What is Retinal Tear? What are the Symptoms of Retinal Tear?

A retinal tear, often confused with retinal detachment, is a relatively common injury affecting the retina, one of the most vital components of our visual system. In this article, we will delve into the intricacies of retinal tears, exploring their indicators, symptoms, available treatments, and situations that can be easily mistaken for them.

What is Retinal Tear?

The retina, a complex layer at the back of the eye, essentially acts as a delicate neural network responsible for our visual perception. Nestled beneath it is the retinal pigment epithelium layer, intricately connected to the retina. In cases of a retinal tear, only a localized segment of the retinal layer becomes detached from the underlying layer known as the retinal pigment epithelium.

What Leads to Retinal Tear?

The vitreous, a gel-like substance, occupies the space between the eye’s lens and the retina. As we age, typically after reaching 50, this vitreous gel gradually detaches from the front surface of the retina, a natural process. However, retinal tears can occur when this separation leads to the vitreous gel tearing a portion of the retina.

While the natural aging process, characterized by the vitreous gel changing shape and tugging on the retina, is a common cause of retinal tears, it’s important to note that traumatic injuries to the head or eye can also lead to this condition. Additionally, certain circumstances elevate the risk of retinal tears.

Factors Increased the Risk of Retinal Tears

• Myopia exceeding 3 diopters amplifies the risk of retinal tears by a factor of ten. Furthermore, as the degree of myopia intensifies, the probability of developing retinal tears proportionally increases.
• Retinal thinning (degeneration) areas: Areas of the retina that are thinning affect 8% of healthy people. Tears may form later in these thinning areas.
• Retinal tear in the other eye: In 8% of cases where one eye experiences a retinal tear, a corresponding tear also manifests in the other eye.
• Having a family history of retinal tear: Having a family member with a history of retinal tears is considered a significant risk factor for developing this condition.
• Severe traumas to the eye: Retinal tears are more prone to develop after experiencing significant eye trauma, which can result from incidents like sports-related injuries, such as getting punched in the eye or being struck by objects like tennis balls.
• Having cataract surgery: The likelihood of a retinal tear sees a modest elevation following a successful cataract surgery. However, in cases where complications arise during the procedure, such as a posterior capsular tear, the risk of retinal tears increases 15-fold. This underscores the critical importance of entrusting skilled surgeons for cataract surgeries.

Symptoms of Retinal Tears

Prominent Symptoms of Retinal Tears encompass distinct visual disturbances, notably bright flashes of lightning, the perception of tulle-like curtains, spider web patterns, and the illusion of moving specks or flies (all these symptoms called floaters). Furthermore, if a retinal tear occurs proximate to a major retinal vessel, it can lead to bleeding into the vitreous gel, culminating in a sudden and pronounced loss of vision for the patient.

Treatment for Retinal Tear

Prompt Treatment for Retinal Tears is Imperative. Retinal tears demand swift attention, and one effective approach is photocoagulation using an argon laser. When patients seek treatment promptly, the argon laser demonstrates a remarkably high success rate. However, if retinal tears go untreated, they can progress to retinal detachment, where the retina separates entirely from its underlying layer. Importantly, argon laser photocoagulation has no impact on retinal detachment. In cases of retinal detachment or when retinal tears are accompanied by significant bleeding, a procedure called vitrectomy becomes necessary. Failing to address retinal detachment promptly can lead to permanent vision loss for the patient.

Argon Laser Application

Argon Laser Therapy is a versatile treatment used for various eye conditions, including retinal tears. This non-surgical procedure is typically performed in an outpatient setting, eliminating the need for hospitalization. For small retinal tears, the procedure can be completed swiftly in 2 to 5 minutes, though larger tears may require more time. Following the procedure, patients may experience initial blurriness in their vision for approximately 30 minutes, which gradually improves. Importantly, there is no need to cover the patient’s eye post-treatment, and the majority of patients do not require eyedrop therapy.

Vitrectomy Surgery

As mentioned earlier, a vitrectomy surgery becomes imperative in cases of untreated retinal detachment or when severe intraocular hemorrhage accompanies the retinal tear. The term “vitrectomy” encompasses all retinal procedures conducted through small incisions made in the white part of the eye (sclera).

The Restoration of Vision Following Retinal Tear Treatment?

Immediately after undergoing argon laser treatment, patients often experience a brief but significant blurring of their vision, which gradually dissipates over the course of approximately 30 minutes. Additionally, any near vision impairment induced by pupil-enlarging eye drops tends to resolve within 6 to 12 hours. It’s essential to note that the extent of vision improvement can vary, contingent upon the severity of the condition and the quantity of tamponade utilized in cases where retinal detachment necessitates a vitrectomy procedure.

What are the Conditions Confused with Retinal Tear?

Among eye conditions, retinal detachment is the one that most frequently bewilders those afflicted by it. It can be regarded as an advanced stage of retinal tears. Unlike retinal tears, which generally do not compromise vision and can be promptly addressed with an argon laser, retinal detachment poses a far graver threat, potentially leading to complete blindness and necessitating immediate surgical intervention.

Another frequently misunderstood condition often confused with retinal tears is the presence of macular holes. These holes can develop at the central visual point of the eye, also known as the yellow spot, either spontaneously or due to trauma. Patients diagnosed with macular holes similarly require a surgical procedure known as vitrectomy for effective treatment.

Preventing Retinal Tears

While it’s not always possible to completely prevent retinal tears, maintaining optimal eye health significantly reduces the risk. It is advisable for individuals in the aforementioned risk group to undergo annual retinal examinations, including the use of eyedrops (dilated fundus examination), to proactively monitor their eye health.

Suspecting a Retinal Tear in Your Eye?

If you suspect the presence of a retinal tear in your eye, it’s crucial to act swiftly, as such tears can rapidly progress into retinal detachment. Drawing from my extensive experience as an ophthalmologist deeply involved in research and treatment of retinal diseases, I strongly emphasize the importance of promptly seeking the care of a qualified ophthalmologist.