What Causes Retinal Tears?

The retina is a tissue-like lining in the back of the eye. It helps us perceive visual pictures by sending electrical signals to the brain. This lining is an important but delicate part of the eye, susceptible to conditions that can impact vision.

One of the most common of these conditions is a retinal tear. Understanding what causes retinal tears and the treatment options available can help patients protect their vision.

A retinal tear is when the retina has a hole in it and separates from its underlying tissue. If we imagine the retina as a piece of cloth, a tear would be like if the cloth began to tear away from its normal condition.

Retinal tears can seriously impact vision. If left untreated, they can lead to a retinal detachment — an eye care emergency where the retina is lifted from the back of the eye.

If a patient has symptoms of a retinal tear or detachment, they should immediately contact their eye doctor.

A retinal tear will not necessarily cause any pain, but it may affect patients in the following ways:

• Cause the appearance of floaters. This is often sudden— and more than one floater may appear.

• Reduce peripheral vision

• Produce flashes of light in one or both eyes

• Blurred vision

• Cause the appearance of shadows in the visual field

Patients should keep in mind that these symptoms can also be linked to other eye conditions. If you are experiencing one or more symptoms, speak to your eye doctor for a proper diagnosis and treatment plan.

Age is one of the primary causes of retinal tears. As we age, the vitreous (a jelly-like substance that fills the middle of the eye) begins to thin and get smaller.

In a healthy eye, the vitreous can freely move around the retina without causing problems. But as the vitreous shrinks, it can stick to the retina and pull it hard enough to tear.

Retinal tears may also be caused by trauma or bleeding in the eye. If blood leaks into a patient's vitreous, a vitreous hemorrhage may develop, which can cause flashes of light and floaters.

Pre-existing conditions and previous medical experiences put some patients at a greater risk for retinal tears. These include:

• Being nearsighted (needing glasses to see far away)

• Having had a cataract, glaucoma, or another eye surgery

• A serious eye injury in the past

• Taking medication that shrinks the size of the pupil

• A family history of retinal detachment

• Having had a retinal detachment in the other eye

• The presence of weak areas in the retina.

Retinal tears can be diagnosed during a comprehensive eye exam. To diagnose a retinal tear, a doctor will apply drops to dilate the patient's eyes. This widens the pupils, and allows the doctor to look in the back of the eyes and have a clearer view of the retina. From there, they can see if the patient’s retina has a tear or shows early signs of detachment.

If the doctor cannot get a clear view of the retina, they may use an ultrasound (B Scan). This method uses radio waves to create a detailed image of the inside of the eye.

There are two primary treatments for retinal tears. Both methods involve creating scar tissue around the tear to prevent fluid from entering.

Laser Photocoagulation: The surgeon uses a laser to create scar tissue and fuse the retina to the surrounding tissue.

Photocoagulation is a quick 15-minute procedure. A lens is placed in front of the patient's eye, and the surgeon makes tiny scars that seal over the wall of the eye.

Cryopexy: A surgeon uses a freezing probe to seal the retina to the wall of the eye. The extreme cold prevents fluid from moving through the tear and detaching the retina.

The procedure takes around 30 minutes and can be completed in an ophthalmologist’s office.

Both retinal surgeries have high success rates and fast recovery times. Patients may experience mild pain in the hours after surgery, which can be treated with over the counter pain medication.

In the weeks after surgery, patients should abstain from vigorous physical activity and driving. In certain situations a doctor may recommend you place an eye patch over the eye where the surgery was performed.

Additionally, some patients may see floaters and flashing lights in the weeks after surgery. If these, or other side effects, continue to occur, contact your doctor for a follow up visit.

A more serious condition, retinal detachment, can occur if a retinal tear is left untreated. Retinal detachment is when the retina is lifted away from the back of the eye.

Retinal detachment can lead to vision loss, and even permanent loss of sight in an eye. This means it is important for patients to immediately see an eye doctor if they experience symptoms.