What is Acute PVD?
Acute Posterior Vitreous Detachment is a sudden separation of the vitreous gel from the retina—a common age-related event. While often benign, in some cases this detachment exerts traction on the retina, causing tears or, if untreated, sight-threatening retinal detachment.
Key Symptoms of Concern
- Sudden flashes of light in your peripheral vision (photopsia)
- A burst or increase in floaters, which may appear like cobwebs or peppering
- A curtain-like shadow or sudden change in vision—an emergency sign
- Visual obscurations from vitreous haemorrhage if a vessel is torn
Why a Specialist Retinal Examination Is Essential
At The Retina Clinic London, we emphasise the importance of an examination by a retinal surgeon using indirect ophthalmoscopy with scleral indentation. This is the only way to thoroughly examine the retina, including the far periphery where tears often occur.
Unlike basic slit-lamp or handheld methods, indirect ophthalmoscopy with scleral indentation allows us to:
- View the entire retinal surface, right to the edge (ora serrata)
- Detect subtle or hidden retinal tears
- Confirm or exclude retinal detachment confidently
This is not routinely performed in NHS clinics or most general eye services, where such detailed techniques require specialist training and equipment.
Superior Treatment: Indirect Retinal Laser vs Contact Lens Laser
If a retinal tear is found, urgent laser retinopexy may be required. We use indirect laser photocoagulation, which offers several critical advantages:
- Greater precision in treating far-peripheral tears
- No need for a contact lens on the eye, reducing discomfort
- Allows treatment even when the eye is anatomically complex (e.g. small pupil, poor view)
- Performed with the patient lying down—more stable and less dependent on patient cooperation
By contrast, contact lens-delivered laser, more commonly used in NHS settings, offers a limited view and is less effective for treating peripheral retinal pathology—precisely where most dangerous tears occur.
The NHS Gap
Unfortunately, most NHS emergency eye clinics:
- Do not perform indirect ophthalmoscopy with scleral indentation
- Rarely offer indirect laser retinopexy, even when it is the most effective treatment
- Are often limited by time and equipment, leading to missed or delayed diagnoses
This is one reason why retinal tears may be overlooked until they evolve into full detachments requiring major surgery.
Why Choose The Retina Clinic London?
With us, you receive:
- Immediate, specialist-led diagnosis with all imaging and indirect examination on-site
- Gold-standard treatment including indirect laser therapy when needed
- Access to our dedicated vitreoretinal theatre if urgent surgery becomes necessary
- The reassurance of care led by Professor Paulo Stanga, a globally respected retinal surgeon
You’re in the right place.
If you’re experiencing any symptoms of acute PVD, don’t delay. Prompt, expert evaluation and intervention can prevent permanent vision loss.
To book, please call us on +44 (0)20 4548 5310.
