About Retinal Tears & Detachments
A retinal tear is a serious condition that needs treatment. It can progress to a retinal detachment that can cause a loss of vision. The most common cause of a retinal detachment is when a tear forms from traction on the retina exerted by the vitreous, the gel inside the eye, as it pulls away from the back of the eye. The process of vitreous shrinkage as we age is normal and usually doesn’t cause problems, but if the symptoms of new floaters or associated flashes are present in your vision, it is important to contact your eye doctor for an appointment as these can be a signal that a tear has formed in the retina.
As you age, the vitreous, a gel-like substance in the back of the eye, shrinks and becomes more liquified. As this occurs, an outer cortex or shell, like the skin of a water balloon, remains attached to the retina. Eventually, the cortex of the gel will start to pull away from the back of your eye. As it does, it may tug on the delicate retina tissue where it can be more adherent and cause a tear.
A retinal tear isn’t painful and doesn’t always have obvious symptoms. Important visual symptoms that you may notice include:
- A sudden increase in floaters or a new, very large floater
- Flashes or lights going off in your vision
- Gray or shadowy vision, particularly at the periphery
- A curtain-like effect coming down or the appearance of a boulder rising up in your vision
A retinal detachment disconnects the retina from the back of the eye and an important cell layer underneath the retina called the retinal pigment epithelium (RPE) that nourishes it. There are several types of retinal detachments. The most common type begins as a tear or hole that allows liquified vitreous fluid to seep behind the retina. Eventually, the retina loses its hold and lifts out of its proper position.
Once detached, the cells in your retina begin to die, which is why, if you have symptoms of a retinal detachment, you should be evaluated right away. Contact Vance Thompson Vision if you have these symptoms:
Without treatment, a retinal detachment can cause permanent blindness. Early intervention is vital to preserving your vision.
Treatments for Retinal Tears & Detachments
A retinal tear can often be fixed in the clinic with a procedure called a retinopexy. This procedure typically uses a laser to create a seal around the tear to prevent fluid from leaking under your retina. Sometimes a procedure called cryotherapy will be used to create the seal around the tear as well which involves creating a small freeze spot on the retina.
A retinal detachment is more serious. In some cases, an in-office procedure called a pneumatic retinopexy may be possible. Often it has to be repaired with surgery. The specific procedure depends on your medical history and needs. Retinal detachments are addressed using one or a combination of three main ways:
- Vitrectomy: A procedure that removes the vitreous gel to allow your surgeon to reattach the retina and seal tears and holes.
- Scleral Buckle: This procedure places a silicone band around the eye for external support on the site of the hole or tear causing the detachment.
- Pneumatic Retinopexy: A small gas bubble is placed in the eye and allowed to expand. Lasers or cryotherapy (freezing) are used to then seal the edges of a retinal tear once the retina has reattached underneath the bubble.