Retinal Tear Causes, Symptoms & Treatments

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What is a Torn Retina?

A torn retina is a severe eye problem that can make your vision blurry. A torn retina will have a tear or hole resembling a rip in cloth. It often leads to a more serious condition called a detached retina.

A detached retina is where the retina is lifted away from the back of the eye. A torn retina requires immediate treatment to prevent further problems (like vision loss).

What Causes a Retinal Tear?

As you age, the vitreous in your eyes begin to shrink and become liquefied. Typically, the vitreous moves around without causing issues. The vitreous is attached to the retina in certain areas. 

Normally, the vitreous detaches from the retina without issue. But in some cases, the vitreous detachment pulls off a portion of the retina, causing a tear. 

When this happens, fluid can pass through the tear and lift or detach the retina. When the retina tears, you may see flashes of light or floaters

Sometimes blood can leak into the vitreous. This is known as a vitreous hemorrhage. A vitreous hemorrhage can cause a large number of floaters.

Who is at Risk of Developing a Retinal Tear?

There are several risk factors for having a torn retina:

  • Requiring glasses to view far away (nearsighted) 
  • Taking glaucoma medications that restrict the pupil (such as pilocarpine) or make it small (such as pilocarpine
  • Having had a severe eye injury 
  • Having a detachment retinal tear or in the opposite eye
  • Having family members with retinal detachment 
  • Having thin spots in the retina 

Warning Signs of a Torn Retina

A torn retina must be checked by an ophthalmologist or eye doctor immediately. Otherwise, your retina may detach, resulting in vision loss

Speak with an ophthalmologist immediately if you notice any of these warning signs:

  • You see flashing lights. Some people say this is like viewing stars after being hit in the eye 
  • You notice many new floaters 
  • A shadow appears in your peripheral vision (side vision)
  • A grey curtain covers some of your field of vision

Retinal Tear vs. Retinal Detachment

Retinal tears are small rips in the retinal tissue. The retina has not yet fully detached, but parts of it are no longer attached to the back of the eye. A retinal tear may lead to retinal detachment.

On the other hand, retinal detachment refers to a partial or complete lack of attachment of the retinal tissue along the back of the eye. A retinal detachment is more severe than a retinal tear.

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The longer a detached retina remains detached, the bigger the risk of permanent vision loss.

How to Prevent a Retinal Tear from Detaching

You can lessen your risk of retinal tears and eye health issues by protecting your eyes. 

You should always wear protective goggles when playing sports like hockey, baseball, or lacrosse and when doing DIY projects. 

It is also essential to take care of your overall health. Make sure that you keep conditions like high blood pressure and diabetes under control. Consuming a healthy diet and doing at least 30 minutes of moderate exercise five days a week helps protect your health.

Even if you do not need glasses or contact lenses, having routine eye exams is an essential part of protecting your eye health and vision.

Most eye diseases and issues do not cause symptoms in the early stages. These include retinal weakness and vitreous changes.

It is best to diagnose and treat problems before they put your vision at risk.

How Do Eye Doctors Check for Retinal Tears?

Your eye doctor or ophthalmologist will check for retinal tears by placing drops in your eyes to dilate the pupil. They will look through a special lens to assess any changes inside the eye.

This is the most efficient way to see if you have a retinal tear or early retinal detachment.

Treatment Options for Torn Retinas 

There are two ways your eye doctor may fix your retinal tear:

Retinal Tear Laser Surgery

During retinal tear surgery, a laser seals the retina to the wall of the eye. The goal is to prevent fluid from entering through the tear and detaching the retina.

Treatment typically takes less than 15 minutes and is performed in your ophthalmologist’s office. The ophthalmologist sets a lens on the front of your eye to focus the laser. They then create tiny burns with the laser to make scars.

The scars seal the retina to the wall of the eye.

Cryopexy

During cryopexy, extreme cold is used to seal the retina to the wall of the eye. The aim is to stop the fluid from going through the tear and detaching the retina.

Cryopexy treatment typically takes less than 30 minutes. It is usually performed in your eye doctor or ophthalmologist’s office.

The surgeon or eye doctor uses a special probe that provides intense and cold energy to the eye retina. This freezes the retina around the tear and produces scar tissue. The scars seal the retina to the eyewall.

How many retinal laser treatments are usually needed?

Laser treatments create a scar within one to two weeks that works to seal the retinal tear. Following treatment, it is essential to monitor the eye to ensure that the tear remains appropriately sealed and that no other tears are developing.

Occasionally, patients require more than one treatment to stabilize the retina.

What are the side effects of retinal tear laser surgery?

Retinal laser surgery is a safe treatment with almost no restrictions and minimal risks and side effects.

Some patients may notice blurring or a decrease in peripheral vision and night vision. However, these effects are typically temporary and go away on their own after a few weeks.

What is the retinal tear laser surgery success rate?

Retinal laser treatment has a success rate of around 90 to 95 percent. Most retinal tears are effectively treated and do not need re-retreatment. There are some individuals who experience retinal tear enlargement (despite surgery). 

These patients may require further laser or cryopexy treatment. If a retinal detachment occurs, surgery is necessary.

Other Conservative Treatments

Some retinal tears are considered low risk without much chance of progressing to retinal detachment, depending on their size and location. For these cases, no treatment is required.

Sometimes the eye spontaneously starts to form a stabilizing scar around the tear. Once a tear has been identified, it must be followed by a trained specialist to ensure that it does not worsen. Retinal tears need to be monitored by a specialist who can take action if necessary.

Common Questions & Answers

Here are some common questions and answers about retinal tears:

How serious is a retinal tear?

The retina is fragile. A tear in the retina is a very severe and potentially blinding problem. If you have a retinal tear, it can enable fluid to enter beneath the retina and lead to a retinal detachment.

What do retinal tear flashes look like?

Retinal tear flashes can be described in several ways. 

These include seeing:

  • A bright spot or streak of light
  • A jagged light that appears like lightning
  • Bursts of light that appear like fireworks or camera flashes

Some people also compare vision flashes to when you hit the back of your head and view bright lights for a few moments.

Are retinal tears common?

Retinal tears and holes are typically common. A healthy, intact retina is vital for clear and healthy vision. When a crack is in this thin tissue, it is known as a tear.

Can a retinal tear heal on its own?

Not all retinal tears need treatment. Low-risk tears may be identified in patients who have no symptoms. These tears may not require treatment.

Some retinal tears heal themselves, meaning they develop adhesion around the tear without treatment. 

Is a retinal tear an emergency?

A retinal tear is an emergency and requires prompt treatment. An individual experiencing loss or impairment of vision or any symptoms linked with a detached or torn retina should seek emergency medical help.

How long does a retinal tear take to heal?

You will require two to four weeks to recover following retinal tear surgery.

Resources
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Retinal detachment, Mayo Clinic, August 2020

What Is a Torn Retina?, American Academy of Ophthalmology, November 2020

Neumann, E, and S Hyams. “Conservative management of retinal breaks. A follow-up study of subsequent retinal detachment.” The British journal of ophthalmology vol. 56,6 (1972): 482-6

Mastropasqua, L et al. “Treatment of retinal tears and lattice degenerations in fellow eyes in high risk patients suffering retinal detachment: a prospective study.” The British journal of ophthalmology vol. 83,9 (1999): 1046-9. doi:10.1136/bjo.83.9.1046

Crim, Nicolas et al. “Myopia as a risk factor for subsequent retinal tears in the course of a symptomatic posterior vitreous detachment.” BMC ophthalmology vol. 17,1 226. 1 Dec. 2017

Berrocal, Maria H et al. “Management of Giant Retinal Tear Detachments.” Journal of ophthalmic & vision research vol. 12,1 (2017): 93-97. doi:10.4103/2008-322X.200158

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