Retinal Detachment and Posterior Vitreous Detachment¶

Jonathan A. Barnett

Background¶

Retinal detachment (RD) = detachment of retinal tissue from the back of the eye. Risk factors include trauma, high myopia (nearsightedness), older age, history of RD in the other eye, prior eye surgery, and family history.
Posterior Vitreous Detachment (PVD) = detachment of vitreous (jelly) from the retina. PVDs eventually will happen to all adults as the vitreous liquefies and shrivels with age. Some are asymptomatic.
PVDs can lead to RDs, but not always. As the vitreous peels away from the underlying retina, vitreous can pull a piece of retina with it, causing a retinal tear. The retinal tear, if not treated, can evolve into an RD.

Both can present with acute flashes and floaters
However, RDs will often present with a black curtain or veil that comes down somewhere in the patient’s field of vision. PVDs may result in blurriness, but will not present with veils, scotomas, or severe loss of vision.

If patient presents with acute flashes, floaters, and/or black curtains in field of vision in one eye, consult ophthalmology.
If not acute, or if symptoms occur in both eyes simultaneously, chances are this is not a PVD or an RD. See Approach to Flashes, Floaters, Spots.