Diferencia entre revisiones de «Vitreous detachment»
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==Management== | ==Management== | ||
* Uncomplicated PVD: No treatment required; reassure patient and educate on warning signs of retinal detachment | |||
* With retinal tear or detachment: Urgent referral to ophthalmology; treatment may involve laser photocoagulation, cryotherapy, or surgical repair | |||
* Monitor: Regular follow-up with eye exams over subsequent weeks | |||
==Disposition== | ==Disposition== | ||
Revisión del 04:04 4 may 2025
Background
Posterior vitreous detachment (PVD) is a common age-related condition in which the vitreous gel that fills the eye separates from the retina. It typically occurs in individuals over age 50, with increasing prevalence in older populations and those with myopia or after eye surgery [1]. While usually benign, it can occasionally lead to serious complications such as retinal tears or detachment [2].
Clinical Features
- Sudden onset of floaters (black spots, cobwebs)
- Flashes of light (photopsia), especially in peripheral vision
- A curtain or shadow in the visual field (if associated with retinal tear/detachment)
- Blurred vision or mild visual disturbances
- Often asymptomatic in early stages or in less dramatic detachments
Differential Diagnosis
- Retinal detachment
- Retinal tear
- Vitreous hemorrhage
- Uveitis
- Ocular migraine
- Intraocular foreign body
Evaluation
Workup
- Detailed history (onset, nature of floaters/flashes, visual changes)
- Visual acuity testing
- Pupillary examination (look for afferent pupillary defect)
- Dilated fundoscopic exam (to assess for retinal tear or detachment)
- Slit-lamp exam with vitreous evaluation
- B-scan ocular ultrasound if fundus not visible due to hemorrhage or opacity
Diagnosis
- Clinical diagnosis based on symptoms and direct visualization of a detached posterior hyaloid membrane or Weiss ring on fundoscopic or slit-lamp exam
- Confirm absence of retinal tear or detachment via dilated eye exam or imaging
Management
- Uncomplicated PVD: No treatment required; reassure patient and educate on warning signs of retinal detachment
- With retinal tear or detachment: Urgent referral to ophthalmology; treatment may involve laser photocoagulation, cryotherapy, or surgical repair
- Monitor: Regular follow-up with eye exams over subsequent weeks