Retinal tears and detachments: Symptoms, causes and treatment
04 November 2021
What is a retinal tear and how can it lead to retinal detachment?
Retinal tears can be worrying when they first occur, particularly if you don’t know what one is, or if the symptoms are severe. To understand what a retinal tear is, it’s first important to know the structure of the human eye and where the retina is. The retina is a thin layer of tissue at the back of your eye. The retina’s main purpose is to receive light from your eye’s lens and send signals to the brain to process the light into a visual image. The retina contains two types of photoreceptor cells: rods and cones. Cones are responsible for detecting colour vision, while rods pick up motion, darkness and lightness.
The retina is very thin and, once it tears, fluid from the eye can enter underneath the retina, leading to a detachment. Our eyes contain a substance called the vitreous which begins as a gel-like substance but slowly liquefies with age and then separates from the back of the eye. This process is called posterior vitreous detachment (PVD). A detached retina occurs when the retina becomes loose and moves away from its normal position at the back of your eye, due to changes in the vitreous. This can lead to blindness as the fluid prevents your brain from receiving light from the retina, and also separates the retina from the blood vessels which nourish it. A retinal tear can also result in hundreds of floaters appearing in your visual field due to bleeding in the eye from the tear.
What are the symptoms of a retinal tear?
There are several symptoms to look out for if you think you may be experiencing a retinal tear. Flashes of light will typically appear as the retinal tear occurs, and could be followed by any of the following symptoms:
- Shadow appearing in peripheral vision
- A curtain affect across visual field
- Blurry vision
- Flashes of light
- Floaters or black dots
In some cases, you may also experience a slightly red or swollen eye. This occurs as a result of increased eye pressure and could be another indication that you are experiencing a retinal tear.
How can you diagnose a retinal tear?
A retinal tear can only be diagnosed once you visit an eye care professional. They have a number of tests they will use to examine your eyes and be able to diagnose you with a retinal tear. You may be given some dilation eye drops prior to the examination to help the optician look at the inside of your eye more clearly. They will then use a tool called a binocular indirect ophthalmoscope to get a 3D image of the inside of your eye. This may be used alongside a slit lamp which shines a bright light into your eye as well as magnifying the image. This helps the optician to get a closer look at your retina and will even highlight any blood that is floating in the eye as a result of the tear.
How can you treat a retinal tear?
Not all retinal tears will require treatment as some can heal on their own, but it’s important to go and get any vision changes checked in case treatment is needed. There are two main types of treatment available for retinal tears – laser photocoagulation and cryopexy. The purpose of both treatments is to seal the tear and prevent fluid from leaking through, ultimately leading to a retinal detachment.
Laser photocoagulation: Administered under numbing eye drops, this process requires a laser to burn the area surrounding the retinal tear, creating scar tissue. This scar tissue then seals the tear closed and helps reattach it to the part of the retina from which it had lifted. This is the most common treatment for retinal tears.
Cryopexy: Also known as cryotherapy, this is a process that uses a ‘freeze burn’ to seal the tear closed. However, this process differs to laser photocoagulation in that the freezing occurs on the outside of the eye, over the part which covers the tear. This treatment is used when blood impedes the view of the retinal tear.
After surgery, you may find that your recovery takes between 2-6 weeks. Following your treatment, it’s possible that your eyes will look red and inflamed, as well as suffering with blurry vision. You will need to wait for your optician’s approval before you can drive, and you might require time off work, depending on how quickly you recover. You will also be told to avoid sudden head movements for the first week as this can open the tear again.
What are the risk factors for retinal tears?
There are a number of risk factors which make you more susceptible to developing a retinal tear and therefore a potential retinal detachment. You are more likely to suffer with a retinal tear if you:
- Are aged 50+
- Have a high short-sighted prescription
- Have a family history of retinal tears or detachments
- Have experienced eye trauma
- Have had a retinal tear before (in either eye)
- Are diabetic
- Have thinning in some areas of the retina
When should you seek medical advice for a retinal tear?
If you notice any of the symptoms we discussed above, it’s important to visit your optician as soon as possible. They will be able to perform any examinations needed to assess your eye health and refer you on for further emergency care if required. Time is of the essence with retinal tears and detachments and the sooner you can seek treatment, the better the chances of saving your sight are. If you delay too long, there may be permanent loss of vision. Ensuring that you attend regular eye tests with your optician means that any changes to the retina will be picked up on, and will go a long way to keeping your eyes healthy.
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