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Retinal Tears: Diagnosis & Repair

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Retinal tears are rips in the retina, the layer of light-sensitive tissue in your eye responsible for sending important visual information to the brain.

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While usually easy to treat, retinal tears can cause retinal detachment if left untreated, which is a much more serious condition.

What Is the Retina?

The retina is an important layer composed of retinal tissue in the eye. In a healthy eye, this thin layer of tissue takes in light and translates it into information the brain can understand.

The retina is one of the most important parts of the eye for sight. It is also vulnerable to tearing due to how thin it is and some of the natural biomechanics of aging.

Symptoms of a Retinal Tear

Common symptoms of a retinal tear include the following:

  • Blurry vision
  • Flashing lights, sometimes described as seeing stars
  • Unexplained floaters in your field of vision
  • A shadow in your visual periphery

One of the more serious symptoms that sometimes accompanies a retinal tear is the appearance of a gray curtain-like shroud in part of your field of vision. This may be the sign of a retinal detachment, a more serious eye health condition that retinal tears can cause. Retinal detachment may lead to permanent vision loss if not promptly treated.

Causes

The most common cause of retinal tears is a complication as a result of vitreous detachment. The vitreous is a gel-like substance in the eye that fills in the back cavity, where your retinal tissue also sits. The vitreous begins attached to the retina, but it separates as we age.

Most people undergo this separation without major issues, but sometimes, the vitreous is sticky and can pull on the retina. This can cause tears or holes to form in the retina as a result.

Trauma to the eye can also sometimes cause retinal tears.

Risk Factors for Retinal Tears

These are some common risk factors for developing a retinal tear:

  • Advanced age
  • Trauma or eye surgery
  • Lattice degeneration (thin patches in the retina)
  • Significant myopia (nearsightedness)
  • A family history of retinal tears or retinal detachment

At this time, doctors cannot accurately predict when or if a person might get a retinal tear beyond helping them understand if they’re in a high-risk group. Even people who are not in one of the high-risk groups can experience a retinal tear. Conversely, people in multiple high-risk groups don’t necessarily develop retinal tears.

Diagnosis of a Retinal Tear

Doctors can diagnose a retinal tear by applying slight pressure to the eye during a test called a scleral depression, or by using a special mirror lens.

Sometimes, doctors may use what is called an ophthalmic ultrasound if the retina is obscured due to a hemorrhage. This is somewhat common if the retina has a tear or hole.

Treatment for a Retinal Tear

Usually, retinal tears can be sealed using a freezing procedure called cryotherapy or with a laser. The treatment is usually done in a doctor’s office. It doesn’t take very much time, and it is both safe and effective by modern medical standards. The procedure may cause mild discomfort, but an anesthetic is used, preventing serious pain.

Some retinal tears don’t require any treatment, as they heal on their own. However, it is important to have a medical professional make that determination. Always promptly see a doctor if you believe you may have a retinal tear, as they can worsen over time.

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Prognosis

When promptly treated, retinal tears usually cause no serious lasting symptoms. Treatment is generally straightforward and effective.

However, experiencing a retinal tear does increase your chance of experiencing a future tear. For this reason, follow-up eye exams are important.

Potential Complications if Untreated

If left untreated, naturally occurring fluid can leak through a retinal tear. This can cause the retina to detach.

Retinal detachment is a serious condition that can cause permanent vision loss. This risk is the primary reason a retinal tear requires medical assessment as soon as you suspect a problem.

When to See a Doctor

Generally speaking, an ophthalmologist is the type of medical professional most suited to treat retinal tears. In some cases, a retinal specialist (a subspecialty of ophthalmology) may be necessary, but your ophthalmologist can refer you to one if they believe that is necessary. Retinal Tears FAQs

Retinal Tears FAQs

How serious is a retinal tear?

Retinal tears are serious if left untreated, as they can cause retinal detachment, a much more serious eye health condition that can cause permanent vision loss in the affected eye. However, if treated promptly, the overall prognosis for retinal tears is generally very good.

What causes retinal tears?

Usually, retinal tears are caused by the vitreous pulling on the retina, which is very thin. While the vitreous naturally detaches from the back of the eye as we age, the retina can sometimes stick to it as it moves, which may cause complications.

What are the symptoms of a retinal tear?

The earliest symptoms of retinal tears are generally floaters, which are tiny dots that float around your field of vision. You may also see unexplained flashes of light. Over time, your vision may blur and you may see shadows in the periphery of your vision.

Can a retinal tear heal on its own?

In some cases, a retinal tear can heal on its own, but treatment is generally required. Without treatment, retinal tears may progress to retinal detachment, which can result in permanent vision loss.

How is a retinal tear treated?

A retinal tear is generally treated with cryotherapy or laser treatment.

References

  1. Detached Retina (Retinal Detachment). (December 2020). UK NHS.
  2. Retinal Tears. (2016). American Society of Retina Specialists.
  3. Retinal Detachment Surgery in the Aging Eye. (October 2021). Retina Today.
  4. Vitreous Hemorrhage: Diagnosis and Treatment. (March 2007). American Academy of Ophthalmology.
  5. Insights into the Genetic Basis of Retinal Detachment. (December 2019). Human Molecular Genetics.
  6. What Is a Torn Retina? (November 2021). American Academy of Ophthalmology.
  7. Interventions for Asymptomatic Retinal Breaks and Lattice Degeneration for Preventing Retinal Detachment. (January 2016). Cochrane Database of Systematic Reviews.
  8. The Role of Scleral Depression in Modern Clinical Practice. (September 2018). American Journal of Ophthalmology.
  9. Randomized Clinical Trial of Cryotherapy Versus Laser Photocoagulation for Retinopexy in Conventional Retinal Detachment Surgery. (September 2001). American Journal of Ophthalmology.
  10. Posterior Vitreous Detachment – Prevalence of and Risk Factors for Retinal Tears. (June 2017). Clinical Ophthalmology.

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