Retinal Tears and Detachments
Located in the back of your eye is the retina, a thin layer of photosensitive tissue that enables you to see by translating light into neural signals that are sent to and interpreted by the brain. Sometimes tears can form in the retina, causing serious vision issues. A retinal tear can also lead to the entire retina moving out of its proper position, known as a retinal detachment.
Should this occur, the retina cannot perform its function, causing significant vision issues and loss. Both retinal tears and detachments require immediate treatment, including in-office procedures and surgery, as they can cause permanent damage and irreversible blindness. If addressed early, retinal detachment surgery is typically successful and you can expect improved vision with few issues afterward.
What Are Retinal Tears and Detachments?
While various factors can contribute, retinal tears and detachments typically occur due to problems with the vitreous gel (or vitreous humor). This clear, jelly-like liquid fills about 80% of the eye’s total volume and is responsible for maintaining the eye’s shape.
As you age, the vitreous gel naturally begins to shrink and lose its thickness. Also referred to as posterior vitreous detachment (PVD), this is generally harmless. However, if the vitreous gel sticks to the retina and pulls away from it, it can cause a retinal tear. The tear can then create an opening, allowing more fluid to leak through. If enough fluid seeps in, the retina can become completely detached from the eye’s back wall.
Risk Factors for Retinal Tears and Detachments
While PVD is the primary cause, certain risk factors can increase your chances of developing a retinal tear or detachment. These include:
- Previous retinal tear or detachment in your other eye
- A family history of retinal detachment
- Weakened areas in the retinal tissue
- Myopia or nearsightedness
- Traumatic eye injury
- Previous eye surgery
Retinal Tear and Detachment Signs and Symptoms
Retinal tears and detachments are painless, and in the case of tears, there may not be any noticeable symptoms. However, if the tear gets bigger, symptoms will become increasingly noticeable. These symptoms tend to intensify just before the retina fully detaches. If any of these symptoms appear, you should seek immediate help from an ophthalmologist, or you may risk permanent vision loss in the affected eye.
- The sudden appearance of new floaters and flashing lights in your field of vision
- A shadow or blurriness appearing in your peripheral (side) vision.
- A gray curtain covering part of your field of vision.
How Are Retinal Tears and Detachments Diagnosed?
If you notice any retinal tear or detachment symptoms, you must quickly schedule an eye exam. These symptoms may not always indicate a retinal tear or detachment and may be due to another issue. Nevertheless, the sooner you’re diagnosed, the sooner your retina specialist can provide treatment.
To diagnose your condition, your retina specialist will provide an examination that includes dilation, in which drops widen your pupil, providing a better view of the retina. They will then observe your retina for any changes with a special lens. Your doctor may also use scleral depression, slight pressure applied to the eye, along with a 3-mirror lens. If the retinal view is obstructed, such as from a hemorrhage or excess bleeding, ophthalmic ultrasound may be required for diagnosis.
Treatments for Retinal Tears and Detachments
In most cases, retinal tears are treated with laser surgery or cryotherapy, a freezing technique. Typically, these procedures are conducted in-office, and you should expect little if any discomfort. Both methods effectively seal tears and secure the retina to its proper position, and help prevent full detachments. But as there is the risk of developing additional, separate tears, continued monitoring is important.
You should know that not all retinal tears require treatment, and patients with no symptoms can just be monitored. It is also possible that some tears may self-heal, with adhesion developing around the tear without treatment.
As for retinal detachments, these are usually treated surgically. And the sooner performed, the better your chances of experiencing vision improvements. Among the more common surgical procedures are:
- Scleral Buckle – With this procedure, a flexible piece of material pushes the sclera, the eye’s white part, against the retina, securing the retina in its proper place.
- Pneumatic Retinopexy – This procedure, which may be performed in conjunction with laser therapy or cryotherapy, involves a gas bubble being injected into the eyeball’s vitreous cavity. This helps to push the torn retina closed. As your eye heals, new fluid is made that fills the eye.
- Vitrectomy – This surgery involves the removal of the vitreous gel. With this procedure, the surgeon can repair the detached retina or remove the force pushing it out of place. Generally, the vitreous gel is replaced with a gas bubble.