Introduction
At The Retina Clinic London, we specialise in the diagnosis and management of Posterior Vitreous Detachment (PVD), a common condition that occurs as part of the natural ageing process. While PVD often resolves without complications, it can sometimes result in retinal tears or detachment, as well as the formation of Vitreous Floaters and Opacities (VFO).
Our state-of-the-art diagnostic tools and personalised care plans ensure that PVD and its associated complications are promptly detected and treated, preserving your vision. To learn more about VFO, visit our Floaters page.
What is Posterior Vitreous Detachment (PVD)?
The vitreous is a gel-like substance that fills the eye and helps maintain its shape. Over time, the vitreous shrinks and pulls away from the retina at the back of the eye, a process known as Posterior Vitreous Detachment (PVD).
As the vitreous detaches, it often leads to the formation of Vitreous Floaters and Opacities (VFO)—clumps of gel or fibres that cast shadows on the retina. While PVD is typically benign, it can result in complications such as retinal tears or detachment, which are sight-threatening if left untreated.
What Causes Posterior Vitreous Detachment?
PVD is primarily age-related, but several factors can increase its likelihood:
- Ageing: The vitreous naturally becomes more liquid and shrinks with age, leading to detachment from the retina.
- High Myopia (Nearsightedness): Changes in eye shape associated with severe nearsightedness increase the risk of PVD.
- Eye Injury: Trauma to the eye can cause vitreous detachment.
- Previous Eye Surgery: Procedures such as cataract surgery may increase the likelihood of PVD.
- Diabetic Retinopathy: Poorly managed diabetes can accelerate changes in the vitreous and retina.
Symptoms of Posterior Vitreous Detachment
PVD may cause noticeable symptoms, including:
- Vitreous Floaters and Opacities (VFO): Moving spots, cobwebs, or clumps that drift across your vision.
- Flashes of Light (Photopsia): Sudden flashes or streaks of light in your peripheral vision, caused by the vitreous tugging on the retina.
- Blurry Vision: Temporary blurriness, especially when looking at bright or high-contrast objects.
- Sudden Vision Changes: A sudden increase in VFO or flashes may indicate complications such as a retinal tear or detachment and should be urgently evaluated.
To better understand VFO, visit our Floaters page.
Diagnosis
At The Retina Clinic London, we use advanced imaging and specialised techniques to accurately diagnose PVD and detect potential complications:
- Visual Acuity Testing: Measures how clearly you can see.
- Ultrawidefield Fundus Imaging: Captures detailed images of the retina to detect retinal tears or detachments, including those in the far periphery.
- Ultrawidefield OCT: Provides high-resolution cross-sectional images of the retina to identify structural changes or early signs of complications.
- Indirect Ophthalmoscopy with Scleral Indentation: A highly detailed retinal examination where the specialist uses a head-mounted scope to assess your retina while you lie on a bed. This is the only way to examine the retina up to the ora serrata (the very edge of the retina) to confirm that no retinal tears are present.
Our comprehensive diagnostic approach ensures that any complications, such as retinal tears or detachment, are identified and treated promptly to protect your vision.
Treatment Options
Treatment for PVD depends on its stage and whether complications such as retinal tears, detachment, or persistent floaters occur.
1. Monitoring
When PVD has not yet fully completed, monitoring is essential to detect and address complications such as retinal tears or detachment as they arise. During this period, we closely track your condition using advanced imaging and regular examinations to ensure your eyes remain healthy.
This proactive approach allows us to catch complications early and deliver timely treatment, preserving your vision.
2. Non-Elective Treatments for Retinal Tears and Detachment
If PVD leads to complications, such as a retinal tear or detachment, prompt treatment is required:
- Laser Therapy for Retinal Tears: Preventative laser treatment is used to seal retinal tears and reduce the risk of detachment.
- Vitrectomy for Retinal Detachment: If retinal detachment occurs, vitrectomy surgery is performed to reattach the retina. This procedure involves removing the vitreous gel, repairing the detachment, and restoring vision.
3. Treatment for Vitreous Floaters and Opacities (VFO)
In cases where VFO caused by PVD does not naturally improve within six months, treatment options are available to improve visual clarity:
- Laser Vitreolysis: A non-invasive laser treatment to break apart bothersome VFO, particularly those that are well-defined, such as Weiss rings.
- Therapeutic Refractive Vitrectomy (TRV): A surgical option for severe or persistent VFO. TRV involves removing the vitreous gel containing the VFO and replacing it with a clear solution, restoring visual clarity.
Why Choose The Retina Clinic London?
At The Retina Clinic London, we provide expert care for PVD and its associated complications, ensuring rapid diagnosis and effective treatment. Here’s why patients trust us:
- Advanced Diagnostics: Using ultrawidefield imaging, ultrawidefield OCT, and indirect ophthalmoscopy with scleral indentation, we provide a comprehensive evaluation to detect and treat complications.
- Emergency Care and Fast Response Times: We offer prompt appointments and short waiting times, ensuring symptoms are caught, diagnosed, and treated early.
- Specialised Treatments: From laser therapy and laser vitreolysis to advanced vitrectomy surgeries, we provide tailored solutions for both benign and complex cases of PVD and VFO.
- Onsite Theatre: All surgical procedures, including vitrectomy for retinal detachment, are performed in our dedicated onsite theatre, ensuring the highest precision and safety standards.
- Personalised Treatment Plans: We work closely with each patient to develop a treatment plan tailored to their specific needs, helping them achieve the best possible visual outcomes.
If you are experiencing new floaters, flashes of light, or sudden changes in vision, please contact us today to schedule an urgent consultation.