Posterior Segment
Posterior Vitreous Detachment
Also known as: PVD, posterior vitreous detachment, vitreous floaters, new floaters, flashes and floaters, vitreous separation, Weiss ring, photopsia
Filed as: Urgent
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
Age-related separation of the posterior vitreous cortex from the retina, presenting with monocular new floaters and brief peripheral photopsia on eye movement. A Weiss ring supports the pattern, and acuity is preserved when the detachment is uncomplicated. The clinical task is an adequate dilated peripheral retinal assessment before reassurance, since a proportion of acute presentations carry a retinal break, and any field defect or obscured view warrants urgent retinal referral.
Recognition
Symptoms: what patients report
- Acute onset of new floaters — often described as cobwebs, threads, a ring, or a dark shape.
- Photopsia — brief flashing lights in the peripheral visual field, typically on eye movement.
- Symptoms are monocular.
- Vision is not significantly reduced if the condition is uncomplicated.
- A curtain, shadow, or field defect indicates retinal detachment — this is NOT uncomplicated PVD.
Signs: what the examination shows
- Weiss ring — circular floater seen on fundoscopy, formed by the avulsed vitreous attachment at the optic disc.
- No retinal tear or detachment visible on dilated fundoscopy with indirect ophthalmoscopy or slit lamp with Volk lens.
- Visual acuity preserved in uncomplicated PVD.
- Visual field: no defect — any field loss mandates urgent retinal referral.
- Vitreous haemorrhage — if present, the view is obscured or a red haze is visible; urgent referral regardless.
What OptoGuide™ covers for posterior vitreous detachment
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration PPP — AAO
- Posterior Vitreous Detachment — EyeWiki
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.