Posterior Vitreous Detachment

[j44ke]

The day before Thanksgiving last year, I was out chopping wood in the evening. As it got darker I started seeing flashes of light in my peripheral vision. There was also a pesky fly bothering me. Couldn't get rid of it. I finished up and put everything away, and as I walked up to the house in the dark, it was like paparazzi. Flashes everywhere. Of course, being an idiot, I thought huh, some kind of lightning bugs or car headlights or distant lightning, even though most of that was impossible. Then when I got inside, I realized the "fly" was actually a giant glob of floater zooming around in my left eye. Which meant that the flashes probably were inside my left eye too. So I ate dinner and went to bed, only to wake up at 2AM thinking "detached retina". Woke up my wife, she called around, found an eye center in Pittsfield, got ahold of a physician (2AM night before Thanksgiving) who interviewed me and then said come in to the office tomorrow (Thanksgiving) at 1PM and I'll meet you there.

Young guy, smart guy, excellent experience. I learned a lot about Posterior Vitreous Detachment, he did a thorough and relaxed examination, gave me a list of things to watch out for that would indicate something more serious (retinal tear or detachment,) and then he sent me on my way. I owe him a Thanksgiving turkey I think.

Yesterday I was cutting up some dead stubs of brush, reclaiming driveway gravel from the snowplow piles, and chopping some kindling for colder weather coming up. And I started seeing flashes of light. So I finished up, figuring it was just my left eye acting up. But then as I walked up to the house, I closed my left eye and surprise, still seeing flashes. And then a large floater bobbed across the field of view in my right eye. So I got my wife off a conference call, and we went to the eye center (now with a branch office conveniently located in Great Barrington) and saw the nice doctor again. Everything checked out, no tears or other significantly more serious retinal problems. I go back in a month for a followup.

Anyway, long way around the barnyard, but I thought I'd post as I had never heard of Posterior Vitreous Detachment. I tend to discount physical anomalies as they appear. Usually my wife says something like, "Are you bleeding?" or "Why is your thumb 3x its normal size?" or "Do you remember passing out?" and then off we go to the emergency room for some this or that issue that needs dealing with. However, I do know that retinal tearing or detachment is serious and recovery success has a factor of time with it - the quicker you seek treatment the more likely you are to recover normal sight - so if you have visual anomalies - flashing lights, sudden appearance of a large floater or multiple floaters or (more serious) persistent black spots or a black curtain effect that reduces your visual field - my wife would tell you to go to the doctor.

[SpeedyChix]

Ah the annoying world of PVD (as in eye, not the guy). I've had fouled vision in my dominant eye for nearly a year now. Thought it was the beginning of a detached retina when it started. It can lead to that and is why you are given all the what to watch for, etc. Doc noted that as nearsighted folks age, they tend to become more susceptible to it. Will often happen in the other eye. As we age the fluid in our eyes thickens and those massive floaters from the posterior virtuous detachment refuse to settle and stay put. There are days my dominant eye vision is like looking through a vaseline-smeared lens. I've been back for a number of follow up appts and the most recent one may be the last of the numb the eye and pushing on it in multiple spots with a barely-blunt instrument.

[kdawg]

I see a few of these a week - and only about 1 in 10 is a retinal problem.

if you have visual anomalies - flashing lights, sudden appearance of a large floater or multiple floaters or (more serious) persistent black spots or a black curtain effect that reduces your visual field - my wife would tell you to go to the doctor.

Smart woman that - I would also add that you want to be seen soon - there aren’t many of these that I don’t see within 24 hours. Hours don’t matter but days do - and if it is a retinal problem you want it repaired soon as that generally has a much better outcome.

[Paul Jacobs]

I am now, for four months, retired and no longer a doctor having relinquished my registration with the General Medical Council. Up until last year I had been an ophthalmologist for 41 years, the last 37 of those I spent specialising in vitreous surgery.

I sympathise with your experiences described above. I concur with the advice given by Jorn.

It is possible to remove significant visual floaters by vitrectomy, a procedure I used to perform more than 500 times per year but more often for other conditions, like treatment of retinal detachment, than visual floaters.

Vitrectomy for removal of floaters is a very successful procedure in most cases but is not without risk. The risks include cataract formation, retinal detachment and loss of sight.

[j44ke]

Once the left eye and my brain worked things out, I only occasionally saw a floater. They were there, just not omnipresent. Earlier this week, I thought I kept seeing a mouse run through my peripheral vision, but I realize now that was a floater - possibly a precursor to the detachment yesterday.

I do get frustrated while birdwatching though. Then my eyesight is at max capacity and optic floaters and small or soaring birds look and move in similar ways.

[echelon_john]

PVD in my right eye for about 2 years. Bad at first, got better, then worse again about a year ago. Compensating for it ok but I’m bummed to think that my sporting clays and hunting days might be behind me. The floaters make it nearly impossible to sight fast-moving objects. Saw a retinal specialist and several ophthalmologists who all recommended against the surgery due to the cumbersome recovery and risk of sight loss. May go to Mass Eye & Ear for another opinion at some point. Anyone been through the surgery?

[SpeedyChix]

Today my other eye decided to join the party. The arc showed up mid-morning and now it's an orb of thousands of tiny bubbles, gray, black, fascinating (if it wasn't my eye). Super dimensional and making for some cloudy vision. "Great" light show in the dark.
Fingers crossed is plays nice with the retina.