Vitreous Detachment: Symptoms, Risks, and Treatment Options

Posterior vitreous detachment

I started noticing a lot of floaters in my vision in October, and on October 28, they suddenly disappeared, but I began seeing many water droplet-like shapes and numerous strands in front of my eyes that won't go away.
I underwent a fundus examination and CT scan of the eye, and the doctor said I have posterior vitreous detachment and inflammation of two blood vessels causing bleeding.
I have high myopia (left eye -1100 diopters, right eye -850 diopters) and had a retinal perforation 10 years ago that was treated with laser.

1.
What treatment options are available for posterior vitreous detachment and vascular bleeding? Is there a risk of blindness? Can surgery be performed to repair the posterior vitreous detachment?
2.
Will the vascular bleeding be absorbed?
3.
Does posterior vitreous detachment increase the risk of retinal detachment again?
4.
I have been wearing contact lenses for a long time; can I continue to wear them?

Deng Xiaojie, 40~49 year old female. Ask Date: 2020/10/31

Dr. Gao Pilin reply Ophthalmology

Dear Miss Deng,
1.
Currently, observation is sufficient; posterior vitreous detachment does not require treatment.
The bleeding is likely to resolve quickly.
Please continue to follow your attending physician's instructions for follow-up treatment.
2.
A small amount of bleeding should be absorbed.
3.
If there is no traction on the retina, it will not lead to retinal detachment.
4.
There should be no impact.
Taiwan E-Hospital Puzi Hospital Ophthalmology: Monday, Tuesday, Thursday, and Friday from 8:00 AM to 12:00 PM; Wednesday from 2:00 PM to 4:30 PM.
Online responses can only serve as a reference; if necessary, you should seek medical attention at a healthcare facility.
I hope to have the opportunity to serve you.
Sincerely,
Gao Pilin

Reply Date: 2020/10/31

More Info

Vitreous detachment, or posterior vitreous detachment (PVD), is a common condition, especially in individuals with high myopia, like yourself. It occurs when the vitreous gel that fills the eye separates from the retina. This can lead to various visual disturbances, such as floaters (the "flying mosquitoes" you mentioned) and flashes of light. In some cases, it can be associated with complications like retinal tears or hemorrhages, particularly in patients with a history of retinal issues.

1. Treatment Options for Vitreous Detachment and Hemorrhage:
Treatment for vitreous detachment typically focuses on monitoring the condition, as many cases resolve without intervention. However, if there are associated complications, such as retinal tears or significant hemorrhage, more aggressive treatment may be necessary. Options include:
- Observation: If the symptoms are mild and there are no signs of retinal tears, your doctor may recommend simply monitoring your condition.

- Laser Treatment: If there are retinal tears, laser photocoagulation can be used to seal the tear and prevent retinal detachment.

- Surgery: In cases where there is significant bleeding or if a retinal detachment occurs, surgical options such as vitrectomy (removal of the vitreous gel) may be considered. This procedure can help clear the blood and address any retinal issues.

Regarding your concern about blindness, while vitreous detachment itself is not typically sight-threatening, complications such as retinal detachment can lead to severe vision loss if not treated promptly. Therefore, it is crucial to have regular follow-ups with your ophthalmologist to monitor your condition.

2. Will the Blood Vessel Hemorrhage Absorb?:
In many cases, blood from a hemorrhage in the eye can be absorbed by the body over time. The duration for absorption can vary, but many patients notice improvement within weeks to months. However, the extent of vision recovery depends on the severity of the hemorrhage and whether any underlying retinal issues exist.

3. Risk of Recurrent Retinal Detachment:
Yes, vitreous detachment can increase the risk of retinal detachment, especially in individuals with a history of retinal problems, such as yourself. The risk is particularly heightened if there are any tears or holes in the retina. Regular monitoring and prompt treatment of any new symptoms (like sudden increases in floaters or flashes of light) are essential.

4. Wearing Contact Lenses:
If you have a history of retinal issues and are currently experiencing vitreous detachment, it is advisable to consult your ophthalmologist regarding the use of contact lenses. While many individuals can continue to wear contacts, your doctor may recommend a temporary cessation, especially if you are experiencing significant visual disturbances or discomfort.

In summary, vitreous detachment is a common condition that can lead to various visual symptoms. While it often resolves on its own, complications can arise, necessitating careful monitoring and potential treatment. Regular follow-ups with your eye care provider are crucial to ensure that any complications are addressed promptly and to maintain your vision health.

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