Vitreous Detachment

Vitreous Detachment is a medical term describing a mild eye condition, which is in general not harmful to the function of the eye.

How does vitreous detachment happen?

The round shape of the eye is formed by a vitreous gel substance full of fibres, which are attached to the retinal surface and hold the contents of the eye in place. Vitreous detachment starts when the fibre-containing the vitreous gel becomes less jelly-like in consistency and more watery, which is what happens as the eyes age. Because of this extra fluid, the vitreous gel and fibres then start to move away from the back of the eye towards the centre of the eye, which leads to shrinking. This involves the vitreous gel separating, the fibres breaking and shrinking away from the retina toward the centre of the eye. Once away from the retina this is termed vitreous detachment.

Does vitreous detachment cause sight-loss?

On its own vitreous detachment is usually not serious and does not cause sight-loss or blindness. Many people aged 50 plus and near-sighted people experience vitreous detachment without severity and it is common for both eyes to be affected over time. About 75 percent of people in the UK who are aged 65 and over have vitreous detachment.

How do the symptoms of vitreous detachment present?

As the vitreous fibred substance shrinks the following symptoms may be felt:

  • Stinging in the affected eye or eyes (initial detachment).
  • Seeing floaters which look like little dots or cobwebs in your visual field.
  • An increase in floaters in the visual field.
  • Light flashes or streaks in peripheral side vision.
  • Blurry vision or a blurred curtain moving across your visual field (when detachment occurs).

When vitreous detachment first starts to occur it can be irritating and take a while to get used to the floaters seen in the visual field. However, over time people affected get used to this. On the whole vitreous detachment will not alter eye or visual function, be harmful to the eye or cause pain.

When is vitreous detachment a cause for concern?

Vitreous detachment becomes a cause for concern when it occurs alongside other eye conditions, particularly those related to retinal detachment or visual impairment, such as macular holes. It is better to seek early medical attention and have your eyes evaluated than struggle with deteriorating vision, which can impact daily activities requiring sight.

How is vitreous detachment diagnosed?

An eye specialist or doctor usually screens the eyes during dilation eye examinations and is able to identify if floaters are present as a result of vitreous detachment. If other eye disorders are present further tests may be necessary.

Is vitreous detachment treatable?

Vitreous detachment alone does not always require treatment because it is not threatening to sight. There is no medical treatment for vitreous detachment, only associated eye disorders. Sudden increased peripheral streaks of light and floaters should be checked. If vitreous detachment creates a macular hole or retinal detachment in the process, these conditions should be identified and treated immediately because they can result in vision loss. Laser treatment and vitrectomy surgery are treatment options, though they are not widely used in the UK for vitreous detachment due to higher surgical risks.

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