Retinal Tears and Detachments


What are retinal tears and detachments?

The retina is a thin layer of light-sensitive nerve fibers and cells that covers the inside and back of the eyeball. For us to see, light must pass through the lens of the eye and focus on the retina. The retina then acts like a camera, taking a picture and transmitting the image through the optic nerve to the brain.

The vitreous fluid, the gel-like material that fills the eyeball, is attached to the retina around the back of the eye. If the vitreous changes shape, it may pull a piece of the retina with it, leaving a retinal tear. Once a retinal tear occurs, vitreous fluid may seep between the retina and the back wall of the eye, causing the retina to pull away. This results in a retinal detachment.

Am I at risk for a retinal detachment?

As we get older, our risk increases. Vitreous fluid shrinks as we age. This is a normal process that usually does not cause retinal damage. However, inflammation or nearsightedness (myopia) may cause the vitreous to pull and can lead to detachments. You are more at risk if you have:

  • Had eye surgery
  • Suffered an eye injury
  • A family history of retinal problems
  • Diabetes

What are the symptoms of a possible retinal detachment?

Some of the symptoms include:

  • A blind spot in your vision
  • Blurred vision
  • Shadowy lines
  • Flashes of light
  • Floaters (spots)

Floaters are a normal part of the eye’s aging process and do not necessarily signal a retinal detachment. However, a sudden onset of floaters appearing in large numbers indicates a need to check for retinal detachment.

If you suspect there’s a problem, it is important that you see an eye doctor immediately. The doctor needs to act quickly to try to repair the damage and prevent permanent vision loss.

What is my best defense against retinal tears and detachments?

Your best defense is awareness. Know the warning signs of a retinal detachment seek immediate eye care if you experience any of those warning signs.

Have regular dilated eye exams if you are very nearsighted or if you have a family history of retinal problems.

Always wear safety eyewear during sports and other hazardous activities. Also, be sure to have your eye doctor examine your eye after any serious eye injury.

How does an eye doctor diagnose retinal detachment?

Because retinal tears and detachments are not visible from the outside of the eye, only a comprehensive eye exam can detect them. Your eye doctor will use a light magnification instrument to view the inside of your eye. Your eye doctor may also use certain types of contact lenses, a slit lamp or ultrasound to diagnose retinal tears or detachments.

What treatments are available for a retinal tear or detachment?

There are several options for treating a retinal tear or detachment. If immediate help is sought for a retinal tear, it may be possible to repair the retina before it detaches.

Laser photocoagulation can repair smaller retinal tears. The laser creates small burns around the edges of the tear, producing scars. These scars seal the borders of the tear and prevent fluids from leaking toward the retina, thereby helping avoid detachment. Laser surgery can be performed on an outpatient basis, requires no surgical incision and causes less damage to surrounding tissue.

Cryopexy uses extreme cold to cause scar formation and seal the edges of a retinal tear. It can be performed on an outpatient basis, but requires local anesthesia to numb the eye.

Liquid silicone may be injected to replace the vitreous fluid to maintain the normal shape of the eye and hold the retina and eye wall in alignment.

To repair actual retinal detachment, fluid must be drained from under the retina to minimize the space between it and the eye wall. A silicone band may be used on the outside of the eye to push the back wall against the retina.

If a retinal detachment is found early, about 85 percent can be successfully reattached. About 40 percent of the people whose reattachments are successful have excellent vision. The remaining 60 percent will have varying degrees of vision. These varying degrees depend upon several other factors including the length of time the retina was detached and if there was scar tissue growth. If a retinal reattachment is unsuccessful, you will eventually lose sight in that eye.