Posterior Vitreous Detachment: Symptoms and Concerns

Q: Posterior Vitreous Detachment: Symptoms and Concerns

Hello： Based on your description, you underwent vitrectomy and intraocular lens implantation for cataracts last year, and your recovery has been good. <br>However, you have recently experienced some new visual symptoms. <br>Here are some explanations and recommendations regarding

Posterior vitreous detachment

Hello Doctor, due to my constitution, I was diagnosed with cataracts last year and I do not have myopia.
In May, I underwent vitrectomy combined with intraocular lens implantation due to a rupture of the posterior capsule of the lens in my left eye.
My recovery was good, and my vision reached 1.0.
However, there are still some faint small shadows floating in my left eye, which the doctor indicated is a normal phenomenon.
During my follow-up visit around June 20, an OCT scan revealed early mild macular folds in my left eye, but since it did not affect my vision, the doctor advised regular monitoring, and no other eye-related issues were found on the OCT.
However, from the end of June to around July 1, I began experiencing symptoms of flashes of light in my eye (similar to a light bulb flickering).
Therefore, I returned to the hospital for a follow-up on July 6 for a fundus examination.
The doctor stated that the retinal thickness was normal and there were no holes, and the flashing symptoms have significantly decreased over the past week or two.
However, since the fundus examination, I have noticed what appears to be long, translucent floaters in my left eye (the elongated, string-like type).
In my daily life, I only notice them in brighter environments, and they do not appear constantly.
I would like to ask if this is posterior vitreous detachment or could it be related to retinal issues? Thank you, Doctor.

tty, 20~29 year old female. Ask Date: 2024/07/23

Dr. Gao Pilin reply Ophthalmology

Hello: Based on your description, you underwent vitrectomy and intraocular lens implantation for cataracts last year, and your recovery has been good.
However, you have recently experienced some new visual symptoms.
Here are some explanations and recommendations regarding your situation.
Posterior Vitreous Detachment (PVD)
Posterior vitreous detachment is a common occurrence, especially with aging or after eye surgery.
Its main symptoms include:
- Floaters: The appearance of small dark shadows or translucent strands.

- Flashes: Particularly in low light or when your eyes are closed, you may see phenomena resembling flashes of light.

The elongated translucent floaters and occasional flashes you described are indeed consistent with the symptoms of posterior vitreous detachment.
Retinal-Related Issues
Although your symptoms may be caused by posterior vitreous detachment, it is important to remain vigilant for retinal tears or detachments.
The main symptoms of retinal tears or detachments include:
- Sudden increase in floaters or flashes.

- Shadows in your field of vision or changes in vision.

According to your recent fundus examination results, the retinal thickness is normal and there are no holes, which is good news.
However, the risk of retinal issues still exists, especially when new visual symptoms arise.
Recommendations:
1.
Continuous Monitoring: If your flashes or floaters change or worsen, seek medical attention immediately.

2.
Regular Check-ups: Continue to follow your doctor's advice and have regular ophthalmic examinations to ensure the health of your retina and macula.

3.
Pay Attention to Rest: Reduce eye strain by avoiding prolonged use of electronic devices, which can aid in your recovery.

Wishing you a speedy recovery.

Reply Date: 2024/07/23

More Info

Posterior Vitreous Detachment (PVD) is a common condition that occurs when the vitreous gel, which fills the eye, separates from the retina. This condition can lead to various symptoms, and understanding these symptoms is crucial for managing any potential concerns.

Given your history of cataract surgery and subsequent vitreous surgery, it is not uncommon to experience some visual disturbances as a result of these procedures. The presence of floaters, particularly the long, translucent strands you describe, is often associated with PVD. These floaters are remnants of the vitreous gel that may cast shadows on the retina, leading to the perception of spots or strands in your vision. While they can be bothersome, they are generally harmless and a common occurrence, especially after vitreous surgery.

The flashes of light you experienced, described as resembling a flickering bulb, can also be a symptom of PVD. These flashes occur when the vitreous gel pulls on the retina, stimulating the photoreceptors and creating the sensation of light. Although these flashes can be alarming, they are typically not a cause for concern if there are no accompanying symptoms such as a sudden increase in floaters, a shadow or curtain effect in your vision, or significant vision loss.

Your recent OCT (Optical Coherence Tomography) examination showing early mild macular folds is noteworthy. While these folds can occur due to various reasons, including PVD, they are often asymptomatic and may not require immediate intervention if they do not affect your vision. Regular follow-up with your ophthalmologist is essential to monitor any changes in the macula or other retinal structures.

It is important to differentiate between PVD and more serious conditions such as retinal tears or detachments. Retinal tears can occur as a result of PVD, and they may lead to retinal detachment, which is a medical emergency. Signs of a retinal tear or detachment include a sudden increase in floaters, flashes of light, and a shadow or curtain over part of your vision. Since your recent examinations have shown no retinal holes or significant issues, it is reassuring, but continued vigilance is necessary.

In summary, based on your description, it is likely that the symptoms you are experiencing are related to posterior vitreous detachment, especially considering your recent ocular history. The floaters and flashes are common manifestations of this condition. However, it is crucial to maintain regular follow-ups with your ophthalmologist to monitor your condition, especially given the history of cataract and vitreous surgery. If you notice any sudden changes in your vision or new symptoms arise, do not hesitate to seek immediate medical attention. Your eye health is paramount, and proactive management is key to ensuring the best possible outcomes.

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