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Floaters, Posterior Vitreous Detachment and Retinal Tears

What are Floaters?

Floaters are debris located in the vitreous (the jelly that fills the eye) which float in your field of vision. Floaters can range in appearance, but often they look something similar to dots, specks, or squiggly lines. They are a common occurrence as we age and people who are short-sighted, diabetic or have previously undergone eye surgery are more susceptible. However, if floaters appear suddenly, or the number of floaters increases rapidly you must see an ophthalmologist immediately, as this can be a sign of a posterior vitreous detachment or retinal tear.

What is a Posterior Vitreous Detachment (PVD)?

The vitreous is the clear, jelly-like substance that fills the eye. It is primarily made up of water and its main functions include: 

  • to help maintain the shape of the eye
  • to allow transmission of light to the retina
  • to keep the retina in touch with the back wall of the eye
  • to acts as a shock absorber

As people age, the vitreous gel liquefies and begins to shrink, eventually detaching or separating from the retina. This is known as a posterior vitreous detachment (PVD) and usually occurs between the ages of 50 and 70. Symptoms can include flashes of light in your vision, as well as an increase in the number of floaters. Although the initial symptoms of PVD may seem harmless, they can be indicators of a more severe problem such as a retinal tear.

What Treatment is Available for PVD and Floaters?

In most cases PVD is not sight-threatening so treatment is generally a detailed eye examination. In some rare cases, floaters may be dense and interfere with visibility and everyday activities your ophthalmologist may recommend a vitrectomy surgery be performed to remove the vitreous and debris from the eye. Vitrectomy surgery is performed under local anaesthetic and using microscopic surgical tools the vitreous is removed and replaced with a salt solution/gas bubble.
If the vitreous has detached fully and cleanly, without any tearing or pulling at the retina, then there is no need for concern. Problems arise, however, when the vitreous tears as the retina shrinks – this can result in the formation of macular holes or detached retinas, which can cause vision loss and requires urgent emergency treatment.
Here at The Eye Specialist Institute we urge people to be weary of symptoms of floaters, they can be a sign of a more severe eye condition such as a retinal tear, and therefore, it is extremely important that you seek guidance of an ophthalmologist as soon as these symptoms arise.

What is a Retinal Tear?

While the majority of PVD’s are harmless and will occur with the vitreous gel separating cleanly causing no damage to the retina, in some rare cases retinal tears or holes can develop.

The retina is a thin lining on the back of the eye responsible for your vision. With age PVD can occur and in some cases the vitreous detaches in a way causing a tear. From here a retinal tear can further develop into retinal detachment if left untreated, which can lead to permanent blindness.
Retinal tears do not always exhibit symptoms however you may notice flashing lights in the outer field of your vision or floaters. Retinal tears have a distinctive appearance which can be detected during an eye examination with one of our retinal specialists at the Eye Specialist Institute. Your ophthalmologist can diagnose retinal tears by conducting a simple eye examination using dilating eye drops and microscope with special lenses to identity if there is any retinal tears or detachment present.

Even if no tears are found during the initial examination, if you experience a sudden increase in floaters or flashes, and/or a loss of peripheral vision at a later date this could indicate new damage to the retinal lining. People who are short sighted or who have had intraocular surgery have an increased risk of developing a retinal tear.

What Treatment Is Available for Retinal Tears?

During your examination at the Eye Specialist Institute, if a retinal tear is detected, your specialist will assess the severity of damage, as well as, the need for treatment. If there is no retinal detachment found, further treatment may not be required. In the case of retinal tears, the most common procedures for repairing them are Laser Retinopexy and Cryoretinopexy (Freezing Laser). Both Retinopexy and Cryoretinopexy are performed under local anaesthetic with mild sedation. Laser treatment is used to seal the tear and prevent retinal detachment from occurring. It will not improve your sight or get rid of floaters. Your Eye Institute Specialist will continue to monitor your retina after surgery with regular check-ups. If you notice any sudden changes such as increased flashes, floaters or loss of peripheral vision.