A tear in the retina is an opening through which the fluid within the eye can go through and elevate the retina, causing a retinal detachment which can be a blinding disease if not treated in a timely manner.
WHAT CAUSES A RETINAL TEAR?
A tear in the retina usually results from an area of thinning of the retina, or from pulling forces from the vitreous gel inside the eye, or from trauma. The gel that fills the back of the eye (called "vitreous gel") changes with time as part of it melts (liquefies) causing it to separate from the retina. This separation is a normal occurence that happens in most people as we age, however in some people, the vitreous gel is very adherent to the retina and may cause a tear in areas of retinal thinning as it separates. A tear within the retina is an opening through which the fluid within the eye can go through and cause an elevation or detachment of the retina, which can lead to blindness if not treated.
Retinal tears also happen more often in patients that are nearsighted (myopic) as the periphery of their retina can be thinner. Another cause of a retinal tear is lattice degeneration which affects 8% of the population and is a thinning of the peripheral retina with strong adhesions of the vitreous gel to the retina.
A retinal tear is an emergency as the goal of a retina specialist is to treat the tear prior to the development of a retinal detachment which can significantly affect vision. Most tears cause symptoms of floaters, cobwebs or flashes but can be asymptomatic in some cases. Any new symptoms or increase in symptoms should be evaluated by a retina specialist as an emergency.
HOW CAN A RETINAL TEAR BE DIAGNOSED?
A retinal tear can be diagnosed by a dilated retinal exam. The standard of care is to accomplish a full retinal exam with what is called a dynamic scleral depressed exam during which a retina specialist will press on your eyelids with a small depressor instrument in order to cause a slight depression of the eyewall. Although uncomfortable, this part of the exam is critical as it is the only way to visualize the part of the retina that is very peripheral and most at risk of getting a retinal tear which could lead to a retinal detachment.
WHAT IS THE TREATMENT FOR A RETINAL TEAR?
Laser therapy is used to create a scar surrounding the retinal tear in order to prevent fluid within the eye to go through the tear and cause a retinal detachment.
(Prior to the advent of Laser, cyrotherapy or freezing of the eye wall in order to cause a scar in the retina was the main treatment)