Vitreous Detachment

What is a vitreous detachment?

A vitreous detachment is a condition in which a part of the eye called the vitreous shrinks and separates from the retina. The vitreous is a gel-like substance that fills the inside of the eye ball. The retina is a light-sensitive area at the back of the eye. A vitreous detachment is also known as a posterior vitreous detachment.

In most cases, a vitreous detachment alone does not harm vision and requires no treatment.

What causes a vitreous detachment?

In normal eyes, the vitreous is attached to the surface of the retina through millions of tiny, intertwined fibers. As we age, the vitreous slowly shrinks, and these fibers pull on the retina's surface. If the fibers break, the vitreous can shrink further and separate from the retina, causing a vitreous detachment.

Who is at risk for a vitreous detachment?

A vitreous detachment is a common condition that usually affects people over age 50.

People who are nearsighted are at increased risk for vitreous detachment earlier in life. Those who have a vitreous detachment in one eye are likely to have one in the other eye, but this might not happen until years later.

What are the symptoms of a vitreous detachment?

One of the main symptoms of vitreous detachment is presence of floaters. As the vitreous shrinks, it becomes stringy. These strands can cast tiny shadows on the retina. These shadows are floaters. Floaters can look like little "cobwebs" or specks that seem to float about in your field of vision. If you try to look at them, they seem to quickly dart out of the way.

People with vitreous detachment might have a small but sudden increase in the number of floaters. This increase can come with flashes of light (lightning streaks) in your peripheral (side) vision. Most people with vitreous detachment will not notice any symptoms. Or, if they do, the symptoms are only annoying and do not interfere with their daily lives.

How does vitreous detachment affect vision?

A vitreous detachment does not harm vision on its own. But in some cases, the fibers can pull so hard on the retina that they create a macular hole, or a retinal tear that leads to a retinal detachment. These are serious conditions. Without treatment, a macular hole or detached retina can lead to permanent vision loss in the affected eye. If you have any of the symptoms above, see your eye doctor right away. Early treatment can help prevent vision loss from a macular hole or retinal detachment.

Can vitreous detachment lead to retinal detachment?

Sometimes. Retinal detachment happens when any part of the retina, the eye's light-sensitive tissue, is lifted or pulled from its normal position at the back wall of the eye. This can happen directly after a vitreous detachment.

When the vitreous detaches from the retina, it is much like an address label being peeled off of an envelope. Sometimes, the label comes off cleanly, but other times, it tears some of the underlying envelope in the process. If the vitreous tears the retina when it detaches, the tear can worsen into a retinal detachment.

Normally, it takes three months after a person's first floater for the vitreous to completely detach. If you have a floater for the first time, you should see your eye doctor regularly during the months following so that he or she can make sure you don't have a retinal detachment.

If a retinal detachment is caught early, it can usually be treated with laser treatment in the eye doctor's office. If the retinal detachment goes untreated for too long (sometimes for only a few days), a much more serious surgery such as vitrectomy or scleral buckle might be required.

If you have recently had a vitreous detachment, watch carefully for symptoms of retinal detachment, such as flashes of light, a shower of dots and a pitch-black curtain entering and moving across your vision in any direction. If you have any of these symptoms, especially if you have more than one symptom at the same time, see your eye doctor or go the nearest emergency room immediately.

This information was adapted from information provided by the National Eye Institute (NEI) to help patients and their families in searching for general information about vitreous detachment. An eye care professional who has examined the patient's eyes and is familiar with his or her medical history is the best person to answer specific questions.