Shafer's sign alludes to the clinical finding of pigment cells in the vitreous. In the absence of prior ocular surgery, this sign is considered practically pathognomonic of a retinal break or rhegmatogenous detachment. A case of a retinal tear with a positive Shafer's sign is discussed.
What is Shafer's sign in ophthalmology?
Learn more. Shafer's sign alludes to the clinical finding of pigment cells in the vitreous. In the absence of prior ocular surgery, this sign is considered practically pathognomonic of a retinal break or rhegmatogenous detachment.
What does Shafer's sign look like?
What is Shafer's Sign eye? Also called “tobacco dust,” Shafer's sign refers to the presence of a collection of brown pigmented cells in the anterior vitreous following a PVD. Click to see full answer. In respect to this, what does vitreous detachment look like?
What does a positive Shafer's sign mean?
Shafer's sign alludes to the clinical finding of pigment cells in the vitreous. In the absence of prior ocular surgery, this sign is considered practically pathognomonic of a retinal break or rhegmatogenous detachment. A case of a retinal tear with a positive Shafer's sign is discussed.
How do you assess the anterior vitreous for Shafer's sign?
As part of this examination, the assessment of the anterior vitreous should be performed, firstly to locate a Weiss ring, and secondly to evaluate the presence or absence of Shafer's sign.
How do I know if I have shafers sign?
Shafer's Sign First identified in 1965, the sign is best observed through slit lamp exam by sending a narrow, bright beam behind the posterior lens to focus on and illuminate the dark vitreous cavity.
What is the treatment for vitreous detachment?
If your vitreous detachment causes a serious condition — like a retinal tear — you may need treatment for that condition. If your floaters still bother you after a few months and make it hard to see clearly, your eye doctor might suggest a surgery called a vitrectomy to remove them.
What does a Weiss ring indicate?
Although a Weiss ring usually indicates that a total posterior vitreous separation is present, vitreous may rarely remain attached to the macula or other posterior structures despite its separation from the optic nerve head.
How is PVD eye diagnosed?
Diagnostic testing Posterior vitreous detachment is usually diagnosed with a dilated eye examination. However, if the vitreous gel is very clear, it may be hard to see the PVD without additional testing, such as optical coherence tomography (OCT) or ocular ultrasound (see Figure 2).
Is vitreous separation serious?
A vitreous detachment does not harm vision on its own. But in some cases, the fibers can pull so hard on the retina that they create a macular hole, or a retinal tear that leads to a retinal detachment. These are serious conditions.
Can vitreous detachment heal itself?
This is a condition where the vitreous, which was gel when the person was younger, has become liquefied and has begun to peel away from the retina. This is a natural development in the majority of people over the age of 60. It doesn't heal, but it usually doesn't require any treatment either.
Is a Weiss ring serious?
While a Weiss ring is usually harmless and will disappear on its own eventually, in a small number of cases a PVD can cause a retinal tear. These are vision threatening and so it is vital to consult with an eye specialist, or an optometrist immediately after developing a Weiss ring.
Where is Weiss ring located?
A "Weiss ring" is the circular peripapillary attachment that is visible within the vitreous after it has become detached from the optic nerve head.
Does vitreous detachment cause blurred vision?
Distorted Vision In the majority of cases, PVD does not result in any side effects aside from flashes and floaters. In rare instances, patients report that their overall vision is distorted. The patient may experience blurry vision, partial loss of vision, tunnel vision, or sensitivity to light.
Can PVD cause blindness?
This is caused by changes in your vitreous gel. PVD isn't painful and it doesn't cause sight loss, but you may have symptoms such as seeing floaters (small dark spots or shapes) and flashing lights.
What causes PVD in the eye?
What are causes of PVD? Age is the primary cause of PVD. As you age, it becomes harder for the vitreous to maintain its original shape. The vitreous gel shrinks and becomes more liquid-like, yet the cavity between your lens and retina remains the same size.
How long do PVD symptoms last?
As long as you do not develop a retinal tear or retinal detachment, a PVD itself does not pose a threat to sight loss and the floaters and flashes slowly subside for a majority of patients within 3-6 months. In these cases, no specific treatment is needed.
How long does it take for vitreous detachment to heal?
As long as you do not develop a retinal tear or retinal detachment, a PVD itself does not pose a threat to sight loss and the floaters and flashes slowly subside for a majority of patients within 3-6 months.
How do you treat vitreous detachment naturally?
5 Tips for Helping Normal Eye FloatersVitrectomy/Laser Therapy. If the floaters are a major nuisance or severely hinder your vision, the best way to get rid of them is through either vitrectomy or the use of lasers. ... Ignore. ... Exercise, Diet and Hydrate. ... Antioxidants and Taurine. ... Reduce Eye Strain.
Is vitreous detachment permanent?
Often, they're accompanied by flashes of light — usually in your peripheral vision — and especially visible in the dark. The flashes and floaters generally subside within one to three months, and 85% of people with posterior vitreous detachment experience no further problems.
How do you deal with posterior vitreous detachment?
How to cope with posterior vitreous detachmentWearing sunglasses on sunny or bright days.Reducing the screen brightness on computers, phones and other devices you use.Gently moving your eyes in circles to help move the position of the floaters in the eye.
Abstract
Pigment cells in the anterior vitreous (Shafer's sign) are known to be associated with retinal breaks. We sought to identify the reproducibility of Shafer's sign between different grades of ophthalmic staff. In all 47 patients were examined by a consultant vitreo-retinal surgeon, a senior house officer (SHO) and optician for Shafer's sign.
Main
Pigment cells in the anterior vitreous (Shafer's sign) 1 are known to be associated with retinal breaks. We sought to identify the reproducibility of Shafer's sign between different grades of ophthalmic staff.
Why does the floater sink to the bottom of the eye?
Anecdotally, optometrists often tell patients that the floater sinks to the bottom of the eye so it is no longer seen . This is not actually the case. Instead the ring simply moves more and more anteriorly until eventually the shadow it casts on the retina is so out of focus that it is more easily ignored.
What is the anterior vitreous?
Anterior vitreous assessment. The vitreous is a transparent gel that occupies more than two thirds of the globe. It is bound by the lens zonules anteriorly and the retina posteriorly. The posterior portion of the crystalline lens is in apposition with the patellar fossa, a concave depression in the anterior vitreous.
Which blood vessels are intermingled with the vitreous?
This vitreous and retinal intermingling is particularly strong at the retinal blood vessels. The vitreous and retina also produce stronger attachments at the vitreous base (a 4mm zone straddling the ora serrata), the optic disc and, to a slightly lesser extent, at the fovea. Vitreous syneresis, synchisis and PVD.
Where does liquefied vitreous escape?
Liquefied vitreous escapes to the retro hyaloid space and the vitreous cortex separates from the posterior sensory retina and optic disc causing a posterior vitreous detachment. The attachment of the vitreous cortex to the optic disc is in the form of a gliotic ring.
What is the shape of vitreous?
They have a gentle curved shape which becomes more tortuous over time and becomes completely confused when vitreous liquefaction occurs. The vitreous is 99 per cent water containing hyluronic acid and 1 per cent delicate fibres derived from immature collagen.
What is the posterior portion of the crystalline lens?
The posterior portion of the crystalline lens is in apposition with the patellar fossa, a concave depression in the anterior vitreous. It develops from a homogenous gel at birth but transvitreal channels of lower density develop throughout life and reflect variations in vitreous synthesis.
Can a vitreous hemorrhage occur in the posterior vitreous detachment?
A vitreous haemorrhage can occur secondary to posterior vitreous detachment. The stronger attachment of the vitreous at the retinal blood vessels means that, should a PVD occur, the tractional forces at an area local to a blood vessel are more than the surrounding retina.
Disease Entity
Retinal detachment is a sight threatening condition with an incidence of approximately 1 in 10000. Before the 1920’s, this was a permanently blinding condition. In subsequent years, Jules Gonin, MD, pioneered the first repair of retinal detachments in Lausanne, Switzerland.
Diagnosis
Patients who present with symptoms of new onset significant photopsias and/or persistent new floaters should be suspected of having a retinal tear, which could lead to a retinal detachment. A patient with constant fixed or slowly progressive visual field loss should be suspected of having a detachment until proven otherwise.
Management
Once a retinal detachment has been identified, one must determine what type of detachment is present. Surgical management is indicated for rhegmatogenous and tractional detachments.
Additional Resources
Gudgel DT, , Boyd K, McKinney JK. Flashes of Light. American Academy of Ophthalmology. EyeSmart ® Eye health. https://www.aao.org/eye-health/symptoms/flashes-of-light-list. Accessed March 13, 2019.
