Posterior vitreous detachment (PVD), sometimes called vitreous detachment, occurs when the vitreous, the gel-like substance attached to the retina in the back of the eye, shrinks and pulls away from the retina. By itself, vitreous detachment does not seriously affect your vision and usually does not require any treatment. However, PVD may make you more susceptible to retinal detachment and macular hole, which are serious conditions that are known to cause visual loss.

The shrinking of the posterior vitreous that causes vitreous detachment is a part of normal aging and generally begins around the age of 50. Posterior vitreous detachment is very common for those over the age of 80.  PVD also is more likely to occur in patients who are nearsighted or have had posterior vitreous detachment in their other eye.

As the vitreous shrinks, it can form clumps and can pull tiny bits of tissue away from the retina. This may be noticed these as “floaters,” which appear as floating spots or other shapes. Less commonly, flashes of light may be seen.  This is caused by the vitreous pulling on the retina.

Vitreous detachment by itself is not a serious medical condition and is not a serious threat to your vision. Vitreous detachment increases the risk of retinal detachment and macular hole. Seek immediate medical care if you have a sudden increase in floating spots, flashing lights, or the sense of a curtain being drawn across part of your vision. These could be signs of retinal detachment or macular hole, which are sight-threatening conditions.

What are the Symptoms of Posterior Vitreous Detachment?

  • Floaters:  A person typically sees anywhere from a few to hundreds of dark spots or objects that appear to be floating in the field of vision. These floaters may represent bleeding inside the eye, or torn retinal tissue, but they usually represent particles that have been in the vitreous all along. With normal aging, the vitreous becomes more liquid and the particles can float and be seen. When they were fixed in space in the more solid gel, the brain did not notice them.
  • Lightning flashes: Lightning flashes are generated by the vitreous tugging on the retina during eye movement. When a posterior vitreous detachment occurs, there may initially be residual areas where the vitreous remains attached to the retina, causing these light flashes.
  • Decreased vision: Decreased vision is not usually present, although vision can decrease secondary to bleeding inside the eye or retinal detachment.
  • If retinal detachment develops early on, central vision may be normal but some patients begin to note a curtain or for that may progressively obscure the peripheral vision, followed by loss of central vision.

How is Posterior Vitreous Detachment Treated?

Because posterior vitreous detachment usually does not produce serious symptoms or lead to serious complications, it is often left untreated. However, if the floating objects and spots associated with posterior vitreous detachment become bothersome, the vitreous may be surgically removed.