What generally to expect while recovering from posterior vitreous detachment?

[cambie]

Hey there, I am a 31 year old male with myopia who had a posterior vitreous detachment 2.5 weeks ago. For about three years, I had a circular swirl flash in the temporal region when I blinked, or sometimes spontaneously. That went away for 3 days and then I developed a lot of floaters and a blotchy large floater or scotoma in the temporal region.

I feel like the large stationary floater (or is it a scotoma?) is improving, like getting some perforations in it. The flashes are similar. I had a retinal examination and the retina specialist said there were no tears.

When people say that the symptoms are better after many months, what are they talking about? Is it the dark spot you see when only the affected eye is open? Or is it the "corrected vision" when both eyes are open? I feel like the corrected vision when both eyes are open is better, but I still see a dark splotch when I have only the affected eye open.

I am curious because I am a practicing radiologist.

[ebpasion]

I have suffered a PVD about 6 weeks ago after an afternoon of swimming and diving into a swimming pool. I suddenly observed cobweb-like floaters that evening in each eye. They have since been replaced by medium-sized unfocused blobs in each eye as well as some curved strings near the bottom of my vision.

As disturbing as these are to see, what seems to bother me more is a bit of "haze" near the top of my vision in each eye. The haze is uncoloured, and seems to move around, as in a floater.

Is this normal in a floater? I have been told that I do not have a retinal tear and hoping that this haze will at the very least, not get worse

-ep

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

The retina can detach in any of the four quadrants due to a PVD which makes a tear (rhegmatogenous) RD.  All can cause flashes and floaters. Superior quadrants are more likely to detach due to gravity.

Flashes with RD are very bright very short duration repetative and often occur in brigh light and without eye movement. Floaaters are showers of floaters like soot or smoke in eye. Large RD create peripheral field defects. Highest risk of RD is first 6 weeks after a PVD develops.

We routinely set up a follow up exam 3-4 weeks after a PVD develops but tell the person to come back sooner if any of these symptoms develop. So I would suggest a follow up exam.

Go to Google IMAGES and type in Post Vit Detachment to see what they look like

JCH MD

[cambie]

Dr. Hagan, I couldn't find this answer with the search function, so:

If your retina detaches while you are undergoing Posterior vitreous detachment, does it detach in the periphery like the garden variety detachment or is it in the temporal region where people get the flashes and floaters? It may be hard to notice a detachment in the temporal region if you already have floaters and sparklers there.

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

Normally a floater, even a large one (Weiss Ring) has some movement to it. If the spot is always in the same place and does not move that is atypical.

Most floaters either drop to the bottom of the eye in the liquid vitreous (syneresis) or move anteriorly which makes them easier to ignore (neuroadaptation).

If you dark spotch is always in one spot and does not move I would suggest a return visit to the retina specialist and perhaps daily monitoring with Amsler Grid testing.

JCH MD