detached vitreous and diving

[ChristyV]

The vision in my left eye seemed a little weird lately and I went to the doctor. She examined my eyes and said I have a detached vitreous. She just said to come back in two weeks, or, if I begin to see flashing lights to come in right away. I told her that I dive and she wasn't sure what effect that would have. I wouldn't think it would have any since my eyes are in an airspace that I can equalize. PLEASE, somone tell me I am right!!!
Thanks!!!!!

 

[DocVikingo]

Hi ChristyV,

No fun.

Unless gas has been purposely introduced into the eye for ophthalmological purposes, the eye is not an air-containing space. Rather, it is filed with a non-compressible clear gel known as vitreous humor. And, while the eye does ride in an orbit open to the air, this also really is not an air-containing space. As such, the eye does not require equalization when diving.

Nonetheless, until medical clearance for return to SCUBA has been received from a qualified source it appears unwise to dive with a vitreous separation. It is possible that the separation could be aggravated by such activity and the retina become involved, at which point very serious visual impairment becomes a risk.

It would be prudent to avoid sudden head or eye movements and significant straining (e.g., lifting SCUBA cylinders). Also endeavor to turn the head to look in a particular direction rather than hold the head in a fixed position and move the eyes.

You or your physician may wish to phone DAN at (919) 684-2948 (Mon-Fri, 9am-5pm EST). Email is slower, but gets you a written response -- https://www.diversalertnetwork.org/myaccount/mscc/emailmedic.asp. DAN also may be able to make a referral to a diving medicine savvy eye specialist in your area.

Please keep the board posted on your progress--it helps us learn.

Helpful?

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[DocVikingo]

You may find this webpage about the condition informative:

Facts About Vitreous Detachment [NEI Health Information]

Regards,

DocVikingo

 

[miketsp]

Just for information:
This happened to me twice in the last 5 years. It seems to be one of the problems of aging. I'm in my late 50s.
Both times I had new floaters and scintillation during rapid eye movements in half-light.
Both times I went in urgently for a complete dilated eye examination as it is important to diagnose urgently if there has been any associated retinal separation.
Fortunately in my case there was none. The ophthalmologist didn't impose any restrictions on my diving when I mentioned this and the prescribed treatment in both cases was 500mg of vitamin C daily for 6 months.
The first time it happened the symtoms cleared up.
The second time I'm now 3 months into the treatment and it's a lot better. I did do quite a lot of diving during treatment.
Again, this was for my specific case after detailed examinations.
This is definitely a situation where a medical examination and opinion is required in each case.

 

[ChristyV]

Thanks to both DocVikingo and MikeTSP. Being a typical diver, I am of course going to listen to Mike! If I restrict myself to boat diving, I won't have to lift any cylinders! Of course I do have to climb a swim ladder! The doctor said she didn't think there was any problem with diving. Well, I'll have to think about this....but thanks you guys!

 

[gert7to3]

There was a discussion about PVD's in November 2007. Here's an OCT scan of my right eye from that post:

http://www.scubaboard.com/forums/diving-medicine/209137-diving-posterior-vitreous-separation-2.html

The rest of that post is also interesting and will probably ease your mind.

My right eye vitreous has since completely and cleanly detached. I haven't uploaded any of my more recent scans. However, next Tuesday, I'll be in the clinic with the OCT I've made most of my scans from. I'll try to post a series of the four month progression where the detachment crossed my fovea, then separated. It's nice to be able to look back on this instead of undergoing it. Then again, my left eye is doing the same thing.

Since your eye is essentially fluid filled with a saturated tissue, decompression is not what you have to worry about. DocVikingo's cautions or other medical advice should be heeded.

Everyone should check their eyes for any changes in their visual fields. Do this by covering each eye separately, then see if there are any distortions or differences between your two eyes. Read with each eye; see if lines are straight and true ( like the door seams of kitchen or filing cabinets). If you perceive any sort of distortion, get it checked out immediately.

It is common to start needing reading glasses from your late thirties or early forties.

Near sighted (myopic) people are more prone to PVD's, macular holes and retinal detachments. These are almost always accompanied by flashes of light, new floaters or spotty shadows.

If you are diabetic or hypertensive these conditions can also impact your eyes. Get regular eye checkups.

 

[ChristyV]

Again, thanks to all of you for responding. Question for Miketsp and Gert7to3, did your doctors prescribe anything other than the vitamin c mentioned or caution you about anything? My doctor did dilate my eyes and do an examination, but I was simply told to come back in 2 weeks....sooner if I see flashing light or more floaters. She did not caution me about lifting or turning my eyes, nor did she prescribe anything. She said that it was good that I followed up when I noticed something different with my vision. Thanks.

 

[gert7to3]

I am an ophthalmic photographer, work with three retinal specialists and operate an OCT microscope, with which I can take images of my own eyes, by myself. I was not cautioned about limiting my activity, and I went diving. That said, I have no idea what your doctor saw nor any clue as to the particulars of your diagnosis.

Your condition is a common event, usually related to the aging process. It will probably play out over a number of months. The worst case scenario, NOT VERY COMMON, is to develop a macular hole. This why you need to follow up with your doctor and monitor your vision in the affected eye. The caution about flashes of light is if you see these flashes in a well lighted environment. As the separation of your vitreous progresses across your fovea (your central vision), you may perceive some shimmering light at night with your eyes closed. At least I did, it's rather distracting. I also saw some small clear distortion in my central vision at the very end when my vitreous fully separated.

Your doctor was being very conservative about diving advice, because she has little medical knowledge of that specific activity. DocVikingo was being very conservative with his advice, as he has to be here on this board.

 

[miketsp]

No, I received no caution except to return if there was any deterioration and instructed just to keep doing my regular, yearly checkups.

 

[ChristyV]

By the way, reading through the posts I realize that it sounded as if I thought eyes could or should be equalized! What I explained to my doctor is that my nose is inside my mask and therefore my mask doesn't squeeze or suck on my face! thanks