Posterior Vitreous Detachment: Jell-O in Your Eyes

A while ago I wrote an article about ocular migraines; more people read the article than any other article I’ve ever written. Having had more than my share of eye issues, and consulting with clients who are also experiencing disorders that many times we don’t understand, this investigative report shines the light on yet another serious eye disorder that is occurring more than we’d like to admit—especially among baby boomers and those with compromised immune systems and chronic inflammation.

Statistically Speaking…
With over 2.8 million baby boomers, age-related eye diseases are becoming increasingly important health issues. The American Optometric Association (AOA) reminds us that those 60 and older should visit their eye doctor for a comprehensive eye exam annually. Early detection can prevent or slow vision loss due to cataracts, macular degeneration, glaucoma, diabetic retinopathy and, yes, vitreous detachment.

The National Eye Institute estimates that over the next 30 years, the current number of blind or visually impaired Americans will double because of aging baby boomers. According to the AOA, 20.5 million people age 60 and over have cataracts. Remember, age-related eye diseases do not have to lead to severe vision loss or blindness. Some of these diseases have no early stage symptoms—the critical time to help slow the progression of disease. Early detection is key.

Normal eye anatomy on left and on right, retinal detachment.

Author’s Perspective…(See illustration above)
When I became a sufferer from vitreal detachment and had surgery to repair it in both eyes, it was the most challenging recovery I could have imagined. The surgery wasn’t painful but having to lie on one side of my body for 14 days caused tremendous pain, not to mention misalignment of my neck, spine and hips but also sores from pressure on specific areas of my body. Only being able to get up five minutes each hour was a medical punishment I don’t wish on anyone.

In preparing this report, I wanted to provide you a perspective from an eye professional. That said, I reached out to a friend and colleague, Dr. Evie Lawson who practices in Gig Harbor and Renton, Washington, for her perspective on what she sees as a serious eye disorder that is not understood by most. The following is her explanation of vitreous detachment… keep in mind that being proactive, by regular exams and seeing your doctor at the first sign of new visual developments, could save you the discomfort I had to go through, being reactive is expensive, potentially dangerous and painful.

Medically Speaking…
What do you do when suddenly there is a black shadow that looks like an upside down space ship floating in your vision? The most likely first response is panic and then your mind turns to thinking about a psychiatrist or neurologist to find out if you are crazy or have a brain tumor. Don’t panic but DO take immediate action; call your local optometrist or ophthalmologist and schedule an eye exam—this is not considered a life-threatening emergency in most cases but it is definitely urgency. New floaters and flashes of light are a sign of a normal progression of time called a posterior vitreous detachment (PVD) or vitreal syneresis. This posterior vitreous detachment is most common in patients ages 60–70, however I have seen it beginning in patients as early as 45 years old.

The vitreous in our eye starts out as a clear ball of “Jell-O" with a surrounding membrane. The membrane has attachments at specific sights in the back of the eye, but also can have random unknown attachments that vary for each patient. As we age this “Jell-O” liquefies and begins to settle—as gravity pulls the liquefied vitreous down it will pull on the membrane that surrounds the vitreous. These random attachments at unknown locations are what can cause a complication in PVDs. If the attachments are on a blood vessel or retina it can pull pieces of the retina or blood vessel off and cause a tear or bleed.

PVDs are very normal and happen in everyone. They can happen with no complications and with people being completely unaware that they are occurring or have occurred. The complications that occur, however, can lead to holes and tears of your retina (the nerves you see with) and worst case scenario can cause retinal detachments which can lead to blindness if not treated. People who have symptoms are the ones who are at the most risk for having complications.

The first precaution to help you avoid any vision loss is to schedule a routine annual eye exam, especially in people over 50. The second precaution is to see your eye doctor immediately if you have any new crazy floaters that suddenly appear in your vision, making you crazy and wanting to run for a psychiatrist—instead, run to your local eye doctor.

Baby boomers Checklist for Health Vision…
The following list was adapted from The American Optometric Association. If you answer YES to any of the questions, you are encouraged to schedule an appointment for a comprehensive eye exam as soon as possible:

Are you:

• Someone with diabetes, hypertension, or any other systemic, chronic or inflammatory disease?
• At risk for certain systemic or eye diseases because of family history or other factors?
• Having more difficulty reading smaller type, such as books and newspapers?
• Experiencing frequent headaches after working on a computer?
• Doing a great deal of reading and other close work and notice visual changes?
• Rubbing your eyes frequently?
• Having tired, burning or chronic dry eyes?
• Losing track of a person or objects in your peripheral (side) vision?
• Avoiding close work?
• Having difficulty driving at night?
• Experiencing frequent near misses, accidents, difficulty parking or judging distances?
• Handling or using chemicals, power tools or lawn and garden equipment?
• Playing eye-hazardous sports like racquetball, softball, or tennis?
• Experiencing difficulty with eye-handbody-coordination?
• Playing sports and having trouble judging distances between you, the ball, or other objects?

Note: Many people do not understand that even though their vision may appear clear, comprehensive exams can uncover change in the eye caused by such disorders as high blood pressure, diabetes, chronic inflammation, retinal disorders and glaucoma.

Symptoms of Posterior Vitreous Detachment

Note: Although most posterior vitreous detachment do not progress to retinal detachments, those that do produce the following symptoms:

• A dense shadow that begins in the peripheral vision and slowly progresses towards the central vision
• The impression that a veil or curtain was drawn over the field of vision
• Straight lines (scale, edge of the wall, road, etc.) that suddenly appear curved
• Central visual loss

Symptoms of Retinal Detachment

• Flashes of light, very brief in the extreme peripheral (outside of center) part of the vision field
• A ring of floaters or hair-like images just to the temporal side of the central vision
• A slight feeling of heaviness in either eye

The Way I See It
I began to notice new floaters prior to becoming a sufferer of vitreal detachment—occurring for about one week prior to the detachment. Had I realized the floaters were a warning sign, I would have had an eye exam immediately. Instead I excused it away with the fact I had been doing a lot of computer work and proof-reading for a release of my new book. I proceeded that week to fly (2 hr. flight) to a conference where I was speaking; the detachment occurred the next day after my lecture. I saw the upside down space ship described by Dr. Evie and only a small crescent moon of light in the other eye. It was one of the most fearful experiences I've ever encountered. I contacted my eye doctor and proceeded to fly home for emergency surgery; the surgery was unremarkable, the recovery was difficult. Don't wait after new visual symptoms manifest, see your eye doctor immediately it could save your vision.

 References:
www.aoa.org/x5099.xml www.laretinasurgeon.com/retinal-detachment. aspx

detached retina