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Vitreous Detachment

Flashes and floaters often indicate a Posterior Vitreous Detachment (PVD) which is a rather dramatic event in the normal aging process of the human eye.

As we age, the watery elements in the vitreous separate from the fibrous components. With this comes a contraction of the fibrous elements away from the retina–a Posterior Vitreous Detachment. This contraction on the retina is responsible for the characteristic “flashes” that often accompany PVD’s. The “floaters” frequently reported are from the reorganization of the fibrous elements as well as from some fragments of retina that may have been dragged into the vitreous cavity by this separation. Besides age, other contributing factors include nearsightedness and injuries to the eye. Both may speed up the normal aging process.

All patients who experience a recent onset of flashes and floaters should be examined carefully through a dilated eye exam by an eye doctor. Most of the time nothing unusual is found, and simple reassurance is all that is needed. The flashes eventually go away, and the floaters usually diminish and become less bothersome with time.

However, a tear in the retina is found in about 2 – 3% of eyes with a PVD. If left untreated, these tears may lead to a retinal detachment, a very serious sight threatening condition requiring a major surgical procedure to repair. When symptoms appear, it is important to examine the eye within a day of their onset. Changes can occur rapidly, and time can be of the essence if a retinal detachment is present.

Usually this process will occur in both eyes. Even if all is normal in the first eye, patients cannot assume that all will be well with the second one. It also should be carefully examined and treated if necessary.