Posterior Vitreous Detachment Symptoms

[AmyH1998]

One week ago I experienced a burst of flashing lights and a large new floater in my right eye. I immediately went to my optometrist who dilated my pupils and did a complete exam. He found no tears or detachment. I was diagnosed with PVD. He suggested a follow up appointment with a retina specialist ophthalmologist. I have an appointment in 10 days. My concern is that I am still experiencing occasional single eye flashes, nothing like that first burst, in the evening. No other symptoms like more floaters or a veil or shadows. Just those single occasional flashes. Should I return to my optometrist for another dilated exam before my 10-day-out appointment with the retina specialist? Or are the occasional flashes normal and to be expected? Thank you for any advice-

[John C Hagan III, MD, FACS, FAAO]

I would suggest you call the retina specialist office and describe your symptoms. Retina surgeons are set up to work people in that have symptoms suggestive of a retinal tear or detachments. The exam the retina ophthalmologist will be much more comprehensive and accurate than the one done by your optom. If you have any family history of retinal detachment or are myopic those are reasons to get in ASAP

[AmyH1998]

I did call them this morning. That is when they set up the appointment for June 30. I am myopic, but only -2.75. Also, I am 56 years old and wear contact lenses. Not sure what to do at this point. No flashes since the one early this morning when I got up out of bed for a few moments.

[AmyH1998]

I am just so confused. I have searched PVD in this forum and seen responses from medical professionals, including yourself, tell people that it’s normal to have occasional continued flashes for a few weeks, yet I feel like you are telling me that it’s an emergency and I should try to be seen right away. So what is the REAL answer? Are continued occasional flashes normal for PVD or not? (Please forgive, I am incredibly frustrated. The retina specialist office seemed much more concerned about what insurance I had than any symptoms I was experiencing…)

[xltjim]

I am not a dr but have had pvd in both eyes.   I did have increased floaters and flashes when it started.  You need to watch for the signs of a retina detachment between now and your appointment with retina dr.  

If you seee a sudden onset of millions of black dots (like swirling ink), lightning flashes (like a storm in vision), also if you start seeing shadows or loss of vision…..call retina dr asap.   This would be an emergency.   If dr won’t see you go to emergency room.

In my case, both my pvd’s caused retina detachments.

[Ron_AKA]

As it was explained to me PVD is the membrane pulling away from the back of the eye. the eye does not sense this as pain but does report it as flashes of light each time a little more of the membrane pulls away. In my case earlier on I could cause the flashing effect at will. In a dark room and even with my eyes closed all I had to do was look left and right rapidly and the flashes would occur at the periphery of my vision and almost looked like a semi circular flash of lightning. I still seem them occasionally and I just went into a dark room and tried to create the flash without success. So perhaps the process has finally slowed down for me. But, I was also told that the lining would likely fully pull away and settle at the bottom of my eye. That has not happened as I still see them both as big somewhat fuzzy floaters. The PVD in my first eye started out looking like a single diamond engagement ring but with the stone missing from the setting. It was like a ring but with a glob thing at the top of the ring. In my second eye I have not seen this image as distinctly but it is still circular shaped.

With the first eye I had an appointment scheduled with the ophthalmologist who did the cataract surgery and I reported it to him. He did not seems concerned, and basically said there is no low risk way to deal with it, and hopefully it would go away. The available treatment is a Vitrectomy, which is high risk with a messy recovery period. They apparently only do it as a last resort if the vision is significantly affected.

The symptoms of retinal detachment or tear include:

- The sudden appearance of many floaters — tiny specks that seem to drift through your field of vision
- Flashes of light in one or both eyes (photopsia)
- Blurred vision
- Gradually reduced side (peripheral) vision
- A curtain-like shadow over your field of vision

The only ones of these I had were the arcs of light which were right at the periphery of my vision, and the one big floater which moves with my eye movement. I was told it is the shadow of it that I am seeing. So I have not had any concerns based on symptoms, and the assurance by the surgeon that there was nothing amiss. I have also been seen by two other ophthalmologists who raised no concerns.

I think if you are experiencing any of these other symptoms in addition to the flashes of light and the big PVD floater, you would want to be seen urgently.

[John C Hagan III, MD, FACS, FAAO]

The above postings are helpful.    If you experiences any of those listed:

The sudden appearance of many floaters — tiny specks that seem to drift through your field of vision
- Flashes of light in one or both eyes (photopsia)
- Blurred vision
- Gradually reduced side (peripheral) vision
- A curtain-like shadow over your field of vision

Then call the retina office and insist on being seen same day.  If you present symptoms remain unchanged see the retina surgeon as scheduled. Sooner or later you will have PVD in other eye. Treat it the same and see retina surgeon.

[AmyH1998]

Thank you all so much for sharing your experiences. The occasional flashes I see are the same intensity/frequency that have occurred since the big floater appeared and my optometrist examined my eyes. (He is a former Air Force eye doctor and he used the slot microscope and a scan that actually showed the floater) He did suggest a follow up with the retina specialist due to the continued occasional flashes that I can only see in dim lighting or dark. So I guess, unless the flashes become worse or I experience any of those other “tear/detachment” symptoms, I will just wait for the appointment on June 30 and go from there. Again, thank you for sharing your experiences. It really helps to know that I’m not in this alone-

[John C Hagan III, MD, FACS, FAAO]

Good plan,

[Petrov]

Hi -AmyH1998!
I have PVD in both eyes - almost at the same time. I've had flashes for three years now - thankfully no retinal tears have been found (so far) - but the depression is constant. Basically - flashes should fade over time - slowly. But no one will tell you - exactly how long they will last! It is very important to know - that in addition to regular examinations during flashes - you also need an examination when the flashes disappear! But there is also a hidden thought: "As long as I breathe - I hope"
Let's not forget - that we have two important "weapons" if evil fate strikes us - laser or surgery. Of course, success is always in percentages - but there's no way.
I wish health and overcoming difficulties.

[John C Hagan III, MD, FACS, FAAO]

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[Ron_AKA]

I had PVD in my first eye about 11 months after cataract surgery, and in my second eye about 13 months after surgery. The first eye PVD was about a year and a half ago, while the second eye is a few months ago now. I am still experiencing the flashing effect generally where it is dark and when my eyes are closed. And, unfortunately the big floater in each eye has not gone away. The older one perhaps has faded a little but that us about it

There is really not much that can  be done without significant risk to deal with PVD. Th big concern is that it is not a retina detachment event and it seems that has been ruled out already. The conservative thing to do would be to see a retina specialist. I have not been referred to one.