RETINAL TEARS

Retinal Tears are breaks most frequently found in the peripheral retina. They may be accompanied by symptoms of light flashes and/or the sudden onset of multiple constant floaters. Prompt treatment of retinal tears is important in preventing retinal detachment.

What causes retinal tears?
Retinal tears are caused by pulling on the retina by the vitreous gel. The vitreous gel is a clear, jelly-like substance that fill the inside of the eye. With age, the vitreous becomes more watery and the gel portion begins to gradually pull away from the retina. This process, called Posterior Vitreous Detachment (PVD), is a normal aging change. However, in some areas, the vitreous attachment to the retina may be so strong that the separation of the vitreous gel from the retina causes a tear at the point of adherence.

What causes the symptoms of light flashes and floaters?
Flashes of light are a direct result of the vitreous pulling on and stimulating the retina. Floaters are debris (protein clumps) pulled free when the vitreous detachment occurs. Floaters that appear as a “swarm of bees” may represent a small amount of bleeding from the torn retina.

Why is treatment necessary?
Treatment of retinal tears is important in preventing retinal detachment. If the tear is not sealed, fluid from the vitreous may get beneath the retina through the tear and the retina begins to separate from the wall of the eye (retinal detachment). If detached, the retina is unable to function and visual loss results.

What is the recommended treatment?
There are two types of treatment used to seal retinal tears: Laser photocoagulation and cryotherapy. The decision as to the type of treatment depends upon the location of the tear and whether there is fluid beneath the surrounding retina.

How does the treatment work?
The goal of treatment is to seal the area surrounding the tear to prevent any vitreous fluid from entering the space between the retina and the wall of the eye. Laser photocoagulation is a bright light which can seal the tear. Cryotherapy is freezing treatment to the area surrounding the tear. In both cases, the eye forms a localized scar around the tear, which prevents fluid from getting beneath the retina. Both treatments require approximately 5 days to create an adequate sealing effect. During that healing period there is a risk that the retina could still detach despite treatment.

What should be expected after treatment?
After treatment, the eye may be a little sore for a couple of days. Usually Tylenol or Advil and the application of a cold compress is sufficient to relieve any discomfort.

Will vision be affected following treatment?
Vision may be somewhat blurred and “floaters” may be more obvious in the days following the treatment. The treatment does not “cure” the floaters, but most patients report that they become less noticeable with time.

What would be the warning signs that a retinal detachment has occurred?
Loss of side vision, like a black curtain or shadow coming form the periphery and moving toward the center, is a common symptom of retinal detachment. Warning signs of retinal detachment or any significant decrease in vision should be reported to your physician immediately.

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