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Partial Vitreous Detachment (PVD), Retinal Holes, Tears or Detachments

The retina is composed of nerve tissue at the back of the eye that transmits light signals to your brain. Different parts of the retina are responsible for different parts of vision. The small central part of the retina, or the macula, is responsible for central vision and fine detail. The larger outer areas of the retina are called the peripheral retina, and are responsible for peripheral or side vision. The large cavity of the eyeball between the retina (in the back of the eye) and the lens (in the front of the eye) is filled with the vitreous body, a gel-like fluid that attaches to the retina.

 

Aging, trauma, and ocular disease can all cause changes to the vitreous body and retina leading to posterior vitreous detachment (PVD), retinal holes or tears, or a very serious condition, a retinal detachment (RD).

Posterior Vitreous Detachment (PVD)

The middle of the eye is filled with a substance called vitreous. The vitreous is normally attached to the retina, in the back of the eye. A posterior vitreous detachment (PVD) is when the vitreous pulls away from the retina.

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Most people with a PVD will not notice any symptoms. Some with PVD will have the following symptoms:  

  • flashes of light in peripheral or side vision  

  • floaters, or tiny specks, moving around in your field of vision  

  • or rarely, decreased vision or a dark curtain or shadow moving across your field of vision

 

Aging is the most common reason a posterior vitreous detachment occurs, though trauma can also be a cause. As the vitreous body separates from the retina,  floaters and flashes are common symptoms and usually resolve with time. A posterior vitreous detachment is a normal aging process, but it is important to have a dilated exam with an ophthalmologist or optometrist to ensure the vitreous separates cleanly, and no retinal holes, tears, or detachments develop.

Retinal Holes or Tears

​Retinal holes and tears can be caused by a variety of conditions including PVD, high myopia (nearsightedness), and trauma.  Symptoms of retinal holes and tears commonly include flashes and floaters but may present with no visual symptoms.  It is important to have a dilated exam with an ophthalmologist if you are diagnosed with a retinal hole or tear.  Retinal holes and tears are usually treated with in-office procedures including laser therapy or cryotherapy which adhere the retina to underlying layers of the eye to prevent a retinal detachment .  If a retinal tear or hole is left untreated,  fluid may accumulate under the retina, causing a retinal detachment.

Retinal Detachment (RD)

The retina is composed of nerve tissue at the back of the eye that transmits light signals to your brain. The vitreous body is the fluid that fills the middle of the eye. As people age, the vitreous body often separates from the retina causing a posterior vitreous detachment (PVD).  As the vitreous separates from the retina, there is a possibility that the retina will develop a tear or detachment. A retinal detachment (RD) is a serious condition where the retina has separated from other layers of the eye. Common causes include retinal holes or tears, trauma, traction, or high myopia. As vitreous fluid pools under the retina, that area loses it ability to provide vision. A retinal detachment requires urgent treatment, and if left untreated, may lead to severe vision loss or blindness.

Symptoms

  • Symptoms of a retinal detachment can vary, but most commonly include persistent flashing lights, new floaters, and a dark curtain blocking the peripheral vision. As a retinal detachment progresses, central vision will be lost, which can be permanent if not treated immediately. If you experience any of these symptoms, please call us as soon as possible to schedule an appointment.

Diagnosis

  • A dilated exam will allow an ophthalmologist or an optometrist  to diagnose a retinal detachment.  Fundus photography and optical coherence tomography (OCT) may be used to document the size, location, and severity of the detachment.

Treatment

  • The size, location, duration, and cause of the retinal detachment will determine treatment. Retinal detachments most often require surgical intervention to repair. Surgical repairs includes lasers, gas bubbles with freezing therapy in the office, or a vitrectomy or scleral buckle at a surgery center. Depending on the location of the retinal detachment, face-down positioning may be necessary for several days following surgery. As with any surgical procedure, there are risks and benefits that will be discussed with your physician prior to surgery.

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