Persistent Hyperplastic Primary Vitreous (PHPV)

 Persistent Hyperplastic Primary Vitreous (PHPV)—now more often called Persistent Fetal Vasculature (PFV) is a congenital (present at birth) eye condition. In a developing baby, the eye has a temporary blood-vessel system—the hyaloid artery and the primary (fetal) vitreous—that feeds the growing lens and inner eye. Near birth, these fetal vessels are supposed to naturally disappear (regress). In PFV, that normal “clear-out” does not fully happen. Some of those fetal vessels and fibrous tissues stay behind and overgrow, forming strands or a membrane inside the eye. This leftover tissue can sit behind the lens (retrolental), pull on the retina, or crowd the front of the eye. Because the tissue can block the visual axis or tug on sensitive structures, vision can be reduced, sometimes severely. PFV is usually in one eye, and most cases are sporadic (not inherited), but both eyes can be affected in rare situations, where doctors also look for broader genetic or systemic issues. EyeWikiCanadian Journal of Ophthalmology

In the womb, every baby has a temporary blood vessel system inside the eye (the hyaloid system and the tunica vasculosa lentis) that feeds the growing lens and retina. After birth, this network is supposed to shut down and disappear. In PFV, parts of that system do not go away. They stay as a fibrous, blood-vessel “stalk” or membrane behind the lens or near the retina. This can pull on eye tissues, cause a white pupil (leukocoria), cataract, glaucoma, or retinal detachment, and reduce vision if not handled promptly. PFV is usually in one eye and is often not inherited; treatment is mainly surgical plus amblyopia care to help the brain use the affected eye as well as possible. EyeWikiAAO+1

Think of the fetal eye as a construction site with temporary scaffolding. The hyaloid artery and primary vitreous are the scaffolding that bring nutrients while the eye is built. When construction is nearly done, the scaffolding must be removed. In a healthy eye, special signals trigger cell self-destruction (apoptosis) and macrophages (cleanup cells) help dismantle and absorb the hyaloid system. If those signals fail or are incomplete, the scaffolding stays, and the child is born with persistent vessels and fibrous tissue—PFV. Scientists have shown in lab and animal studies that imbalances in growth factors (like VEGF), and problems with programmed cell death and macrophage signaling (including Wnt-related signals) can prevent normal regression. In short: PFV is a failure of normal cleanup. PMCFrontiersSpringerLinkReview of Ophthalmology

---

Types of PFV

Doctors group PFV by where the persistent tissue sits. Understanding type helps predict what problems the eye might have and which tests are most useful.

1) Anterior PFV
This type mainly involves the front of the eye. A fibrovascular membrane forms behind the lens (retrolental). The ciliary processes (little ridges behind the iris) can look stretched or elongated, and the anterior chamber (the fluid space in front of the iris) can be shallow. A cataract is common. The eye itself can be smaller than normal (microphthalmic). These front-of-the-eye changes can block light entering the eye and blur vision. WebEyeEyeWiki

2) Posterior PFV
This type mainly involves the back of the eye. There may be a fibrous stalk extending from the optic nerve toward the back of the lens—a remnant of the hyaloid artery. That stalk or associated membranes can pull on the retina, sometimes creating a retinal fold or tractional retinal detachment. Because the retina is the “film” that senses light, traction there threatens vision. WebEyePMC

3) Combined (Anterior + Posterior) PFV
This is actually the most common presentation—both the front and back of the eye show features. Combined disease often means a more complex exam and imaging plan to map all the affected structures. RadiopaediaScienceDirect

PFV is a classic cause of leukocoria (a white pupil reflex) in infants and toddlers; it is a well-known mimic of retinoblastoma, and careful imaging helps tell them apart. Retinoblastoma often shows calcifications on imaging; PFV does not. This distinction matters for safe, appropriate care. EyeWiki+1PMC+1

---

Causes

Important context first: In most children with PFV, there is no identifiable “external” cause—it is sporadic and unilateral. The core cause is failure of normal regression of the fetal hyaloid vessels and primary vitreous. When both eyes are involved or when other birth defects are present, clinicians consider rare genetic or syndromic contributors. The items below group what we know into mechanisms and reported associations. They’re written in plain English to show how each could contribute. Canadian Journal of OphthalmologyEyeWiki

1. Primary mechanism: failure of hyaloid regression. The temporary blood supply in the eye should disappear; when it does not, PFV forms. EyeWiki

2. Too much “stay-alive” signaling (e.g., VEGF) around birth. Persistently high vessel-growth signals can prevent the normal shutdown of fetal vessels. Frontiers

3. Weak cleanup/apoptosis signals. If endothelial cells don’t get the “time to go” message, vessels persist. SpringerLink

4. Reduced macrophage-mediated regression. Macrophages help prune fetal vessels; if this process is impaired, vessels remain. SpringerLink

5. ATOH7 gene (rare, usually bilateral). Homozygous ATOH7 mutations in a large family were linked to PFV; animal models support this role in early eye development. Genetic Eye Diseases Database

6. Norrie disease (NDP gene) association. Some infants with Norrie disease show PFV-like fibrovascular changes and bilateral involvement. PMCNCBI

7. COX15 mutation (rare syndromic report). A mitochondrial gene variant has been reported with bilateral PFV and systemic findings. Canadian Journal of Ophthalmology

8. PITX2 gene (with Peters anomaly). Rare cases link PITX2 mutations to anterior segment malformations plus PFV. Nature

9. FOXC1 gene (with Axenfeld–Rieger traits). When neural crest–related genes are abnormal, anterior segment dysgenesis can coexist with PFV features. PubMed

10. PAX6 (suggested in case reports). Some reports suspect PAX6 involvement when PFV coexists with other ocular anomalies. PMCScienceDirect

11. Chromosome 6p25 deletion (Axenfeld–Rieger spectrum) reported with PFV. This chromosomal change has been described with ARS and PFV in rare cases. SpringerLink

12. Combined anterior-posterior ocular maldevelopment. When multiple developmental steps misfire, the fetal vasculature may not regress on time. SpringerLink

13. Abnormal Wnt-pathway signaling during regression. Wnt signals help coordinate macrophage-mediated vessel pruning; disruption can stall regression. SpringerLink

14. Genetic “modifier” influences (unspecified). Reviews emphasize no single dominant PFV gene; bilateral disease raises suspicion for genetic contributions. Specialty Vision

15. Severe microphthalmia as part of a broader developmental sequence. When the eye is very small from early on, normal vascular remodeling can be disturbed. PMC

16. Morning glory optic disc and other complex malformations (reported co-occurrence). Complex ocular malformations can travel together, including PFV. PMC

17. General embryonic vascular dysregulation (animal models). Multiple knockout/transgenic models show that disturbing vessel growth or apoptosis leads to PFV-like tissue. ScienceDirect

18. Persistent tunica vasculosa lentis in the lens region. If the lens-feeding network doesn’t regress, a retrolental membrane forms (anterior PFV). WebEye

19. Persistent hyaloid artery and Cloquet’s canal remnants. If the artery and its channel don’t involute, a stalk can form (posterior PFV). PMC

20. Sporadic, idiopathic development (the most common “cause”). In many infants, no external trigger is found—the process is simply incomplete. Canadian Journal of Ophthalmology

---

Symptoms and Signs

Because PFV starts at birth, babies and toddlers cannot describe symptoms. Most clues are visible signs parents or clinicians notice, or findings doctors see on exam. Here are common ones in plain English:

1. Leukocoria (white pupil). Instead of a reddish reflex in photos, the pupil looks white or gray. EyeWiki

2. Poor visual attention in one eye. The child may favor one eye or not fixate well, especially if PFV blocks the visual axis. American Society of Retina Specialists

3. Amblyopia (lazy eye). When one eye is blurry early in life, the brain can suppress it, causing long-term vision reduction if untreated. American Society of Retina Specialists

4. Strabismus (eye misalignment). One eye may turn inward or outward as the brain relies on the “better” eye. American Society of Retina Specialists

5. Nystagmus (eye shaking) in more severe cases. Abnormal eye movements can appear when vision is poor in both eyes or one very early in life. American Society of Retina Specialists

6. Microphthalmia (small eye). The affected eye often looks smaller, especially in anterior or combined PFV. WebEye

7. Cataract (cloudy lens). A cloudy lens blocks light and worsens the white pupil. WebEye

8. Shallow front chamber. The space in front of the iris can be small, a sign doctors look for with a light or slit lamp. NCBI

9. Elongated ciliary processes. These structures can look pulled forward and stuck to a membrane behind the lens (a typical anterior PFV look). AAO

10. Dilated iris vessels or ectropion uveae. Front-of-the-eye vessels can look prominent; the iris edge may look flipped outward. NCBI

11. Retinal traction or fold (posterior PFV). Internal pulling may distort the retina and impair vision. PMC

12. Retinal detachment (tractional). If pulling is strong, the retina can detach, further lowering vision. PMC

13. Increased eye pressure (glaucoma) or pain/photophobia from pressure. An abnormal front segment can raise pressure and cause discomfort or light sensitivity. NCBI

14. Reduced red reflex at newborn screening. The simple “red reflex” test looks wrong, prompting referral. AAO

15. A relative afferent pupillary defect (RAPD) on exam. Doctors may detect a nerve/retina signal imbalance when shining light between eyes. WebEye

---

Diagnostic Tests

Why so many tests? PFV can look like other conditions (especially retinoblastoma), so doctors use a stepwise combination of observation, hands-on eye tests, and imaging. Below are 20 helpful tests grouped into Physical Exam, Manual Tests, Lab/Pathology, Electrodiagnostic, and Imaging. Each entry says what it is and why it helps.

A) Physical Exam

1. Visual behavior and fixation preference. The clinician watches how the baby fixates and follows a target and whether one eye is preferred. This screens for amblyopia and unequal vision. American Society of Retina Specialists

2. External inspection for eye size. A simple look compares eye sizes; a smaller eye (microphthalmia) supports PFV, especially anterior/combined types. WebEye

3. Pupil and iris check with a penlight. A white reflex or irregular iris features can suggest PFV and guide urgent referral. AAO

4. Alignment screening. Observing for strabismus (eye turning) helps detect vision asymmetry due to a blocked visual axis. American Society of Retina Specialists

5. Nystagmus check. The presence of involuntary eye movements suggests significant early visual loss, prompting full imaging. American Society of Retina Specialists

B) Manual Tests (hands-on office tests)

6. Brückner (red reflex) test. Using a direct ophthalmoscope, the clinician compares the red reflexes. An asymmetric or white reflex points to cataract or retrolental tissue seen in PFV. AAO

7. Handheld slit-lamp biomicroscopy. A close look at the front of the eye may show retrolental membrane, stretched ciliary processes, or shallow anterior chamber typical of anterior PFV. AAO

8. Indirect ophthalmoscopy (often under anesthesia). This wide-angle look can reveal a hyaloid stalk, retinal fold, or traction in posterior/combined PFV. WebEye

9. Cycloplegic retinoscopy/refraction. After safe dilating drops, the doctor measures refractive error; significant anisometropia or high hyperopia can accompany PFV and amblyopia risk. American Society of Retina Specialists

10. Handheld tonometry (iCare/Perkins). Measures eye pressure to screen for PFV-related secondary glaucoma, especially with shallow chambers. NCBI

C) Lab and Pathological Tests

11. Histopathology (when surgery is done). If cataract or membrane tissue is removed, the lab can confirm fibrovascular tissue consistent with PFV remnants. This is not for initial diagnosis but confirms the nature of the tissue. Nature

12. Targeted genetic testing in bilateral/atypical cases. Panels may include ATOH7 and genes linked to anterior segment dysgenesis (e.g., PITX2/FOXC1) or NDP when features suggest Norrie disease. This helps counsel families and look for systemic issues. Genetic Eye Diseases DatabasePubMedNCBI

13. RB1 genetic testing—if retinoblastoma is a concern. When the picture is unclear, ruling out retinoblastoma with appropriate genetics supports a safe plan. (Imaging remains first-line for differentiating.) EyeWiki

14. Infection work-up when indicated (TORCH). If history or exam hints at congenital infection as a leukocoria cause, targeted serology can help exclude look-alikes; this is not routine for straightforward PFV. AAO

D) Electrodiagnostic Tests

15. Electroretinography (ERG). ERG checks retina function. In eyes with posterior PFV and retinal traction or detachment, ERG helps estimate visual potential and guide expectations. (General pediatric retina practice.) Lippincott Journals

16. Visual evoked potentials (VEP). VEP measures how signals travel from eye to brain. It is useful in infants to objectively assess pathway function when the media are partly clear. (General pediatric neuro-ophthalmic practice.) Lippincott Journals

E) Imaging Tests (the big differentiators)

17. B-scan ultrasonography (US). This bedside ultrasound can see through cloudy media to detect a retrolental mass or stalk, shorter axial length consistent with PFV, and—critically—the absence of calcifications that would raise concern for retinoblastoma. EyeWiki

18. Ultrasound biomicroscopy (UBM). A high-frequency ultrasound that maps the anterior segment in detail, showing shallow chambers, elongated ciliary processes, and retrolental membranes to plan surgery. ResearchGate

19. MRI of the orbits/brain. MRI helps distinguish PFV from retinoblastoma and other leukocoria causes, without radiation. Doctors look for no calcification, microphthalmia, Cloquet’s canal/stalk, or retinal folds that favor PFV. PMC+1

20. Optical coherence tomography (OCT ± OCT-A). OCT gives a microscopic cross-section of the retina and posterior lens surface. It helps show retinal traction, foveal development, and photoreceptor layer status; OCT-angiography can reveal abnormal flow patterns in PFV eyes. Modern OptometryPMC

Non-pharmacological treatments (therapies & other supports)

Important: These do not “dissolve” PFV. The core problem is structural, so surgery is often needed. These steps support vision, protect the better eye, and improve long-term outcomes.

1. Early referral after an abnormal red reflex: fastest path to diagnosis and timely care. PMC

2. Regular specialist follow-up schedule: needed to watch for glaucoma, detachment, and amblyopia over years. WebEye

3. Amblyopia therapy (patching): covering the stronger eye hours per day trains the brain to use the weaker eye after surgery; dosing varies by age and response. AAO

4. Glasses or contact lenses for aphakia or anisometropia: clarity and focus are essential to teach the brain to see. Scleral or silicone-elastomer pediatric lenses are common after lens removal. WebEye

5. Visual stimulation / early intervention programs: simple high-contrast toys, face-to-face play, and therapist-guided activities to reinforce visual pathways. AAO

6. Orthoptics / vision therapy elements (home tracking tasks, fixation practice) as adjuncts to patching in selected cases. AAO

7. Protective eyewear for sports/play to guard the better eye and the operated eye. AAO

8. UV and glare control: hats and kid-safe sunglasses (100% UV) to reduce light discomfort after surgery. WebEye

9. Low-vision services (if vision remains limited): lighting, magnifiers, contrast-rich print, and classroom accommodations. AAO

10. School support plans: seating, large-print materials, and teacher awareness to reduce visual strain. AAO

11. Parental coaching for drop/patch adherence: routines, charts, and reward systems increase success. AAO

12. Infection-prevention habits after surgery: clean hands for drops, shield at night, no eye rubbing. PMC

13. Safe sleep/head positioning if gas bubble is used (surgeon’s instructions) to keep the retina attached. Retina Today

14. Avoid trampoline/high-impact play early after retinal procedures until the surgeon clears it. Retina Today

15. Genetic counseling if PFV is bilateral or there’s family history of retinal vascular disorders. MDPI

16. Family psychological support: helps with chronic care demands and adherence. (Good pediatric practice.) AAO

17. Nutrition guidance (see section below): supports general eye development; does not cure PFV. Office of Dietary Supplements

18. Sunrise-to-sunset routines for patching and drops: habits make daily therapy more reliable. AAO

19. Emergency action plan: if there’s sudden redness, pain, or vision drop, know how to reach the eye team immediately. WebEye

20. Protective strategies for the better eye long-term: eye safety at home/school/sports across childhood. AAO

---

Drug treatments used around PFV care

(class • typical pediatric use/timing • purpose • mechanism • key side effects/notes)

Safety note: Dosing in infants/children is specialist-directed. Never start or change eye drops without your pediatric ophthalmologist’s plan.

1. Prednisolone acetate 1% (topical steroid): Often used after PFV/cataract surgery, e.g., 4–6×/day then taper over 4–6 weeks to calm inflammation and protect the healing eye. It reduces inflammatory gene signaling via glucocorticoid receptors. Side effects: steroid IOP rise, delayed healing, infection risk — so follow the taper exactly. PMCThe Open Ophthalmology Journal

2. Loteprednol 0.5% gel (soft steroid): Alternative to prednisolone; a randomized pediatric trial showed similar effectiveness for post-cataract inflammation. Often chosen if steroid IOP spikes occur. Side effects are similar but sometimes milder on IOP. Lippincott Journals

3. Atropine 1% (cycloplegic): Used after surgery to rest the iris/ciliary body, prevent painful spasm, and reduce synechiae; also used as amblyopia penalization in some ages. Typical post-op schedules range from daily to every other day for short courses (exact plan varies). Mechanism: muscarinic blockade causing dilation and ciliary paralysis. Side effects: light sensitivity, flushing/fever if over-absorbed; keep drops away from mouth/nose and follow pediatric dosing. PMC

4. Antibiotic drops (e.g., moxifloxacin or combo steroid–antibiotic): Short post-op prophylaxis, often 4–6×/day then taper to reduce surface bacteria while the wound seals. Side effects: local irritation; allergic reaction is uncommon. PMC

5. Timolol (β-blocker, topical) for elevated IOP: Used if glaucoma occurs after PFV surgery. Pediatric regimens are individualized (often 0.25–0.5% once or twice daily, clinician-directed). Purpose: lower aqueous production to reduce pressure. Side effects: slow heart rate, wheeze in susceptible children — pediatric oversight is essential. Mayo ClinicPubMed

6. Dorzolamide 2% (topical carbonic anhydrase inhibitor): Another pressure-lowering drop in children; pediatric studies (including <6 years) show acceptable safety. Purpose: reduce aqueous fluid production. Side effects: stinging, rare allergy. U.S. Food and Drug AdministrationPMC

7. Dorzolamide-Timolol combination (e.g., Cosopt): Used when one drop isn’t enough; caution with timolol concentration in young children. Purpose: dual mechanism pressure control. Side effects combine the above; avoid in certain heart/lung conditions. EyeWiki

8. Acetazolamide (oral carbonic anhydrase inhibitor): Short-term systemic help when IOP spikes or while awaiting surgery; pediatric dosing is weight-based (example ranges often ~10–20 mg/kg/day divided, specialist-set). Side effects: tingling, appetite loss, metabolic acidosis; needs careful follow-up. PediatricsPMC

9. Avoid/Use with extreme caution — Brimonidine (α2-agonist): Contraindicated in infants <2 years due to serious CNS depression and apnea. If a child is older, specialists weigh risks carefully. FDA Access DataPMC

10. Anti-VEGF (e.g., bevacizumab) — investigational/adjunct only: In rare selected cases, surgeons have reported using pre-op anti-VEGF to reduce bleeding risk from very vascular PFV tissue, not as a stand-alone cure. Evidence is limited to case reports; it may change traction forces, so this is strictly surgeon-directed and not routine. SAGE Journals+1

---

Dietary “molecular” nutrients

Plain truth: Food and supplements cannot reverse PFV. Nutrition supports overall eye and brain development and post-operative healing. Infants should not receive supplements unless prescribed. For pregnancy/breastfeeding, and older children, these are the usual evidence-based focuses:

1. Omega-3s (DHA/EPA): In pregnancy/breastfeeding, 8–12 oz/week low-mercury fish supports infant neuro-visual development; DHA helps retinal/brain membranes. Food: salmon, sardines; if supplementing, use products vetted by your obstetric/pediatric team. U.S. Food and Drug AdministrationOffice of Dietary SupplementsUS EPA

2. Vitamin A (and provitamin A carotenoids): Vital for the visual cycle and immune function. Use normal dietary amounts (orange/green veg, dairy, eggs); avoid megadoses, especially in pregnancy. Office of Dietary Supplements

3. Lutein & Zeaxanthin: Macular pigments concentrated in the retina; get them from leafy greens, eggs, corn. Supplements are usually not needed for children unless advised. PMC+1

4. Vitamin D: Important for general health and possibly ocular development; follow pediatric RDAs/AI and avoid excess. Office of Dietary Supplements

5. Zinc: Cofactor in many retinal enzymes; food sources include meat, legumes, and nuts (age-appropriate textures). Office of Dietary Supplements

6. Choline: Supports neural development (eggs, meats, some beans) — particularly during pregnancy/breastfeeding. U.S. Food and Drug Administration

7. Iodine: Needed for neurodevelopment; ensure adequate intake in pregnancy/breastfeeding (iodized salt, seafood). U.S. Food and Drug Administration

8. Vitamin C & E (antioxidants): Broad tissue support from fruits/vegetables and nuts/seeds; no PFV-specific effect, but part of balanced diet. Office of Dietary Supplements

9. Protein-rich foods: For healing after surgery (fish, poultry, legumes, dairy). Office of Dietary Supplements

10. Hydration & fiber: For overall recovery comfort and medication tolerance (e.g., acetazolamide can reduce appetite). PMC

High-mercury fish to avoid in pregnancy/young children: bigeye tuna, king mackerel, shark, swordfish; prefer “Best Choices” list. U.S. Food and Drug Administration

---

Regenerative / stem-cell drugs

There are no approved “immunity boosters,” regenerative drugs, or stem-cell medications that treat PFV as of August 21, 2025. PFV is a developmental structural condition; care is surgical + amblyopia + glaucoma management. Experimental ideas (gene therapy to Wnt/Norrin pathways, pharmacologic vessel-regression triggers, cell-based repairs) remain research-only. If you see clinics offering stem-cell “cures” for PFV, that is not standard of care and may be unsafe. Ask your pediatric ophthalmologist about clinical trials if you’re interested in future therapies. EyeWikiAAO

Safer alternatives right now (6 evidence-guided domains):

1. Timely surgery when indicated. 2) Rigorous amblyopia therapy. 3) Accurate optical correction. 4) Careful glaucoma monitoring/treatment. 5) Low-vision and school supports if needed. 6) Family education and long-term follow-up. PMCAAO

---

Surgeries

1. Lensectomy + anterior vitrectomy (front-of-eye PFV): Removes the cloudy lens and front membranes, often with cautery of the vascular stalk tips to prevent bleeding. Goal: clear the visual axis, reduce traction, and make space in a small eye. AAO+1

2. Pars plicata/pars plana vitrectomy (back-of-eye PFV): For posterior or combined PFV, the surgeon removes fibrous/stalk tissue, relieves traction, and repairs the retina; small-gauge instruments are used, with age-based sclerotomy placement to avoid damage. PMCPubMed

3. Membranectomy / stalk transection: Carefully cutting/removing the persistent stalk/membranes reduces pulling on the retina; sometimes done with endodiathermy to control bleeding. Austin Publishing GroupAAO

4. Retinal reattachment steps (if needed): internal laser, and sometimes gas tamponade with post-op head positioning; scleral buckle is rarely needed in PFV patterns. Retina Today

5. Glaucoma surgery (if pressure stays high): angle surgery (goniotomy/trabeculotomy) or other pediatric glaucoma procedures may be used when drops are not enough. EyeWiki

Outcomes: Anterior PFV generally has better surgical and visual outcomes than posterior forms, especially with early intervention and strong amblyopia care. EyeWikiPMC

---

Prevention points

• Primary prevention of PFV is not known. Most cases are sporadic and not due to anything a parent did. EyeWiki

• Do the newborn red-reflex check and re-check at well-child visits; get prompt referral if it’s abnormal. PMC

• Prenatal care and avoiding known teratogens (alcohol, tobacco, high-mercury fish) support overall fetal development, even though they don’t specifically prevent PFV. U.S. Food and Drug Administration

• Protect the better eye with safety eyewear during sports/play as the child grows. AAO

• Early surgery when indicated prevents secondary damage (retinal detachment, glaucoma). PMC

• Amblyopia therapy adherence prevents vision loss from brain “ignoring” the weaker eye. AAO

• Post-op drop hygiene and shield use lower infection risk. PMC

• Routine pressure checks to catch glaucoma early. WebEye

• Follow-through on glasses/contacts to give the eye a focused image. WebEye

• Ask about genetics if PFV is in both eyes or there’s a family pattern of retinal vascular disease. MDPI

---

When to see a doctor

• Right away if you notice a white pupil, wandering eye, or the baby doesn’t track faces/toys by expected ages.

• Urgent if the operated eye becomes very red, painful, very light-sensitive, if the child vomits with eye pain, or you see a sudden vision drop — these can signal infection, high pressure, or retinal problems. PMCWebEye

---

What to eat and what to avoid

1. During pregnancy/breastfeeding: eat 8–12 oz/week low-mercury fish (e.g., salmon, sardines) for DHA; avoid high-mercury fish (swordfish, shark, bigeye tuna). U.S. Food and Drug Administration

2. For kids (age-appropriate): fatty fish 1–2×/week; eggs and dairy if tolerated for vitamin A and choline. US EPA

3. Leafy greens and colorful produce for lutein/zeaxanthin and antioxidants. PMC

4. Whole grains, beans, lean proteins to support healing after surgery. Office of Dietary Supplements

5. Use iodized salt (small amounts) and include iodine sources if pregnant/breastfeeding. U.S. Food and Drug Administration

6. Adequate vitamin D per pediatric guidance (diet, safe sun, or prescribed supplement). Office of Dietary Supplements

7. Avoid megavitamin supplements (especially vitamin A) unless prescribed. Office of Dietary Supplements

8. Avoid herbal/“eye booster” products in infants/children unless your pediatrician approves. Office of Dietary Supplements

9. Limit sugary drinks/ultra-processed snacks; they don’t help recovery or eye health. Office of Dietary Supplements

10. Hydration (water, breastmilk/formula as appropriate) supports comfort and overall health. Office of Dietary Supplements

---

Frequently Asked Questions

1) Is PFV the same as cataract?
No. PFV is a developmental tissue left inside the eye; it can cause a cataract or sit behind a cataract. Removing the cataract alone is often not enough — the PFV membranes/stalk may also need removal. WebEye

2) Did I do something to cause this?
Almost certainly no. PFV is usually sporadic and not linked to parental actions. EyeWiki

3) Can glasses or drops cure PFV?
No. Glasses and drops support vision and control pressure, but they do not remove the persistent fetal tissue. Surgery addresses the structure. PMC

4) How soon should surgery happen?
Timing is individualized, but many cases benefit from early surgery to clear the visual axis and reduce traction, followed by intense amblyopia therapy. PMC

5) Will my child see normally after surgery?
Vision varies. Anterior-only PFV tends to have better outcomes than posterior/combined types. Strong amblyopia therapy and good follow-up help the brain learn to see. EyeWiki

6) Is PFV hereditary?
Most cases are not. Rare bilateral cases or overlaps with other retinal vascular gene conditions may have genetic components; ask about testing. MDPI

7) How do doctors tell PFV from retinoblastoma?
Clinical exam plus ultrasound and MRI (no radiation) help distinguish them. PFV lacks the calcifications typical of retinoblastoma. PMC

8) Is brimonidine a safe glaucoma drop in babies?
No for infants <2 years. It’s contraindicated due to serious CNS side effects. Other drops (timolol, dorzolamide) may be used carefully by specialists. FDA Access DataPubMed

9) Are anti-VEGF injections a PFV cure?
No. They’re not standard for PFV. A few case reports used them as adjuncts to reduce bleeding risk, but surgery remains the main treatment. SAGE Journals

10) Will my child need glasses or a contact lens?
Often yes, especially if the lens is removed (aphakia). Good optical correction is essential for visual development. WebEye

11) What about school and sports?
Most children do well with classroom adjustments and protective eyewear. Your eye team can write a support letter. AAO

12) Could PFV come back after surgery?
The tissue doesn’t “grow back,” but membranes can re-form or the retina can re-detach in some cases, which is why follow-up is vital. PMC

13) How long will we need follow-up?
Usually for years, because children’s eyes change and risks like glaucoma can appear later. WebEye

14) Can diet or vitamins fix PFV?
No. Diet supports general health; PFV is a structural issue. Follow surgical/amblyopia plans; use nutrition as healthy support. Office of Dietary Supplements

15) What’s the single most important thing parents can do?
Stick closely to the plan: attend all visits, give drops exactly as prescribed, patch as directed, and protect the better eye. These steps maximize the child’s visual potential. AAO

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: August 21, 2025.