Retinal Tear And Detachment

By:    Published: December 7, 2011

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Many people are familiar with increased vision problems as a common occurrence in older individuals, but there are also several other eye conditions that may develop as a result of aging. One problem that some people experience as they get older is retinal tear or detachments. This condition occurs in about 30,000 people each year in the United States, says the National Institutes of Health (NIH). Because there are several signs that typically precede this condition, it is helpful to understand what retinal tears and detachments are and what to look for so that the condition can be corrected quickly.

Definition

The retina is a layer of tissue located at the back of the eye. This tissue sends signals to the brain based on the light that passes through the lens of the eye, which allows people to see. The choroid is another eye tissue located in this area. It is attached to the retina and supplies it with blood. Filling the bulk of the eye is a clear, gel-like substance called vitreous.

As a person ages, the vitreous may start to sag or sink down. This pulls the retina away from the outside of the eye, which can eventually lead to breaks in this layer of tissue. A retinal tear occurs when the tissue tears, allowing fluid to leak out. A retinal detachment occurs when the retina separates from the choroid, cutting off the blood supply to the retina. This usually develops after a retinal tear has already occurred.

Symptoms

Although it sounds painful, there is actually no discomfort or pain associated with retinal tears and detachments. However, there are several signs that may signal a tear or detachment has occurred or is about to occur:

  • Floaters in your line of sight. These are specks, lines, clouds or lines that are somewhat see-through. They often move around in your line of vision. Floaters are the easiest to see when looking at a blank wall or blue sky.
  • Flashes of light. The flashes that people with retinal tears and detachments experience can be an arc of light, a lightning-like streak or a strobe-type flash.
  • Shadows in your peripheral vision. If you begin to see some kind of shadow on the edges of your line of sight, you may be experiencing retinal problems. Typically, this shadow will start off at the edges and begin to come closer towards the center of your vision as the condition progresses.

See a doctor right away if these symptoms come on suddenly, as this is usually the case with retinal tears and detachment.

Causes And Risk Factors

As people age, the vitreous gel in their eyes begins to change. Generally, it thickens and begins to shrink as the gel-like substance loses water. This causes the sagging in the vitreous, which pulls the retina down with it. When a detachment or tear occurs, the debris from that break moves into the vitreous, causing the floaters that most people with this condition experience. The flashes of light are produced when the vitreous pulls on the retina. Though this is painless, it causes the retina to become excited and send signals to the brain. The result we see is a sudden flash of light.

For most people, the thickening of the vitreous begins to occur around age 45. Although it is obviously much more common in older individuals, this condition can occur at any age. Once person experiences a retinal tear, the chances that their retina will detach are much higher since the vitreous will be able to travel through the tear.

Treatment

In many cases, a retinal tear leads to retinal detachment. If the retina is detached from the back of the eye, it often results in partial or total loss of vision. Fortunately, these complications can often be avoided with treatment.

When laser treatments are performed for retinal tears, they are usually successful at preventing retinal detachment. Because of the serious nature of this condition, it is best to perform the surgery as quickly as possible after the retinal tear occurs in order to prevent the loss of vision. The laser is used to create burns around the area where the tear occurred. This binds the retina to the underlying tissue, ensuring that detachment will not occur and preventing vitreous fluid from leaking through the tear. In cases where a laser cannot be used, a cryoprobe is used to freeze the tissue around the tear rather than burning it.

Once a retinal detachment occurs, it is usually too late for laser or cryoprobe treatment. That is why it is essential to see a doctor as soon as you experience the symptoms of a retinal tear. In some cases, other surgical procedures can be used to potentially restore vision that is lost due to a retinal detachment. Those options include:

  • Vitrectomy: Removal of the vitreous gel
  • Scleral buckle: Placing a band around the eye
  • Pneumatic retinoplasty: Injecting a gas bubble into the eye

An important part of treatment for both retinal tears and detachments, even after surgery, is follow-up exams. This allows a doctor to ensure that your eyes are not developing any further problems and that the retina is intact.

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