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| ==Background==
| | #REDIRECT[[Posterior vitreous detachment]] |
| 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 <ref> Byer, N. E. (1994). Natural history of posterior vitreous detachment with early management as the premier line of defense against retinal detachment. Ophthalmology, 101(9), 1503–1513. </ref>. While usually benign, it can occasionally lead to serious complications such as retinal tears or detachment <ref> Foos RY, Wheeler NC. Posterior vitreous detachment. Ophthalmology. 1982;89(12):1502–1512. </ref>. | |
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| ==Clinical Features==
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| * Sudden onset of floaters (black spots, cobwebs)
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| * Flashes of light (photopsia), especially in peripheral vision
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| * A curtain or shadow in the visual field (if associated with retinal tear/detachment)
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| * Blurred vision or mild visual disturbances
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| * Often asymptomatic in early stages or in less dramatic detachments
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| ==Differential Diagnosis==
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| * [[Retinal detachment]]
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| * Retinal tear
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| * [[Vitreous hemorrhage]]
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| * [[Uveitis]]
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| * [[Migraine headache|Ocular migraine]]
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| * Intraocular foreign body
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| ==Evaluation==
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| ===Workup===
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| * Detailed history (onset, nature of floaters/flashes, visual changes)
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| * Visual acuity testing
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| * Pupillary examination (look for afferent pupillary defect)
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| * Dilated fundoscopic exam (to assess for retinal tear or detachment)
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| * Slit-lamp exam with vitreous evaluation
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| * B-scan ocular ultrasound if fundus not visible due to hemorrhage or opacity <ref> American Academy of Ophthalmology. Posterior Vitreous Detachment. Accessed April 2025. https://www.aao.org </ref>
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| ===Diagnosis===
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| * Clinical diagnosis based on symptoms and direct visualization of a detached posterior hyaloid membrane or Weiss ring on fundoscopic or slit-lamp exam
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| * Confirm absence of retinal tear or detachment via dilated eye exam or imaging
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| ==Management==
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| * Uncomplicated PVD: No treatment required; reassure patient and educate on warning signs of retinal detachment
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| * With retinal tear or detachment: Urgent referral to ophthalmology; treatment may involve laser photocoagulation, cryotherapy, or surgical repair
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| * Monitor: Regular follow-up with eye exams over subsequent weeks
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| ==Disposition==
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| * Discharge with precautions if no retinal pathology found; instruct to return immediately if new floaters, flashes, or curtain-like visual loss occurs
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| * Urgent referral to ophthalmology if retinal tear, detachment, or vitreous hemorrhage suspected
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| ==See Also==
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| ==External Links==
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| ==References==
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| <references/>
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