Vitreous detachment

[Julsurfer]

Hi about 6 months ago I had a fall and as a result had a vitreous detachment in one eye.  My sight is blurry and I can see a cobweb and a brown spot (floater).   As this is not a retinal detachment I have been told i have a 50% chance of it becoming a full retinal detachment.   I understand this vitreous detachment cannot be fixed by surgery.

I am concerned about the risks of retinal detachment - and need to fly to another State and back on the same day, probably in the next week.
I would like to know if the pressure in the cabin of a plane can cause me any more problems to this eye that has the vitreous detachment?   Should I go back to the eye specialist and ask him?   Can flying in a plane for several hours cause pressure on the eye and increase the risk of retinal detachment for me

Can someone assist me please?   I am very concerned and worried

thankyou
Julie

[BUTTERCUP109]

It is great to talk to doctors about this; they have the education to know what they are talking about; but sometimes it helps to talk to someone who actually experienced what you are describing. I have had two vitreous detachments, one in each eye, about a year apart. I was also told that there was a risk of a retinal detachment within the first few months, but that after the first six months or so the risk was minimal...MINIMAL! And here is why (to the best of my understanding).You asked what the partial detachment was all about. If you have ever cracked an egg open and noticed the membrane around the egg white that clings to the inside of the eggshell...imagine this it the vitreous "face" or hyloid membrane. The gel inside your eye( egg white, but more like jelllo) has such a membrane surrounding it. Jarring, sudden movements cause the gel to slosh around. As a result, that membrane is tugged on...then it pulls away a little bit. So now it has started to detach. It is in a weakened state. It will continue to pull away til it reaches a kind-of state of equilbrium with the physics of the sloshing that is going on in there.  During this time, too much sloshing will cause the membrane to rip a piece of the inner eggshell away. Here is your "retinal detachment".  If it is gonna happen, chances are it will happen soon, because after a few months this process of pulling away from the eggshell is essentially over. Heat won't affect it, rubbing your eyes won't.. Jumping up and down, bungy jumping, diving, trampolines...that stuff will. If you have made it 6 months, STOP WORRYING!
Now, to the cobwebs and spot. I am 99.99999 % sure that you have what I have had in both eyes. When the vitreous membrane pulled away from where it was attached to your retina, it took a piece of tissue surrounding the optic nerve along with it. Don't worry, this tissue doesn't function in the seeing process. Sometimes it is called a Weiss ring. It is attached to the vitreous membrane which is waving around like a flag on a breezy day! Doctors will tell you it will become less noticeable over time. Who am I to contradict this? I had the first one for more than a year before I did something about it because it blurred everything I looked at. I still have the other one. Same blurrring. I may soon be doing something about it. Let me know if you want to know more.
Don't worry about flying, though...really.

[Julsurfer]

Hello Doctor
thankyou for your response.  When I had the fall, the eye specialist said it was a vitreous detachment but did not mention anything about a hole in the peripheral retina.   I was so upset I went to an optician first, and then the eye specialist and neither mentioned anything about any other damage.  

So I can travel on a plane and this will not increase the pressure in my eye?  I am trying to be careful not to get into situations where I could have another fall or increase the heat or pressure on my eye as I don't want this to go any further.

Doctor - my fall occurred in late February/early March 2009.   You mentioned that after a time the detachment is complete.   Can you explain what this means and if after this amount of time, mine is complete?     And is there any special precautions I should take to reduce the risk of further detachment?
Thanking You Kindly
Julie



  

[Sandra M Brown, MD]

Flying on an airplane will have no effect on the vitreous detachment or the risk of retinal detachment.  Also, once your vitreous detachment is complete, the risk of retinal detachment drops markedly.  Even with a partial vitreous detachment, the quote of "50% chance retinal detachment" seems high.  Are you sure that vitreous detachment was the only problem, or did something else occur such as a hole in the peripheral retina that increases your risk of retinal detachment?

Vitreous detachment should not cause blurred vision except when the big floater is "in the way" of your central vision.

[BUTTERCUP109]

I did not go into my treatment because there is so much controversy surrounding the treatment of what I am assuming is some kind of vitreous opacity that you are experiencing...and, I certainly have no idea what the philosophy is in Australia about such things.
First, if you have vitreous opacities (also known as floaters), an ophthalmologist can see it with a complete eye exam. So, before you apply anything I say to yourself, get a diagnosis from your doctor. Then look up floaters online. There are all kinds. From tiny specks and threads that most people think you are talking about when you say "floater". These are indeed insignificant and not worth treating. On the other end of the spectrum are a variety of large opacities than can actually obstruct vision. I believe, and some doctors believe that these are significant enough to justify their removal. Only you can decide if you are in this catagory.
There are only two treatments (maybe a third, soon).
The first is a vitrectomy, removal of the internal contents of the vitreous compartment. Doing so will speed the development of cataracts and carries a risk of retinal detachment, but it will completely get rid of the problem. This is what I did.
The second is to have the opacities vaporized with a laser. In the U.S., only 3 doctors do this procedure. It is available also in Europe. It is the subject of a lot of debate. But the doctors who have learned how to do it have great success with no adverse effects.
The third is in development. It is an injection that will dissolve the opacity. I think it is called Vitreosolve.
I had complications from my vitrectomy. Retina inflammation. But believe it or not, I would do it again if I had the decision to make over. Right now, I am considering the laser treatment for my other eye.
All this seems very extreme, and it is. Most people do as their doctors instruct and just learn to live with it. It is, however, a fact that only you...not your doctor...knows how disabling it is to your life.

[Julsurfer]

Hi  Buttercup
Thanks for this great and detailed explanation.  I have the same blurring - its like I have my eye open under water in a swimming pool.  
You said you have done something about the problem with one eye. ( I had the first one for more than a year before I did something about it because it blurred everything I looked at. I still have the other one. Same blurrring. I may soon be doing something about it. )      Can I ask what you did about it?

(As I am probably on a different time zone to you (Australia) I will check this forum tomorrow (you may be asleep during our working day)
cheers and thanks very much
Julie