Diving with "posterior vitreous separation"

[gert7to3]

Moving Target,

Did you see your doctor because you noticed a vision problem or was this observed during a regular exam?

Oftentimes a branch retinal vein occlusion (BRVO) occurs where a retinal vein is crossed by retinal artery. The artery may press against the vein partially obstructing it. This is frequently a side effect of hypertension. Much of the time BRVO resolves spontaneously.

So far as testing goes, the retinal specialist you were probably referred to may order a fluorescein angiogram. This test will measure the blood flow within your retina and define the area affected by the occlusion.

Since no gas bubble has formed inside your eye BRVO would probably not preclude diving. Of course, the underlying issue needs to be addressed.

Wikipedia has concise explanation and photo: Branch retinal vein occlusion - Wikipedia, the free encyclopedia

Just be aware the photo is of a fairly severe BRVO and yours may just be a little spot.

Good luck, I hope this is just a small, passing event for you.

 

[Moving Target]

Unfortunately after seeing images mine is more widespread than the wikipedia image. I noticed some blurry areas in the periphery of my vision which were even worse in the morning. After realizing it was more than just an issue with dryness and nothing in my eye I went to see an ophthalmologist right away. After describing the symptoms and a typical exam (20/15 in both eyes) he decided to try something else. When presented with a grid pattern (my eyes were dilated so this was done through a corrective lens) I noticed some distortion of the grid in the top left of the left eye. After closer inspection he found the BRVO.

The shock is that I am young to be faced with this issue at 38, and in excellent Heath. No high blood pressure, no other maladies or medications, etc.. I saw a retinal specialist today who confirmed everything and prescribed some steroid drops for the issue opting not to proceed with any injections. I have been advised due to my age I have a strong chance of recovery and that diving to his knowledge would not be an issue. Referred to a hematologist for more research and testing.

Thanks for your insight, it is very much appreciated.

 

[gert7to3]

Your prognosis does sound good. Your visual acuity is excellent and that bodes well for your recovery. The best step for you to follow is to monitor the area of distortion in your visual field. If anything changes before your next appointment, yell for help, don't wait.

Rest assured that the Wiki image is of a person who has multiple serious issues beyond a vein occlusion.

 

[CF L]

I have been told by my optometrist recently that I have PVD. I've found a question-and-answer page from a diver magazine that suggests diving within 6 months of the onset of symptoms may not be advisable, which contradicts what I've read on this thread.

My symptoms including a floater and flashing light in dark environments started in late May and I have a dive trip booked in early October. From what I've read symptoms may go away in a few months when the detachment is complete, so fingers crossed that may happen for me when I leave for my trip, but if I need to cancel the booking I have to do it by the end of August.

I am wonder if anyone with PVD have avoided diving in the initial few months?

 

[gert7to3]

I dove after my initial DX, but both my PVDs took several years to fully resolve. My right eye progressed faster. That said, I am not in any way shape or form advising you to ignore your OD's recommendation and go dive. I would suggest obtaining a fuller explanation from your OD about why he/she thinks diving should be avoided. You also may want to get a second opinion from a retinal specialist. Especially one who treats a lot of macular hole and retinal detachment patients. Most PVD's resolve on their own. Macular holes are a potential complication, though they are highly treatable. Attached are three views of the progression of the PVD in my right eye.

 

[tursiops]

I'm a cardiologist, not an ophthalmologist but I can't think why greater depths would be a problem for a non-compressible fluid filled structure like the vitreous portion of your eye. However, it's your vision we're talking about. Call DAN and get some expert advice. If needed, they can refer you to a diving-knowledgeable ophthalmologist in your area.

I've been trying to get a response from DAN about the consequences of getting a XEN gel implant for glaucoma, but they do not answer my emails or contact-questions. Crickets. I thought it would be helpful to them to have a chance to look over my question and think about it before responding to me, rather than calling them and expecting an answer on the fly. I guess not.

 

[Kendall Raine]

I recently had a vision problem - I was seeing flashing lights in my peripheral vision when out at night. Saw an opthomologist who diagnosed 'posterior vitreous separation' which is where the gel inside the eyeball separates from the lining of the eye causing a flashing light sensation. He said it would get better with time and is actually quite commom as you get older (I'm 55) When I asked him about diving with this condition he said I should be fine, just don't go really deep. As he was not a scuba diver, I was unable to get a clear definition from him as to what he considered "really deep". Problem is, I'm going on a dive vacation next week and am planning to get myAOW there which, of course, includes a deep dive. Anyone out there been diving with this condition? We're leaving 11/09 so any reassurance would be appreciated. Thanks so much!

I had flashes and floaters 20 years ago after a dive trip diagnosed by my optometrist as PVD and that it would resolve over time. Likely cause by astigmatism, not diving and no contraindication to diving. When the flashes persisted I saw an opthalmic surgeon who said I had a retinal tear and performed laser surgery to tack it down. Again, cause was likely function of astigmatism and the shear stress therefrom. Nothing to do with diving or implications for diving, at any depth. Still good after many years post-op of dives in the 200-400 foot range. I think you're good for AOW.

 

[CF L]

I contacted a medical referee in the UK following advice from a Duke Dive Medicine staff member in the following thread I started.

Diving with PVD Symptoms

I have been told by my optometrist recently that I have Posterior Vitreous Detachment. I've found a question-and-answer page from a diver magazine that suggests diving within 6 months of the onset of symptoms may not be advisable, which contradicts some discussions I've read on this forum. My...

scubaboard.com

Based on the referee's response, I think I should be fine to dive.

 

[windycityretina]

As an ophthalmologist, I'd like to address the concern regarding diving with posterior vitreous separation (PVS).

Posterior vitreous separation, or posterior vitreous detachment (PVD), occurs when the vitreous gel inside the eye separates from the retina. While PVD is a common age-related change and often occurs without significant symptoms, it can sometimes lead to complications such as retinal tears or detachments.

When considering activities like diving with PVD, it's essential to understand the potential risks involved. The change in pressure associated with diving, particularly during rapid descents and ascents, can theoretically exacerbate existing retinal issues, including tears or detachments. However, the actual risk varies depending on several factors, including the severity of the PVD and the presence of any underlying retinal pathology.

Therefore, I recommend consulting with your ophthalmologist before engaging in diving activities, especially if you have been diagnosed with PVD or have a history of retinal problems. Your ophthalmologist can assess your individual risk factors, conduct a thorough eye examination, and provide personalized recommendations based on your specific situation.

In general, it's essential to proceed with caution and prioritize your eye health when participating in activities that involve changes in pressure, such as diving. Regular eye examinations and open communication with your ophthalmologist are key to ensuring the safety of your vision, both in and out of the water.

If you have any further questions or concerns, please don't hesitate to reach out. Your eye health is our priority.

Best regards,
Ankit Desai, MD
Ophthalmologist