What is a Retinal Tear?
The retina is a thin lining of tissue at the back of the eye; when light passes through the front of the eye, the retina converts this light into electrical impulses, and sends a message to the brain to provide us with sight. A retinal tear is when a small crack or hole appears on this delicate piece of tissue, causing visual disturbances such as ‘floaters’ in your vision. They can appear as the result of severe trauma to the head, such as a hard blow or violent shaking, or can happen spontaneously with age due to the vitreous (a gel-like substance in the eye) changes its texture as we get older. Risk factors that increase the likelihood of these are age, previous eye injury or eye surgery; a fast diagnosis and treatment reduces the risk of a complete retinal detachment which can cause blindness.
What are the typical symptoms of a Retinal Tear?
A retinal tear causes visual disturbances that are hard to ignore. They are not painful, and in some cases do not present with any obvious signs and are picked up during an eye examination. The signs of a retinal tear should not be ignored, and you should seek medical attention as soon as possible to avoid a detachment. Some of the common retinal tear symptoms include:
- Floaters. Retinal tear floaters may appear suddenly, and look like small dots, specks, or cobwebs in your vision that drift in and out. There may be one or two, or there may be hundreds of them depending on how severe the tear is.
- Flashes of light. This can occur in one or both eyes and is known as photopsia, and may be persistent throughout the day.
- Blurred vision. Blurred, fuzzy or double vision may be a sign of a retinal tear. This can be caused by bleeding as a result of the tear.
- Reduced peripheral vision. What can usually be observed out of the corner of your eye, known as peripheral vision, may gradually become reduced in the affected eye.
- Loss of vision. In more severe cases, a retinal tear may cause loss of vision in the affected eye. This is caused by blood filling the eye.
- Shadows. Where a retinal detachment has followed a tear, a shadow can be observed in the peripheral vision. Individuals describe this as a curtain closing in from one side, or even a dark spot that is fixed in your vision.
What causes a Retinal Tear?
A retinal tear is caused by the retina, a thin nerve tissue at the back of the eye, being torn. This can be a result of age, where a gel-like substances known as the vitreous, breaks down and becomes thinner. This is a common condition known as posterior vitreous detachment (PVD) and can lead to the gel pulling on the retina and tearing it, the most likely cause of a retinal tear. Some other risk factors have been identified to lead to a retinal tear:
- Short-sightedness. Extreme cases of near-sightedness or short-sightedness, known as myopia, can be a leading cause to a retinal tear. Myopia means the eye has grown slightly too long, and as a result the light passing into it does not focus directly on the retina but instead slightly before it.
- Eye surgery. Prior surgery on the eyes, such as cataracts removal, can cause complications post-surgery resulting in retinal tears.
- Diabetes. When poorly managed, diabetes can lead to scar tissue growing on the surface of the retina and can lead to a tear or detachment.
- Inflammatory disorders. These can lead to a buildup of fluid beneath the retina, making the retina itself more vulnerable to tears.
- Lattice degeneration. This thinning of the retina occurs more commonly with age. As the tissue thins, it becomes more vulnerable to damage.
- Trauma or injury. Where a severe head or eye injury has occurred, a complication of this could be retinal damage such as a tear or detachment.
How to help prevent a Retinal Tear
As the condition is often a result of ageing, retinal tear prevention is not always achievable. There are ways of lowering the risk, however, that are listed below:
- Wear eye protection. Safety goggles and other appropriate eye protection should be worn when doing high-risk activities, such as sports or handling irritable substances. This can reduce the risk of trauma to the eye and prevent a retinal tear occurring.
- Treat known medical conditions. Getting the appropriate treatment for underlying health conditions that can lead to retinal damage, such as diabetes and inflammatory disorders, will reduce the risk of any tearing.
- Regular eye check-ups. You should visit the opticians every two years, or as often as your optician recommends if you suffer with persistent issues with your eyes. Regular check-ups will quickly diagnose and abnormalities such as retinal tears, and treatment can be arranged as quickly as possible.
- General good health. Maintaining a healthy lifestyle, such as a balanced diet, quitting smoking, reducing alcohol intake and regular exercise, can lower blood pressure and reduce risk of developing conditions such as diabetes which may lead to retinal tears.
If you have concerns, speak to an optician or doctor about retinal tear causes and prevention.
How is a Retinal Tear typically diagnosed?
Where a suspected retinal tear has occurred, it should be investigated by a medical professional without delay. A specialist doctor will ask you questions about what symptoms you may be experiencing, as well as any trauma or previous surgery that could have lead to a retinal tear.
- To diagnose a tear, a doctor will need to examine your eye closely and inspect the retina. This is done by dilating the pupil using eye drops before using lights and lenses to observe the back of the eye. Occasionally, slight pressure is applied to the eye to assist in the examination; this is usually a painless investigation, though can be uncomfortable for some individuals.
- In cases where the retina cannot be seen clearly, an ultrasound scan or an optical coherence tomography (OCT) scan may be required to get a clearer view of the eye. Both examinations are completely painless.
How is a Retinal Tear treated?
Recovery time for a retinal tear will depend on the severity of it, and treatment may be required to prevent a detachment. In minor cases, retinal tears heal on their own by developing an adhesion around the tear and are observed regularly with eye exams to make sure they do not get worse. In more severe cases, the following treatment options are used and are fast and effective:
- Cryopexy. Sometimes referred to as cryotherapy, this treatment involves applying a freezing probe to the eye, causing a burn. The burn then heals, which seals the retinal tear shut. A local anaesthetic is applied before this procedure is carried out.
- Photocoagulation. Known as retinal tear laser surgery, the process is similar to cryotherapy. A laser is used to apply heat to the tear and creating a burn which then heals over the tear, closing the hole up. Dilating eye drops and numbing drops are used to help the uncomfortable sensation of this procedure.
In more severe cases, surgery may be required to repair a retinal tear.
Is a Retinal Tear an emergency?
A retinal tear is considered a significant condition that should be investigated without delay. Should symptoms present themselves and not be treated, there is a risk that the tear can lead to a retinal detachment; this can cause total blindness in the affected eye. Warning signs of the tear described in the aforementioned symptoms section usually appear before a detachment has occurred or advanced, and should therefore be acted upon as soon as possible.
How can Doctify help with a Retinal Tear?
At Doctify, we are proud to work with leading specialists in all fields of medicine. Our service could put you in touch with some of the country’s leading consultants based on real patient reviews. To find the right doctor for you, visit www.doctify.com/uk.