Posterior vitreous detachment

This detachment is caused by changes in your vitreous gel. PVD isn’t painful and it doesn’t cause sight loss, but you may have symptoms such as seeing floaters (small, dark spots or shapes) and flashing lights.

These symptoms will calm down as your brain learns to ignore them. With time, you should be able to see just as well as you could before your PVD started.

The symptoms of PVD are very similar to those of a different eye condition called retinal detachment, which needs prompt treatment to stop you losing part or all of the sight in your eye. Because of this, it’s important to have your eyes examined by an ophthalmologist (hospital eye doctor) or an optometrist (also known as an optician) within 24 hours of noticing any symptoms so that an accurate diagnosis can be made. You can do this by visiting your optometrist or attending A&E or eye casualty. You can also call 111 for advice about where to go to get your eyes checked.

About 10 to 15 per cent of people with PVD develop a retinal tear, which, if left untreated can develop into a retinal detachment. A retinal tear or detachment can be successfully treated if diagnosed early.

Most people diagnosed with PVD will not develop a retinal tear or detachment.

This page contains a summary of our information on PVD. To read our full information, download our Understanding posterior vitreous detachment booklet, which is accredited by the Royal College of Ophthalmologists:

Your eye is filled with a clear gel called the vitreous. The vitreous helps to keep your eye’s shape. It is made up mainly of water and a protein called collagen.

As you age, it is common for the vitreous to become more watery and less like a gel. When the vitreous gets too soft, it loses its shape, and comes away from the retina and shrinks in towards the centre of your eye. Once the vitreous detaches, it does not reattach again. This is not a problem as we don’t need the vitreous attached to the retina to see well. PVD is a natural change in the eye and is not a sign of another eye health problem.

The most common cause of PVD is age. Most people with PVD are over the age of 50 but you can have a PVD in your 40s, particularly if you’re short-sighted or if your eye has been injured or you’ve had previous eye surgery.

It’s normal to get PVD in both eyes, although often it will occur in one eye at a time. Usually people get PVD in their other eye between six months to a couple of years after the first eye. As PVD is a natural change, there is no way to prevent a PVD from happening.

PVD can cause several symptoms:

• Floaters for the first time or more floaters than you had before. The new floaters are usually noticed suddenly. There may be lots of new floaters or commonly a large cobweb-like floater.
• Flashes of light in your vision, usually like brief streaks of light in your peripheral (side) vision.
• Blurred vision.

As the process of a PVD can last some weeks to some months, your symptoms may be ongoing for this period. Generally, your floaters and the flashes of light will gradually calm down and become less obvious to you. You might be aware of your floaters in the long-term following a PVD, although they are generally not as noticeable as when they first began. As long as the symptoms are not worsening after your eyes have been checked and PVD is diagnosed, then they are not usually a cause for concern.

If you’re worried about any symptoms that don’t go away, speak to your optometrist or ophthalmologist about it.

Floaters

Floaters are very common and many people have them, even if they don’t have PVD. They’re floating clumps of cells that form in your vitreous. You can see them because they cast shadows on your retina when light comes into your eye. These floaters do not harm your eye.

Floaters can be different shapes and sizes – dots that can look like flies, threads, circles, clouds, spiders or cobwebs. You may notice that your floaters move around a lot, or they may not seem to move much at all. They tend to be more obvious on a sunny day or when looking at a bright computer screen or a white or lightly coloured background.

You may only have a few floaters or you may have many of them. Floaters may appear quite suddenly, and they may be very frustrating or worrying to you. When they’re at their most intense, you might think that your floaters will always interfere with your vision, but for most people, they become less obvious over time. Floaters never leave the eye but become less noticeable as the vitreous settles down and your brain learns to ignore them.

Flashes of light

When your vitreous pulls away from your retina, your retina reacts to this stimulation by sending a signal to your brain. Your brain processes this signal as a small, short flash of light. You’ll often see more in dark or dim lighting as they will show up more against a darker background. These flashes of light won’t affect you for as long as floaters, and they will probably become a lot less frequent once the vitreous has fully come away from your retina.

If you have a large floater, moving your eyes gently round in circles may help. This moves the vitreous inside your eyes and can sometimes move the floater out of your direct line of vision so you’re less aware of it.

If your optometrist has advised you to wear glasses, wearing these when you need to will help you to see what you’re doing more easily. When your vision is clearer, you’re more likely to be able to concentrate on the task, rather than on the floaters.

Wearing sunglasses in bright conditions will make your floaters less noticeable. The tinted lenses reduce the amount of light entering your eyes, which means that your floaters cast a fainter shadow on your retina.

If your floaters are distracting you when you’re using a computer or tablet, reducing the brightness of the screen may make them less noticeable.

There isn’t any medical treatment for PVD and there’s no evidence that eye exercises, diet changes or vitamins can help. Given that the symptoms of PVD improve over time and that the vitreous does not need to be attached to the retina to see well, PVD does not need to be treated.

You may have heard that it’s possible to treat PVD either with a laser or with surgery to remove the vitreous from your eye. Very few ophthalmologists offer laser treatment for floaters, and in the UK it’s not a routine treatment. The laser may make large floaters smaller but it’s still not clear whether it’s safe or makes your vision any better. It’s very unlikely to be funded by the NHS so you’d usually have to pay for this privately. If you’re considering laser treatment, make sure you ask about the risks beforehand.

There is surgery called a vitrectomy where your vitreous is removed from your eye. Although this can reduce your floaters, it’s a major operation and there are risks from having this surgery. Because of this, it is necessary to discuss the operation carefully with a surgeon before considering a vitrectomy.

In most people with PVD, the vitreous comes away gently from the retina without any problems and does not cause any long-term changes to your sight. A very small number of people may experience complications from their PVD.

In a small number of people, PVD can lead to a retinal tear. This is because the vitreous may be more firmly attached in certain places to the retina. As your vitreous moves away from your retina in PVD, it can pull on your retina, causing it to tear. The risk of this happening tends to be highest when the symptoms of PVD first begin and in the first six weeks. Once the vitreous has fully detached from the retina, the risk of developing a tear from PVD goes back down.

Retinal tears can be successfully treated to prevent them from developing into a retinal detachment which can cause sight loss, but they do need to be treated promptly. Retinal tears from PVD are much rarer than PVD alone and only 10-15 per cent of people have a retinal tear following PVD. An even smaller number of these people go on to develop a retinal detachment.

If someone does develop a retinal tear from a PVD, it tends to occur when the PVD symptoms first begin or if the symptoms noticeably increase. Having your eyes examined on the same day or within 24 hours of the start of new or worsening symptoms means that your ophthalmologist or optometrist can look for any signs of retinal tear or detachment.

It’s important to remember that most people who have PVD do not develop any complications.

Most people with a PVD can carry on with their normal day-to-day activities with no restrictions because there is no evidence to show that certain activities can cause complications with your PVD. Some ophthalmologists advise that high impact exercise should be avoided during the first six weeks after the start of a PVD as this is when the risk of having a retinal tear or detachment is highest..

There is no evidence either way that any of the following activities will cause any problems with your PVD, but some people may be advised to or choose to avoid:

• Very heavy lifting, energetic or high impact exercises, such as running or aerobics.
• Playing contact sports, such as rugby, martial arts, or boxing.
• Inverted positions in activities such as yoga or Pilates.

You should always ask your ophthalmologist for advice about what activities you should avoid doing and for how long as the advice given may depend on whether they feel your retina may be particularly at risk, for example if you are very short sighted or have a history of eye surgery.

You can carry on with daily activities such as walking, gentle exercising, reading, watching TV, cooking, and using your computer. There is no evidence to suggest that flying in an aeroplane will harm your PVD or make it worse. Wearing contact lenses or makeup will also not affect your PVD.

A PVD will not usually cause your prescription to change, and it’s ok to have an eye examination for new glasses while you have a PVD. However, if you have a lot of floaters affecting your vision, you may wish to wait until these have settled before having an eye examination.

If you are a driver, you do not have to notify the DVLA that you have had a PVD. You can usually continue driving (if no other eye conditions are affecting your sight) but it’s best to speak to your ophthalmologist or optometrist for advice.

If you have any questions about PVD, we're here for you. Just get in touch with our Sight Loss Advice Service.

Watch our Living with posterior vitreous detachment story