Medicines for Posterior vitreous detachment

What it is

Posterior vitreous detachment (PVD) is a very common, usually harmless change that happens as part of ageing. The inside of the eye is filled with a clear jelly (the vitreous), which is attached to the retina at the back of the eye. Over time, this jelly naturally becomes more liquid and shrinks, and eventually separates (detaches) from the retina — this is PVD. It becomes more common with age, and is usually a normal part of getting older, and is also more common in people who are short-sighted or have had eye surgery. As the jelly pulls away, it commonly causes new symptoms: floaters (small shapes, dots, cobwebs or a ring that drift across the vision), and flashes of light (brief flickers, often at the edge of vision, especially in dim light). While PVD itself is harmless and the symptoms usually settle over weeks to months as the brain adjusts and the floaters become less noticeable, the important point is that, as the jelly separates, it can occasionally pull hard enough to cause a tear in the retina, which can lead to a retinal detachment (a sight-threatening emergency). This is why new floaters and flashes should always be checked promptly, to make sure the retina is intact.

How it is treated

The key action for new floaters and flashes is a prompt eye examination (by an optometrist or eye service) to check the retina and exclude a retinal tear or detachment, since PVD and a retinal tear can cause the same symptoms and cannot be told apart without examining the eye. Where the examination confirms an uncomplicated PVD with no retinal tear, the reassuring news is that no treatment is needed — PVD is harmless, and the floaters and flashes usually become much less noticeable over the following weeks to months as things settle and the brain adapts. People are advised to return promptly if symptoms change or worsen — particularly a sudden increase in floaters, more flashing lights, or a dark shadow or curtain coming across the vision — as these can indicate a retinal tear or detachment developing, which needs urgent treatment. Where a retinal tear is found, it can often be treated promptly (for example with laser) to prevent a detachment. Persistent, very troublesome floaters are occasionally treated, but this is uncommon. The reassuring message is that posterior vitreous detachment is a common, harmless age-related change, and that the floaters and flashes usually settle — but new symptoms should always be checked promptly to make sure the retina is not torn.