Posterior Vitreous Detachment Complications

The posterior portion of the human eye contains a jelly-like material called the vitreous. The vitreous has multiple attachment points on the retina, which is a thin layer of cells responsible for gathering visual images, according to the Academy of Ophthalmology. This gel-like substance may become separated from the retina during trauma, disease, nearsightedness or aging; this detachment is called a posterior vitreous detachment. Although many posterior vitreous detachments are asymptomatic, some may cause vision complications if not managed appropriately.

Retinal Tears

One complication of a posterior vitreous detachment is a retinal hole or tear. When the vitreous pulls away from the retina, the retina may rip or a piece of the retina may come off with the vitreous, according to Royal National Institute of Blind People. About 15 percent of people who have a posterior vitreous detachment also have a retinal tear or hole of some type, according to Drs. Diana L. Shechtman and Diane E. Calderon in an article on the Review of Optometry website. Since a retinal hole or tear may lead to a retinal detachment, an ophthalmologist would seal the ends of the hole down with laser therapy. If the tear is too large to laser, the doctor may have to perform a more complex procedure.

Retinal Detachment

According to the American Academy of Ophthalmology, a retinal hole or tear may progress or worsen to a retinal detachment. When the retina comes away from the rear wall of the eye, the cells die and can cause visual loss. Signs of a retinal detachment include a curtain or veil moving across the field of vision, and an increased amount of flashing lights and floaters. Retinal detachments can be visually devastating; if these signs are noticed after a posterior vitreous detachment, urgent management is vital to preserve vision.

Vitreous Hemorrhage

Sometimes when the vitreous pulls on the retina, blood vessels may be damaged creating bleeding inside the vitreous. This bleeding is known as a vitreous hemorrhage, according to Shechtman and Calderon. A hemorrhage may be small, or may completely obscure vision in the affected eye; for many patients, the hemorrhage will clear over time. Patients with a vitreous hemorrhage after a posterior vitreous detachment are at risk for an underlying retinal tear; the retina must be evaluated for tears before a retinal detachment develops. Vitreous hemorrhages may cause significant visual loss and patients need to be monitored closely until the hemorrhage clears.

Macular Changes

The vitreous is also firmly attached to the retina in the center area which is called the macula. According to the Review of Optometry website, when the vitreous pulls on the macula, the patient may develop blurry vision or decreased visual acuity. If the vitreous pulls on a piece of retina in the macula area, the condition is called a macular hole. If the vitreous is still partially attached to the macula, retinal surgeons may remove all of the vitreous from the back of the eye in a procedure called a vitrectomy, to relieve the traction.