Explanation – A posterior vitreous detachment (PVD) is a normal physiologic event, that is, it happens just about to everyone! The prevalence of a PVD increases with age and degree of myopia (nearsightedness). The vitreous is a proteinaceous gel composed mainly of water, but like a jellyfish, does have substance. It is not renewed as we age. With time, the protein portion of the gel degenerates and turns to water. This leaves “pockets” of water instead of gel. At some point, the gel collapses on itself and the gel pulls away or separates from the surface of the vitreous. At this time, and for the next six weeks, the retina is at highest risk for a retinal tear. A retinal tear may develop into a retinal detachment which is a potentially blinding condition.
Symptoms of a posterior vitreous detachment are sudden painless onset of floaters and flashes. Floaters may be described as small black spots, a “cobweb” like effect or haziness all of which moves with eye movement. Flashes may or may not be associated and are generally most noticeable in a darkened room. At times, the “floater” may be so large that it obscures central vision. If this is a persistent complaint, vitrectomy may be entertained.