What is vitreous detachment?
Posterior vitreous detachment (PVD) is an age-related natural process. It involves the separation of the vitreous gel that fills the eye from the retina.
VITREOUS
DETACHMENT
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HOW DOES IT
OCCUR ?
The vitreous body is a gel-like thick substance found inside the eyeball that is “attached” to the walls of the retina, the thin layer of nerve tissue that lines the back of the eye and gives it shape and transparency. Although the vitreous body is mostly composed of water, it also contains hyaluronic acid, collagen and proteins among other substances.
Over time the vitreous gel becomes liquid, condenses (as a natural consequence of ageing) and detaches from the retina and floats inside the eyeball.
What are the symptoms?
In most cases vitreous detachment symptoms are mild although depending on the water content and the accumulation of fibres, vision could be more affected since transparency is altered. This process usually causes shady vision and the typical myodesopsia, also known as “floaters”.
RISK
FACTORS
Although vitreous detachment is an age-related process, certain conditions might accelerate its onset or even lead to complications. Such conditions include:
- Trauma: in case of ocular traumatism or conditions that involve major anteroposterior forces the vitreous body might detach suddenly form the retina
- Myopia magna: in patients with very high prescriptions or serious eye conditions the attachment between the vitreous body and the retina is anomalous and PVD might occur at an early age
- Stickler syndrome’s disorders and other hereditary vitreoretinopathies
- Peripheral retinal degeneration: weaker peripheral areas of the retina where vitreous detachment might cause retinal tear
COMPLICATIONS
ASSOCIATED WITH VITREOUS DETACHMENT
Although is most cases vitreous detachment is a gradual process with mild symptoms, occasionally, due to sudden detachments or weakness of the retina it might lead to retinal tear.
This occurs when the vitreous body detaches from the retina with an unusual force causing a small tear in it. If retinal tear is not treated on time, liquid may leak to the sub-retinal space and cause retinal detachment.
In other cases the separation from the retina might tear small blood vessels causing vitreous haemorrhage.
Early diagnosis is always the most effective way to prevent and treat such complications.
Differential diagnosis
A detailed examination by an ophthalmologist is essential to differentiate vitreous opacities and disorders caused by posterior vitreous detachment from other causes that may imply serious conditions such as:
Uveitis: Processes of ocular inflammation
Vitreous haemorrhage: Intraocular bleeding, commonly associated to diabetic retinopathy
Synchysis scintillans and asteroid hyalosis: accumulation of cholesterol or calcium inside the vitreous body
Tumoural pathologies
DVP
TREATMENT
Vitreous detachment does not require treatment since it is a natural process that in most cases bears no significant relevance. However, the possible complications associated with a minority of cases must be diagnosed and treated without delay.
- Laser retinal photo-coagulation: in case of retinal tear, the retina must be sealed to prevent retinal detachment.
- Vitrectomy: in cases where complications lead to chronic vitreous haemorrhage or retinal detachment.
- Laser Vitreolysis: in cases where vitreous condensation or myodesopsia (floaters) are extremely dense and significantly affect the patient’s vision laser treatment may be applied.
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FREQUENTLY
ASKED QUESTIONS
Select any of the following FAQs from our patients and check the answers. If your doubts are not solved please use the contact form below to get in touch with us.
Does vitreous detachment affect everyone?
It does. It is a process that affects everyone at some point in life, although depending on the characteristic and conditions of the eye it may affect some patients earlier.
Are vitreous detachment and retinal detachment the same condition?
They are not. Vitreous detachment is a common physical condition that will sooner or later affect everyone. Retinal detachment is a serious condition that requires early treatment since it may lead to serious loss of vision. Retinal detachment may also be one of the complications of vitreous detachment.
When should I see an ophthalmologist?
From the very moment you begin to notice vision loss or “floaters” it is recommended to visit a specialist for a thorough examination of your eyes and an accurate diagnosis to rule out any conditions or complications associated with vitreous detachment.
Should I have my eyes checked periodically after the diagnosis?
Since in some cases there are complications associated with vitreous detachment (retinal tear, vitreous haemorrhage or retinal detachment) after diagnosis it is recommended to have periodical examinations until the situation becomes stable. Then you may continue with the regular examinations scheduled by your doctor.
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