Incidence of Acute Symptomatic Posterior Vitreous Detachment, its Complications and Impact on Emergency Eye Care Set Up

Abstract

Purpose. To determines the incidence of complications of acute symptomatic posterior vitreous detachment (PVD) and its impact on ophthalmic emergency setup. Design. A retrospective study of 172 patients presented in one years’ time, with acute symptomatic posterior vitreous detachment. Methods. A retrospective record of 172 patients (n=172) was reviewed who were seen in one years’ time period at local hospital’s eye departments as emergency referrals. Referrals were made by primary care physicians and optometrists. Only patients with acute symptomatic PVD were taken into account. Their symptomatology, visual acuity, fundus examination findings, follow up appointments and outcomes were checked. Results. Mean age at presentation was 62.76 years. Acute Symptomatic Posterior vitreous detachment was detected without complications in 126 (73.25%). Retinal breaks were found on initial presentation in 33 patients (19.18%). Out of these, 18 had rhegmatogenous retinal detachment on initial presentation (10.46%), while one patient who also had vitreous haemorrhage developed it later. PVD was seen with vitreous haemorrhage in 4 patients (2.32%). Seven patients presented with PVD and associated retinal haemorrhages (4.06%). Demographically 96 patients were females (55.81%) as compared to 76 males (44.186%). The highest incidence was between 51 to 75 years of age (84.29%). Posterior vitreous detachments accounted for 7.50% of total eye emergencies in one year. Conclusions. Patients with flashes and floaters should be seen urgently. Priority should be given to patients with cells in vitreous (shafer’s sign) as well as retinal or vitreous haemorrhages. These patients should be seen by experienced ophthalmologist to rule out any break with 360 degree indirect ophthalmoscopic examinations. Junior doctors should have extensive training with indirect ophthalmoscopy with scleral indentation and should not miss shafer’s sign in all patients with acute symptomatic PVD.