Trauma-Induced Posterior Vitreous Detachment

Causes and Risk Factors

Direct ocular trauma is a recognized precipitating factor for posterior vitreous detachment, which can occur at a younger age than typical age-related PVD, according to the American Academy of Ophthalmology 1, 2
Both blunt trauma and penetrating eye injuries can cause vitreous detachment, as reported by the American Academy of Ophthalmology 3
Surgical trauma, including cataract surgery and intraocular injections, can precipitate PVD, as noted by the American Academy of Ophthalmology 1, 2
PVD typically occurs naturally between ages 45-65, but trauma can cause it to happen earlier in life, according to the American Academy of Ophthalmology 1, 2

Symptoms of flashes and floaters may appear immediately after the traumatic event, as reported by the American Academy of Ophthalmology 3, 4
New symptoms can develop within 6 weeks following the initial trauma or PVD, according to the American Academy of Ophthalmology 5, 3
Patients should be monitored for new or changing symptoms for up to 6 weeks following trauma, as this is the period when retinal breaks may develop, as recommended by the American Academy of Ophthalmology 5, 4

Photopsias (light flashes) occur due to vitreous traction on the retina as the vitreous separates, as explained by the American Academy of Ophthalmology 1, 2
Floaters may result from blood from torn retinal vessels, condensations of vitreous collagen, or epipapillary glial tissue (Weiss ring), according to the American Academy of Ophthalmology 1, 2

Between 8% and 22% of patients with acute PVD symptoms have a retinal tear at initial examination, as reported by the American Academy of Ophthalmology 1, 2
Patients with acute PVD but no retinal breaks have approximately a 2% chance of developing breaks in the following weeks, according to the American Academy of Ophthalmology 5, 1
Patients with any degree of vitreous pigment, vitreous/retinal hemorrhage, or visible vitreoretinal traction should return for follow-up examination within 6 weeks, as recommended by the American Academy of Ophthalmology 5, 4

All patients with trauma-related eye symptoms should be advised to contact their ophthalmologist promptly if they develop new symptoms such as flashes, floaters, peripheral visual field loss, or decreased visual acuity, as recommended by the American Academy of Ophthalmology 5, 3
Patient history should specifically identify changes in visual symptoms and any interval history of eye trauma, as noted by the American Academy of Ophthalmology 3, 4
Examination should include visual acuity measurement, vitreous evaluation (looking for pigment, hemorrhage, or syneresis), and thorough peripheral fundus examination, as recommended by the American Academy of Ophthalmology 3, 4
B-scan ultrasonography is recommended when media opacity prevents direct visualization, according to the American Academy of Ophthalmology 3, 4