Posterior vitreous detachment

[Loose rivets]

Does anyone have any info on posterior vitreous detachment?

It seems that it is common in the over 60's but the data on the web is incomplete and repetitive.

Does the CAA have an axe to grind if subject can pass the eye-tests?

Is the resultant space between the membrane and retina filled with fluid, or air / gas. If it is gaseous, could this expand at altitude ... i.e. somehow vented outside the eye.

The associated floaters are more serious than the type common in aircrew...are these part of the detached membrane, or can they be zapped like the less serious ones?

Any info appreciated

RB

[moosp]

...Is surgically removing a bottle from WHERE???

(Sorry to trivialise but I couldn't resist..)

[Circuit Basher]

Loose Rivets - no specific mention in JAR FCL3, other than a few catch-alls as follows:(a) An applicant for or holder of a Class 1 medical certificate shall not possess any abnormality of the function of the eyes or their adnexa or any active pathological condition, congenital or acquired, acute or chronic, or any sequela of eye surgery (see paragraph 1 Appendix 12 to Subpart B) or trauma, which is likely to interfere with the safe exercise of the privileges of the applicable licence(s).
….
(c) An applicant with significant defects of binocular vision shall be assessed as unfit. There is no stereoscopic test requirement (see paragraph 3 Appendix 13 to Subpart B).
….
(g) An applicant with visual fields which are not normal shall be assessed as unfit (see paragraph 3 Appendix 13 Subpart B).From direct family experience, get yourself checked ASAP and follow the medical advice to the letter. My sister first suffered a detached retina a couple of years ago in one eye and had it successfully re-attached surgically (laser) and then had the other retina detach a few months later. This was re-attached, but the operation failed - 6 subsequent operations (including removing the lens, the vitreous humour, filling the eye with nitrogen, filling the eye with saline, considering corneal graft) have failed to restore sight in the eye to anything better than a blurry haze.

My sister is now monocular (at 50) and finding it hard to come to terms with the loss of stereoscopic vision - has just fractured cheekbone and dislocated shoulder as a result of falling down steps due to lack of depth perception.

As I said - good luck, but if the medics say lie down in a darkened room for 10 days - do it! It isn't necessarily a big problem, but you can have a big effect on the outcome!

[LastCall]

Loose Rivets

If you are referring to a detached retina, I suffered this malady 6 years ago and was 'off-the--line' for 6 months as a result.

There was a thread on this in the spring where I described my experience with this problem. You'll find it at the top of page 4 of this 'Medical & Health' forum.

Let me know if you need any more info, and I'll try to give you whatever background knowledge that I picked up.

Good Luck.

[Loose rivets]

Thanks for data guys, though I am a little confused about the bottle...must be getting old.

However, happily it is not the retina that is detached, but the membrane behind the vitreous, which I think defines the rear boundary of the virtuous humour. This drops away from the retina in a high proportion of people of my age, and 92 pc in a sample taken of seventy-year-olds!

When part of this fabric remains attached it is prone to tug on the retina causing crescent moon flashes as one pans. As bright yellow as the moon in my case.

It's a funny thing, but when I am talking hypothetically with doctor friends, they are the providers of endless data: but when I finally get something I was worried about, they clam up. Well, unless I cough up 300 quids an hour that is, then I can get some semi intelligible grunts and lots of maybe's or could happens. Ah well, it's a dollar driven and litigatious world I suppose.

It seems that zapping floaters with a laser is a service offered, but I'm not sure that it is possible following PVD.

Anyway, I would like to get the floater out of the way, and also be sure that I won't make it worse by flying as a passenger. So any further data would be helpful.

[Loose rivets]

Hi.

I have put some considerable study into this subject now, and I have to say that I am still not sure wether I will go for surgery. The prognosis for the natural absorption of floaters associated with PVD is not good. I have to say that mine were made worse buy a lot of driving some weeks after the first event.

My first surgeon had the misfortune to suffer the detachment at a young age, and is as a consequence very unsympathetic about my distress. He said I would learn to look through it. He after all became an eye surgeon after the event!

What I feel he did not take into account was the long term mental processing that becomes established at my age (Gawd. soon an OAP! ) the fact was that I had, and according to him still have, fabulous eyesight, made him feel that I was worrying about nothing. Like you I suffered no pain and the flashes are very slight now...BUT after a while both eyes were hurting---a lot. Focusing on a laptop screen was becoming impossible.

After a lot of pressing for some sort of explanation, I worked out myself (it’s one of my interests) that I was suffering pain from mussel spasm. No form of relaxation techniques helped, and even two days in bed in the dark helped only for a few moments, then the pain again.

I need to digress for a moment. I have made numerous comments about the use of Valium, last but not least in the thread about very bad sim nerves. After a lot of soul-searching, I went to my (new young) GP and asked for some to try as a specific relaxant. I only wanted 4 to test the theory, but got 60: I bit my tongue.

Visual processing is very complex, and in someone of my age, seemingly very set in its ways. I reasoned that corrections were being made to see round the blobs in my left eye. After 6 weeks of worry, 1/6th of the recommended daily dose totally relaxed both eyes. Focus came to its usual crispiness when the junk swings out of the way, and even a shortage of tears was instantly cured.

What is incredible is that three eye surgeons did not seem to know what was happening; all the more so because it now seem well established that people who, perhaps wisely, elect to only have one eye done with “ lasic?” correction, are prone to what is loosely described as severe eye-strain...until the other one is done. It seems the dis-balance is highly disruptive to some people.

Just knowing that there was an escape route seems to help break the loop. I have all but eliminated that side of the problem. Again, like our Sir Patrick telling us not to look at the sun, I feel that I must warn against the after affects of this drug. The American PDR lists irritability as one of the symptoms of coming off Diazepam. To me that is the understatement of the year. Back to the eyeball.

I have been offered the chance to have the floater removed. Some days I feel that I would be wise not to interfere with the eye. But on a bad day, it is very disruptive and the spasm threatens in the background. The dangers are that there will be some retinal damage as the tools are inserted, and there is also the probability of cataract starting more quickly. As you say, no attempt is usually made to re-attach the rear membrane-like boundary to the eye. I suppose that is because one of the main anchor points (that is usually lost) is on or near the optic nerve’s entry point.

I cannot understand why there is not more danger to the retina as the gel flops around. I guess that statistically one is reasonably likely to not have a significant tear.

There is a plethora of info under “floaters” and a lot of American eye-centers offer laser zapping for $1,500 per eye. But I just do not feel comfortable about those sort of energies hitting the inner eye unless it is vital for retinal surgery- and the loss of some area is the lesser of two evils.

As I write this, I am almost pixel-perfect in both eyes...but tomorrow I may be looking through a lace-curtain with black bits swinging about. On those days I am certain that I will give the ok for the procedure.

I suppose it’s like modern engineering philosophy. If it’s not causing any great problems, don’t fix it.

[Flyin'Dutch']

I get the impression that people are talking 'cross purposes here.

Posterior Vitreous Detachment is not the same as a retinal detachment.

Retinal detachment is an emergency which requires urgent attention and needs to get fixed.

Posterior Vitreous Detachment is a 'benign' condition which entails that the gelly in the eyeball is not nicely laying against the back retina. This results in floaters or 'mouches volantes' I write 'benign' as they can be a pain in the neck.

There is nothing particular disqualifying about them as I understand it as long as your field of vision is normal and you have a normal visual acuity.

Although you can get some flashing lights with PVD; persisting flashes are more a symptom of retinal detachment. Retinal detachment is rare in people with normal vision, lest they have had a trauma (squash balls being the typical culprits) but spontaneous retinal detachments are not uncommon with people with severe shortsightedness.

Retinal detachments can require lasering as part of the repair and prevent treatment, never heard it being used for PVD (but I am not an ophthalmologist!)

HTH

FD

[Loose rivets]

Hi again.

Oops, did I say Mussel spasm?? Well, I had one of those as well, but only after eating Paella.

FD. That’s right. For a time there was some input that assumed that I had mentioned a retinal problem as the main factor. When ST re-opened the thread, some time had elapsed and now we are just alluding to the potential damage to the retina due to tugging.

ST. Glad to hear the symptoms are slight, though I have a confession to make. When I was getting some intermittent worsening, I hung myself upside-down and swung my eyes about in the hope of sticking the junk out of the way. I had not at that stage read enough about the anchor points to realise how dangerous this was; I feel that I did make it even worse, though at first, it did progress in stages with some very hopeful signs. I recommend the cutting back of vigorous eye movement. If like me you are a car enthusiast, this is difficult, as good driving necessitates wide angle, and vigorous scanning. It’s astonishing how difficult it is to suppress these movements...and indeed raises the question of safety.

I agree entirely with your comparison with tinnitus. I earned myself a 6k whistle, after 800 hours of training in 13 months on a noisy turbo-props. I had a really tough time getting used to this. I am living with the blobs better than I was, so with 3 months to go before surgery, I may gain acceptance...but at first it was like being in an iron mask.

The irony is that I all my ills are due to keeping fit. A herniated disc was caused by keeping up with the kids in the gym, and the eye problem is probably due to hanging upside down on an inversion table to help my back. I was certain that aging was something that other people did. Keep that right arm supple, cos a mate of mine who has scraped through his medical for 40 odd years, says that when the urge to do something energetic tempts him, he lies down till he feels better...then gets down to the pub.

All the best for the new year.

[Flyin'Dutch']

If anyone gets the symptons that LR and I have had, you should treat it as a medical emergency as it's of course not possible at that stage for the sufferer to know which condition they have. PVD is less serious but you must assume the worst case initially.

Indeed for the hapless victim the symptoms can be very similar, although PVD is a lot more common than the amount of patients that report 'flashing lights' suggests.

Many many people report having floaters but have never noted the flashing lights.

Anything to do with one's eyes needs to be taken very serious as you only have 2 and they need to last you a lifetime.

I honestly thought he wrote that squashed balls could cause the problem....

:}

Only the non-testicular version!

FD

[Loose rivets]

Surgically removing the bottle ? ( In 2nd post.)

Very good...it’s taken weeks, but at last I’ve got it!

need time these days, it’s the age thing: but better late than never.