Posterior Vitreous Detachment / Diagnosis possible?

[Luvtoski]

When I asked my Retina Specialist at my last appt. 1 year ago, if he could detect a PVD in my right eye with his OCT and visual exam...he said there was no way for him to tell whether or not I've been thru the PVD or if I was in the process of a PVD.

According to all of my reading on this forum, other Retina Specialists seem to be able to clearly tell their patients the status of a PVD .   Is my specialist just out of touch with technique ?

I have another appointment with him next week and want to know what to ask again.  I had ERM/Vitrectomy with him in my Left eye 3 years ago so I know that eye is full of saline , but I want to know about my right eye so that I know how careful I need to be this Summer with bouncing on tubes, etc.

Which part of the exam shows the PVD?  His slit lamp exam or the OCT result?  

Thank you !

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

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[Petrov]

Hi Doctor Hagan!
Which test is most certain to determine if PVD is complete (complete detachment or partial)? One doctor told me it was partial and another full…

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

Unfortunately it is not possible to tell if a PVD is complete or almost complete.  Even in what is called "complete PVD" the vitreous is usually still attached at the periphery of the retina in what is called the vitreous base.

[Petrov]

Thanks so much Dr. Hagan! Now I understand the complexity of the problem - and why the rainbow-shaped highlights under the eyebrows (crescent-shaped, bluish-green color - from top to bottom - quickly) - persist if I ask to see them - mainly in the dark... Interestingly, doctors do not pay attention to what exactly I see :( - for example, sometimes I see white fluffy spots - which move very slowly (again in the periphery) - in both directions (from bottom to top and back - especially after waking up from sleep) But of course - for me it is the most important that -the doctors so far do not see holes or tears in the retina - and I am happy about that. Of course - I have a great fear that a retinal break (or tear) will happen.
Thanks again - from the bottom of my heart Doctor - Stay alive and well.

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

"Well and alive" good things. You are welcome

[Luvtoski]

Thank you Dr. Hagan !  I'll cut the Retina Sp. some slack then. ;-)

Was a little disappointed with his previous answer because I have several friends that have gone to other specialists when my friends spotted floaters. Those specialists clearly told my friends they were in the process of a PVD, and then a follow up visit showed them the process was complete.

I see some while lines just above my retina in the OCT from 2011, and it is still there in 2012 over one year later.  Will be curious if it is still there this year.  If it is, I doubt that the line indicates my vitreous as I read the PVD usually takes approx. 6 months to complete.

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

A PVD may sometimes, but not always, be detached with direct or indirect ophthalmoscope   And OCT may show a PVD but looks at a very narrow band of the eye. Thus a PVD may exist but not show up on OCT

JCH MD