The retina is a light-sensitive layer of tissue that lines the inner surface of the eye. It is attached to the vitreous, the gel-like substance that gives the eye most of its volume. As a result of the aging process, the vitreous thins and its shape changes, sometimes causing it to pull away from the retina. This separation, known as posterior vitreous detachment (PVD), is a normal part of aging, but it can result in a retinal tear. Without treatment, retinal tears can cause retinal detachment that may result in blindness, so it is important for adults older than 50 to be vigilant about getting regular eye examinations.
Causes of a Retinal Tear
In addition to aging, there are other possible causes, including blunt force trauma to the eye and complications of eye surgery, of retinal tears. Anyone who is nearsighted, or has a family history of retinal tears, is at greater risk.
Symptoms of a Retinal Tear
Although retinal tears do not usually cause pain, patients may experience the following symptoms:
- Flashes or floaters in the field of vision
- Reduction of vision
- Shadows/curtain in peripheral vision
Floaters or blocked areas of vision (curtains) may result from a retinal tear because, as the vitreous pulls away from the retina, debris loosens and floats across the field of vision. Stress on the retina as the vitreous pulls away can also result in images, such as flashing lights.
Floaters, which may appear as dots, circles, lines, clouds or webs, are experienced by about 70 percent of the population, and do not necessarily indicate a retinal tear. If floaters or flashes appear suddenly, however, there is cause for concern, and a physician should be consulted.
Diagnosis of a Retinal Tear
The sooner a retinal tear is diagnosed and treated, the less likely it will develop into a retinal detachment. Diagnosis of a retinal tear is made after a thorough medical eye examination, and the performance of the following diagnostic tests:
- Dilated-eye examination
- Ultrasound of the eye
- Fundus photography of the retina
- Visual-acuity test
- Slit-lamp examination
- Fluorescein angiography
Early detection, and prompt treatment, of a retinal tear can often keep the retina from detaching, preventing permanent damage to the patient's vision.
Treatment of a Retinal Tear
A retinal tear is treated with either a laser or cryotherapy procedure, or both, depending on the size and location of the tear. Either method of treatment is painless, and is used to seal the retina to the wall of the eye. This prevents fluid from traveling through the retinal tear, potentially causing a detachment.
Repairing a tear in one part of the retina does not prevent a tear from developing in another, and those who have had retinal tears should be monitored. A regular eye examination is essential for detecting retinal tears at their earliest possible stages.