outer baggie or sack of the vitreous away from the retina. With this separation of the vitreous and especially when it is incomplete or in the process of separating, there are particular risks of retinal holes, tears, or actual detachment. When the vitreous has not fully separated, it can also create some traction on the retina which is where the peripheral and brief arcs or flashes of light come from. Fortunately, the complications to the retina are a very small percentage of those who experience a posterior vitreous detachment.

The typical story I hear is something like this: "I was minding my own business doing this particular activity and I noticed a sudden onset of dark specks moving around my vision and then at nighttime when I move my head or move my eye I would get a peripheral flashes of light." Typically, the flashes will subside within a few days or a couple of weeks. If you dodge the bullet and don't have a retinal problem, then for most people what remains is some varying degree of a disruption or disorganization of the vitreous which may seem like light clouds moving around or outright densities that we call floaters.

The incidence of posterior vitreous detachment's is about 25% of 60-year-olds, and about 60% of 80-year-olds. Clearly this is an age related phenomenon. There is no procedure or even a need to reattach this separated vitreous. As you may have discovered, most local and well-qualified eye doctors will tell you to just learn to live with it. As an eye floater treating specialist, I do see these posterior vitreous detachment's, but that is not a primary target of my treatments. I target and aim for the particular densities that are more responsible for the sensation of floaters. If those can be treated, the mild symptoms associated with a posterior vitreous detachment are much better tolerated and can usually be ignored.

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3 comentários

I was diagnosed with this yesterday, about a month after cataract surgery. I have a ring with a big dark area just outside my main field of vision, so I see it all the time, and I have flashes whenever I move my eye or my head quickly, so when driving or reading. I guess the detachment is still in progress. It's quite bothersome. No evidence of retinal tears or detachment, but I'm supposed to check back again in a month.


maria cvach
maria cvach
07 de fev. de 2022

Thank you so much for this fantastic explanation!


Thank you, Dr Johnson, for your visual explanation of PVD. A "spot" just appeared in my vision that I thought was on my glasses, and that night the "lightning" light appeared in my peripheral vision. I went to the doctor the day after Thanksgiving, and was diagnosed with PVD. Dr Dooley actually showed me the spot, or "floater", that I was seeing, after dilating and taking a picture of my eye. However, when I got home I was unable to explain the diagnosis to my husband (!), so I found your video and we watched it. Thank you.

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