Retinal Tears and Detachment


Retinal Detachment is a very serious eye condition that happens when the retina separates from the tissue around it. Since the retina can't work properly under these conditions, you could permanently lose vision if the detached retina isn't repaired promptly.
Retinal Tears -- although different than retinal detachment -- are often the first stage leading to a retinal detachment. If fluid from within the eye passes through a retinal tear, that can separate the retina from its underlying tissue -- and that's retinal detachment.


Retinal Tears and Detached Retina

 

What Are the Symptoms of a Retinal Tears and Detached Retina?

Retinal tears are painless. Some symptoms include seeing an increased number of floaters and flashes, and decreased vision.

Floaters are small, moving spots in the field of view and can even be seen when the eyes are closed. A sudden increase in number or size of floaters may suggest a retinal tear. Flashes, the seeing of a bright light in your field of vision, is also a possible sign of a retinal tear. This happens when the vitreous pulls on the retina and causes a bright visual response.

Retinal tears can progress to a more serious stage when retinal detachments occur, so early detection of retinal tears are essential to prevent the problem from worsening.

A Detached Retina doesn't hurt, so look for these symptoms:
• Flashes of light
• Seeing "floaters" (small flecks or threads)
• Darkening of your peripheral (side) vision

What are the causes of Retinal Tears and Detached Retina?

Retinal tears occur when the gel-like vitreous in the eye becomes more liquid and exerts an abnormal pull on the retina.

Retinal detachment can occur as a result of:
• Shrinkage or contraction of the vitreous (VIT-ree-us) — the gel-like material that fills the inside of your eye. This can create tugging on the retina and a retinal tear, leading to a retinal detachment.
• Injury
• Advanced diabetes
• An inflammatory eye disorder

How retinal detachment occurs?

Retinal detachment can occur when the gel-like material (vitreous) leaks through a retinal hole or tear and collects underneath the retina.

Reasons for holes or tears include:
• Aging or retinal disorders can cause the retina to thin. Retinal detachment due to a tear in the retina typically develops when there is a sudden collapse of the vitreous, causing tugging on the retina with enough force to create a tear.
Fluid inside the vitreous then finds its way through the tear and collects under the retina, peeling it away from the underlying tissues. These tissues contain a layer of blood vessels called the choroid (KOR-oid). The areas where the retina is detached lose this blood supply and stop working, so you lose vision.
• In certain inflammatory conditions or other disorders, fluid also can accumulate beneath the retina without a tear or break.

What are the risk factors of Retinal Tears and Detached Retina?

Retinal Tears: If you have high degree myopia (short-sightedness), you could have a higher risk of retinal detachment due to thinning of the retina predisposing to the development of holes or tears. Family history may contribute to the risk. Another risk factor is after surgery for cataracts. Regular eye examinations can pick up problems early. With prompt treatment, a torn retina can be fixed before full retinal detachment occurs.

Detached Retina: The following factors increase your risk of retinal detachment:
• Aging — retinal detachment is more common in people older than age 40
• Previous retinal detachment in one eye
• A family history of retinal detachment
• Extreme nearsightedness (myopia)
• Previous eye surgery, such as cataract removal
• Previous severe eye injury or trauma
• Previous other eye disease or disorder

How is Retinal Tears and Detached Retina Treated?

Retinal tears are usually treated with laser treatment to prevent the retinal tear from developing into retinal detachment. Laser treatment works by forming a scar around the retinal tear and prevents the vitreous from seeping through the tear. Some retinal tears need not be treated as they may not lead to retinal detachment. However they may still need to be observed and followed up to ensure that the retina remains stable.

Treatment of retinal tear is usually successful with a success rate of 95 per cent and early treatment of retinal tear can preserve normal vision and prevent severe vision loss.

There are many ways to treat a Detached Retina. These include:
Laser (thermal) or freezing (cryopexy). Both of these approaches can repair a tear in the retina if it is diagnosed early enough. This procedure is often done in the doctor's office.
Pneumatic retinopexy. This procedure can be used to treat retinal detachment if the tear is small and easy to close. A small gas bubble is injected into the eye (specifically into the clear, gel-like substance between the lens and the retina), where it then rises and presses against the retina, closing the tear. A laser or cryopexy can then be used to seal the tear.
Scleral buckle. This treatment for retinal detachment involves surgically sewing a silicone band (buckle) around the white of the eye (called the sclera) to push the sclera toward the tear until the tear heals. This band is not visible and remains permanently attached. Laser or cryo treatment may then be necessary to seal the tear.
Vitrectomy. This surgery for retinal detachment is used for large tears. During a vitrectomy, the doctor removes the vitreous (the clear, gel-like substance between eye's lens and retina) and replaces it with a saline solution.
• Depending on the complexity of the retinal detachment, various combinations of vitrectomy, buckle, laser and gas bubble may be used to repair the retina.