# Posterior vitreous detachment

- Category: acute
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class FD99.04 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Posterior Vitreous Detachment - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK563273/
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Recognition & Referral)

## Complete treatment card

```text
POSTERIOR VITREOUS DETACHMENT
Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class FD99.04 -
         condition scope only, no dose · No dose - referral pathway, no medicine given in primary
         care · Posterior Vitreous Detachment - StatPearls - NCBI Bookshelf -
         https://www.ncbi.nlm.nih.gov/books/NBK563273/
Review status: REVIEWED against the source listed above  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (3)
    - Flashes are brief, felt in the temporal field, triggered by eye or head movement, and more
      noticeable in dim lighting.
    - About two-thirds of patients with PVD report blurred vision.  [blurred vision]
    - Floaters appear as small mobile specks most visible against a bright background.  [floaters]
  SIGNS - what you find (3)
    - The Weiss ring is a glial tissue ring about 1.5 mm across, attached to the hyaloid just in
      front of the optic disc.
    - Pigment granules and red cells in the anterior vitreous, called the Shafer sign or tobacco
      dust, suggest an accompanying retinal tear and warrant referral.
    - The detached hyaloid membrane looks like a crumpled, translucent sheet floating in the mid-
      vitreous.
  TESTS (4)
    - OCT can detect a shallow PVD that slit-lamp exam and B-scan ultrasound both fail to identify.
    - OCT stage 4 is complete PVD with a prominent Weiss ring visible on slit-lamp exam.
    - On slit-lamp exam, complete PVD with collapse shows a loose, easily detected, fully separated
      hyaloid membrane.
    - B-scan ultrasound is used to assess the state of the vitreous gel and the extent of
      detachment.
  IF NOT THIS - what else fits (3)
    - Other causes of flashing lights include a retinal tear or detachment, and migraine with or
      without aura.
    - Other causes of floaters include vitreous hemorrhage from a retinal tear, detachment, or
      proliferative diabetic retinopathy.
    - Posterior uveitis syndromes such as multiple evanescent white dot syndrome or birdshot
      chorioretinitis can also produce flashing lights.
  Source  StatPearls "Posterior Vitreous Detachment" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)[1st line]
   Adult    Posterior vitreous detachment presents with acute onset of floaters or photopsia
            (flashes). A GP cannot reliably distinguish benign posterior vitreous detachment from an
            acute retinal tear or detachment on bedside examination; all patients with acute-onset
            symptoms must undergo same-day dilated ophthalmoscopic examination by an
            ophthalmologist. Instruct the patient to seek emergency care immediately if a dark
            curtain, shadow, or peripheral vision loss develops. - Refer
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Posterior vitreous detachment presents with acute onset of floaters or photopsia
            (flashes). A GP cannot reliably distinguish benign posterior vitreous detachment from an
            acute retinal tear or detachment on bedside examination; all patients with acute-onset
            symptoms must undergo same-day dilated ophthalmoscopic examination by an
            ophthalmologist. Instruct the patient to seek emergency care immediately if a dark
            curtain, shadow, or peripheral vision loss develops.
   Caution  Sudden shower of new floaters with flashes of light, or a curtain/shadow over part of
            vision — needs same-day ophthalmology assessment to rule out retinal tear or detachment.
            No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
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