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Seeing floaters or flashing lights can be caused by posterior vitreous or retinal detachment

The vitreous is the jelly of the eye and it sits right in front of the retina. As we get older, the jelly increasingly turns more to fluid. With time, the fluid coalesces, and moves towards the back of the eye forcing the back of the vitreous forward. Ultimately, this causes a separation of the posterior vitreous from the retina–an event called a posterior vitreous detachment or PVD. A PVD is an age-related event that happens to most people by the age of 80 years. In some cases, when the jelly moves forward, it causes a tear in the retina that is a risk factor for retinal detachment. This usually happens in an area where the vitreous is tightly adherent to the retina, and occurs in 14% of…

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 Floaters: Retinal Detachment, Posterior Vitreous Detachment, or Vitreous Hemorrhage?

Posterior vitreous detachment occurs when the posterior vitreous capsule detaches from the retina. This is usually an age-related phenomenon that does not require emergent intervention but may lead to retinal detachment in the future. Patients should follow closely with ophthalmology.

 Posterior Vitreous Detachment: peeling paint

The findings on POCUS for retinal and PVD are similar. Both clearly have detachment of a membranous surface from the posterior wall of the eye. However, PVD will not be tethered to the optic disc

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A Case of Posterior Vitreous Detachment – Medical Student Clinical Pearl

PVD is less echogenic than retinal detachment. PVD can often be seen moving with eye movements, more so than with retinal detachment. There is often a lag seen between movement of the globe, and movement of the vitreous appendage. In PVD, the detached vitreous is not connected to the optic disc, which contrasts with retinal detatchment. PVD can vary widely in size and can be seen with or without vitreous hemorrhage.

Acute Visual Loss in the Emergency Department: Pearls and Pitfalls

Posterior vitreous detachment (PVD) is common in patients over 60 years and occurs with vitreous gel pulling away from the retina. . Patients with nearsightedness (myopia) are at greater risk, similar to retinal detachment. This can also occur after cataract surgery. Symptoms include flashes of light and floaters. This may lead to retinal detachment, with greatest risk within the first 6 weeks of symptom onset. These patients require ophthalmology consultation.

Vitreous Syneresis: An Impending Posterior Vitreous Detachment (PVD)

PVDs can also be associated with vitreous hemorrhage. The presence of blood in the vitreous cavity can make the patient's vision quite poor, and some patients will describe seeing "tiny red floaters" from the red blood cells.

When Shadows Float Before Your Eyes

In posterior vitreous detachment, as the fluid from the degenerating vitreous gel moves between the skin of the vitreous and the retina, the vitreous separates from the retina, usually near the optic nerve. As the vitreous tears from the retina, a fragment of tissue remains attached to the receding vitreous. Because the tissue is tethered to the vitreous, this fragment, known as Weiss's ring, sometimes remains in the central field of vision.