Retinal tear / detachment

(also called vitreous separation)

As part of the aging process, at some point in our life, the vitreous will shrink and separate from the back of the eye. The onset of the vitreous separation is usually accompanied by symptoms of floaters and flashes.

Because the retina is an extremely thin and fragile structure, if the vitreous separation produces sufficient force, it can cause a break or tear in the retinal surface. Fortunately, when the retina tears, it usually does so in the far corners of the retina, which therefore does not compromise the patient’s vision. However, retinal breaks or tears can over time (days to years) begin to accumulate fluid underneath them, which can gradually cause the retina itself to separate from the wall of the eye with disastrous consequences on one’s vision.

It is for this reason, that patients who have symptoms of vitreous separation should be evaluated for the presence of retinal tears. If retinal tears are found, they are usually sealed (using laser therapy or cryotherapy) in order to prevent retinal detachment from occurring.

Once retinal detachment occurs, it is important for the patient to have the condition repaired before the central part of the retina (macula) itself becomes involved in the retinal detachment. Once the macula is involved, the prognosis for good vision, even after successful repair, is reduced. Methods of repair of retinal detachment include pneumatic retinopexy in the doctor’s office and vitrectomy in the hospital. The type of procedure recommended depends on the specific characteristics of the retinal detachment.