The sudden appearance of new floaters or flashes of light can be concerning, especially for contact lens wearers. This condition, known as Posterior Vitreous Detachment (PVD), is a common, age-related change where the vitreous gel inside the eye separates from the retina. Understanding PVD is the first step in addressing concerns about continued contact lens use. This guide provides practical guidance on safely managing contact lens wear during this natural process, emphasizing the need for professional monitoring.
Understanding Vitreous Detachment
Posterior Vitreous Detachment (PVD) is a natural occurrence, typically developing in people over the age of 50. The vitreous is a clear, jelly-like substance that fills the space between the lens and the retina. As a person ages, this gel gradually becomes more liquid, causing it to shrink and pull away from the retina.
This separation process is not painful and does not inherently cause vision loss. The most common symptom is the sudden onset of floaters, which appear as specks, threads, cobwebs, or a ring-like shape (a Weiss ring). These are shadows cast on the retina by small clumps of condensed vitreous gel.
Another frequent symptom is the perception of flashes of light (photopsia), usually seen in the peripheral vision. These brief streaks occur because the shrinking vitreous gel tugs on the retina. PVD is generally a benign, self-resolving event, with symptoms calming down as the brain learns to ignore the floaters over a period of weeks to months.
Guidance on Contact Lens Use During PVD
Generally, wearing contact lenses is permissible and safe for individuals experiencing an uncomplicated Posterior Vitreous Detachment. PVD is an internal event occurring in the eye’s posterior cavity, while contact lenses sit externally on the cornea. Since the lens does not interact with the vitreous or the retina, it does not directly worsen the PVD or increase the risk of complications.
The most important consideration is maintaining an ongoing discussion with your eye care professional regarding contact lens use. It is crucial to schedule a comprehensive, dilated eye exam immediately upon noticing new symptoms. This exam confirms the PVD diagnosis and rules out any retinal complications. Your eye doctor will then confirm if you can continue wearing your lenses based on your retinal condition.
While both soft and rigid gas permeable (RGP) lenses are usually allowed, impeccable lens hygiene becomes even more important. Poor lens care leading to irritation or infection could complicate the assessment of PVD symptoms. Severe irritation might cause excessive eye rubbing, which some experts suggest could potentially create traction on the retina, though this is rare.
Some individuals find that the presence of floaters, especially large ones, combined with the surface sensation of a contact lens, can make their vision feel more distracting or “busy.” If you wear RGP lenses, discuss whether they are causing excessive surface irritation, as this discomfort might be confused with other ocular symptoms. Ultimately, the decision to continue wearing contacts must be confirmed by the eye care professional managing your PVD, along with a commitment to increased monitoring.
Recognizing Urgent Warning Signs
While PVD is typically harmless, the immediate concern is that the pulling action of the vitreous can sometimes cause a retinal tear, potentially leading to a sight-threatening retinal detachment. It is imperative to know the signs that differentiate a normal PVD from an ocular emergency. Approximately 10 to 15 percent of people with PVD develop a retinal tear, which requires urgent attention.
You must seek immediate medical attention if you notice a sudden, dramatic increase in floaters, often described as a “shower of pepper” or a dense cloud. A significant increase in the frequency or intensity of flashes of light is also an emergency signal. These symptoms can indicate a retinal tear or bleeding inside the eye.
The most serious warning sign is the appearance of a dark shadow, curtain, or veil that begins to obscure part of your central or peripheral vision. This is a telltale sign of a retinal detachment, where the retina has separated from its underlying support tissue. If you experience any of these emergency symptoms, remove your contact lenses immediately and seek care from an emergency room or a retina specialist without delay.