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Seek Help for Signs of Vitreous Detachment.

Floaters and flashes may be signs of this common eye condition or a more serious retinal injury. Your eye-care specialist can tell the difference.

You notice those small dark shapes that pass through your field of vision as you move your eyes. You try to focus on them, only to have them dart away.

They're known as floaters, and seeing a few of them usually is not a cause for concern. But, if you experience a sudden increase in the number of floaters, it's time to seek prompt help from an eye-care professional. This influx of floaters could signal a condition known as posterior vitreous detachment (PVD), which does not jeopardize your vision, but it also could indicate a more serious, sight-threatening retinal problem.

"Vitreous detachments are pretty common," says Rishi Singh, MD, with Cleveland Clinic's Cole Eye Institute. "When you see these new floaters, it's best to have them evaluated and, specifically, have a dilated eye examination performed by an ophthalmologist."

Vitreous Detachment Explained

Accounting for 80 percent of the volume of the eye, the vitreous is a gel-like substance that fills the interior of the eye and helps to preserve its round shape. The vitreous contains tiny collagen fibers that secure it to its base near the front of the eye and also the optic nerve and retina in the back.

Over time, the collagen fibers degrade and the vitreous gradually liquefies, leading to destabilization of the vitreous gel. The vitreous contracts, and as it does, it moves forward in the eye and separates from the retina, resulting in PVD.

PVD occurs more commonly in people over age 60, according to the American Society of Retina Specialists (ASRS). People who are nearsighted (can't see far away) or suffer ocular trauma are more likely to develop PVD and also experience it at a younger age. Additionally, the condition may develop after cataract surgery.

PVD causes a sudden increase in the number of new floaters, which result from stringy strands in the vitreous that cast shadows on the retina. The floaters often are accompanied by new flashes of light (usually in the peripheral vision) that are especially visible in dark surroundings. The ASRS notes that the floaters and light flashes generally subside within one to three months, and that 85 percent of people with PVD experience no further complications. However, if you develop PVD in one eye, you're likely to experience it in the other eye within a year.

Address PVD Complications

Although PVD usually causes no vision loss and often requires no treatment, it can result in some sight-stealing consequences. Usually, as the vitreous shrinks, the collagen fibers connecting it to the retina break off, and no harm is done.

However, occasionally the fibers do not break off easily, but instead tug at the retina. If they pull on the retina hard enough, the tension that's created can cause a retinal detachment or tear. Both of these conditions can cause vision loss, so they require immediate treatment.

"Very few people with vitreous detachment have a very serious tear or retinal detachment," Dr. Singh says. But, since both PVD and retinal detachment cause an increase in floaters and flashes of light in your vision, you can't differentiate between the two. "You actually have to go in and have an evaluation to determine that," he adds. "Definitely make sure you get checked if you have those symptoms."

Retinal tears can be treated with office-based procedures using lasers or extreme cold (cryopexy) to seal the tear. These same treatments may be used for retinal detachments, along with surgery to reattach the retina to the back wall of the eye. As part of the surgery, removal of the vitreous (vitrectomy) may be necessary--gas is injected into the eye to fill the space occupied by the vitreous and temporarily hold the retina in place as the eye heals and produces fluid that replaces the vitreous permanently.

"The treatments are very successful, and the success rate approaches 90 percent," Dr. Singh says. "The outcomes can be improved by early evaluation and management. Earlier treatment is important because people who get treated earlier get better results."


* Tell your eye-care specialist immediately about any signs of posterior vitreous detachment (PVD), retinal tears or retinal detachment--such as a sudden increase in eye floaters or light flashes in your eyes--and undergo a dilated eye examination.

* Wear protective goggles when you play sports or work with saws or other tools that create debris that can cause eye trauma.

* Understand your likelihood of developing PVD, especially if you have risk factors for the condition, such as myopia (nearsightedness), a history of PVD in one eye, a history of ocular trauma, or previous cataract surgery.

* Know the risk factors for retinal detachment, such as severe myopia, a personal history of retinal detachment in one eye, a family history of retinal detachment, a history of ocular trauma, or previous eye surgery, such as cataract

Caption: A posterior vitreous detachment occurs when the vitreous body degrades over time, causing the vitreous to liquefy. As the vitreous destabilizes, it slides forward in the eye and separates from the retina. The condition can lead to a more serious, sight-threatening problem, such as a retinal tear or detachment.
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Title Annotation:Vision
Publication:Men's Health Advisor
Geographic Code:1USA
Date:Jun 1, 2018
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