ConditionEyes & vision
Posterior Vitreous Detachment (PVD)
Posterior vitreous detachment (PVD) is a common, age-related change in which the clear gel filling the eye (the vitreous) shrinks and separates from the retina at the back of the eye. It causes a sudden shower of new floaters, often a ring-shaped "cobweb", and brief flashes of light, usually in one eye. PVD itself is harmless and does not need treatment, but in about 1 in 7 people with symptoms it tears the retina, which can lead to retinal detachment. A dilated eye exam within 24 hours is essential.
Also called: PVD, vitreous detachment, age-related vitreous separation
At a glance
- What it is
- The vitreous gel separating from the retina, a normal aging change.
- Who gets it
- Most people over 60-70 eventually; earlier with nearsightedness, eye surgery or injury.
- Symptoms
- Sudden new floaters (often a ring or cobweb), flashes of light at the edge of vision.
- Risk
- Retinal tear in about 10 to 15 percent of symptomatic cases.
- What to do
- Get a dilated eye exam within 24 hours of new symptoms.
- Treatment
- Usually none; floaters fade over weeks to months. Laser seals any retinal tear.
When to get help
Call 911 or go to the ER
- A dark shadow or curtain spreading across your vision
- A sudden large shower of many floaters, like soot or smoke, or vision becoming very blurred
- Loss of central vision
See a doctor within a day or two
- Any new floaters or flashes of light, even if mild, especially in one eye: see an eye doctor within 24 hours
- A sudden increase in floaters or flashes in an eye already diagnosed with PVD
Book a routine appointment
- Follow-up eye exam 4 to 6 weeks after a PVD diagnosis, if advised
- Long-standing floaters that bother you but have not changed
Usually safe to manage at home
- Floaters from a previously diagnosed PVD, checked by an eye doctor, that are slowly fading and unchanged
What happens in PVD
The vitreous is a clear gel that fills the inside of the eye. In youth it is firm and attached to the retina. With age, the gel becomes more liquid and shrinks, and eventually it peels away from the retina, starting at the back.
Where the gel was attached around the optic nerve, it often leaves a ring of condensed tissue floating in the vitreous, called a Weiss ring, which people see as a circle, cobweb or fly-like floater.
As the gel separates, it can tug on the retina. This pulling stimulates the retina and is perceived as flashes of light. If the pull is strong or the retina is thin in places, it can tear.
Who gets PVD
- most people over 70, and many in their 50s and 60s
- people with nearsightedness (myopia), who often get it earlier
- after cataract surgery or other eye surgery
- after eye injury
- with eye inflammation or diabetic eye disease
It usually affects one eye first; the other eye often follows within months to years.
Symptoms
- floaters: dots, strands, cobwebs or a ring drifting across vision, more noticeable against a bright background such as a white wall or blue sky
- flashes: brief arcs or streaks of light, often at the edge of vision, more noticeable in the dark
- mild blurring from floaters in the line of sight
There is usually no pain or redness.
PVD vs retinal tear vs retinal detachment
| PVD alone | Retinal tear | Retinal detachment | |
|---|---|---|---|
| Floaters | Few to several, often a ring | Often many, may look like a shower or soot | Floaters plus a shadow |
| Flashes | Brief, intermittent | Often more persistent | May be present |
| Vision | Normal apart from floaters | Usually normal | Curtain or shadow, loss of part of vision |
| Treatment | None | Laser or freezing treatment | Surgery |
Because these cannot be distinguished without a dilated exam, all new floaters and flashes need prompt assessment.
Diagnosis
An eye doctor (optometrist or ophthalmologist) will:
- dilate the pupils with drops
- examine the vitreous and the entire retina, including the far periphery, with special lenses
- look for pigment cells or blood in the vitreous, which suggest a tear
- use ultrasound if bleeding prevents a clear view
- use optical coherence tomography (OCT) to see the vitreous-retina interface
A follow-up exam is often scheduled 4 to 6 weeks later, because tears can develop after the initial separation.
Treatment
PVD without complications
No treatment is needed. Floaters usually become less noticeable over weeks to months as they settle and the brain learns to ignore them. Flashes typically stop once separation is complete.
Retinal tear
A tear is treated promptly with laser photocoagulation or cryotherapy (freezing) to seal the retina and prevent detachment. These are quick outpatient procedures.
Retinal detachment
Requires surgery: pneumatic retinopexy, scleral buckle or vitrectomy.
Persistent bothersome floaters
For rare cases where floaters severely affect vision long-term, vitrectomy (removing the vitreous) or YAG laser vitreolysis may be considered, after weighing the risks.
Frequently asked questions
What is posterior vitreous detachment?
It is a normal age-related change in which the gel inside the eye shrinks and separates from the retina. It causes new floaters and flashes. It is harmless in itself, but needs a prompt eye exam because it can cause a retinal tear.
How long do PVD floaters last?
Floaters usually become less noticeable over weeks to months as they settle and the brain adapts. Some remain permanently but are rarely troublesome. A sudden increase in floaters or new flashes needs another eye exam.
Is PVD an emergency?
New floaters or flashes need an eye exam within 24 hours, because about 1 in 7 people with symptomatic PVD have a retinal tear. A dark curtain or shadow in your vision is an emergency and needs same-day care.
Can PVD cause blindness?
PVD itself does not cause blindness. However, it can lead to a retinal tear or detachment, which can cause permanent vision loss if untreated. Prompt examination and laser treatment of any tear prevents most detachments.
Will I get PVD in my other eye?
It is likely. PVD often occurs in the second eye within a few years of the first. Know the warning signs and get an eye exam promptly if new floaters or flashes appear.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Ophthalmology: Posterior Vitreous Detachment
- American Academy of Ophthalmology: Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern
- National Eye Institute: Floaters
- American Society of Retina Specialists: Posterior Vitreous Detachment
- NHS: Floaters and flashes in the eyes