Encyclopedia - Vitreous Detachment

What symptoms should send the patient to the doctor?
What medical care is required?

Vitreous detachment, often called posterior vitreous detachment, occurs when the vitreous humor, the gel that fills the inside of the eye behind the lens, shifts and separates from the retina. This shift is often harmless, although it does produce visible symptoms.

One is the appearance of floaters, particles floating in the vitreous humor that appear to be circular spots or small spots strung together with a web-like thread. Floaters are most noticeable in bright light or when looking at distant objects. These floaters occur because of the formation of opaque spots in the vitreous. They sometimes disappear in weeks, but can persist for much longer periods, months or years.

Vitreous detachment can also result in flashes -- quick bursts of light caused when the vitreous rubs against the retina. These generally are short-lived.

What symptoms should send the patient to the doctor?

If the floaters increase in number or the flashing becomes continuous, an immediate visit to an ophthalmologist is recommended because these can be symptoms of a retinal detachment or other problem resulting from the shift of the vitreous. Left untreated, a retinal detachment can lead to permanent loss of vision.

A major warning sign of a possible retinal detachment is that the flashers and floaters occur in just one eye. (Flashers in both eyes are unusual, and generally are caused by migraine headaches.) Floaters in one eye can also be symptoms of a hemorrhage in the eye or an infection, which also require quick treatment.

Other warning signs include blurred or distorted vision, the appearance of cobwebs or veils, and the feeling that a curtain is descending over the visual field.

Persons who are at higher risk of retinal detachment caused by a vitreous detachment include those who are nearsighted because myopia is associated with a thinner-than-normal retina, those who have undergone eye surgery such as a cataract operation, and those with eye inflammation (uveitis) or a previous eye injury. The occurrence of vitreous detachment in one eye indicates an increased risk for the same detachment to occur in the other eye.

What medical care is required?

Fortunately, most people who experience vitreous detachment will not require medical care. If the floaters are persistent or very bothersome, the only treatment available is vitrectomy surgery during which the vitreous gel is surgically removed and replaced with a saline solution. Although the risks associated with vitrectomy surgery are relatively small, they usually outweigh the benefits as a treatment for floaters.