What are they?
A retinal tear occurs when there is a break or tearing in the continuous layer of the retina. If left untreated, this can lead to a retinal detachment which is when fluid goes through the tear and the retina detaches off the back of the eye.
What symptoms do they cause?
Many tears will cause you to see flashing white lights and/or a cloud of spots floating in your vision “flashes and floaters”. When the retina detaches a dark curtain will creep into your vision.
Why does it occur?
Most of the time retinal tears occur due to aging and the vitreous separating from the retina. People who are short-sighted (myopic) are more likely to develop a retinal tear since their retinas are thinner.
How is it diagnosed?
Retinal tears and detachments can be diagnosed by clinical examination.
What is the management?
Most retinal tears require treatment so that they don’t progress to a retinal detachment. There are two main forms of treatment, both of which are designed to encircle and seal off the tear. Most commonly it will be laser treatment in the clinic. Although occasionally it needs to be performed in an operating theatre in a hospital.
Retinal detachments are a serious eye condition and may need to be dealt with on an emergent basis. There are difference methods of treating retinal factors which are based on a number of factors. These include:
- A gas or air bubble is injected into the eye in the clinic and you will be asked to put you head in a certain position to cover over the retinal tear.
- You will then either be scheduled for laser treatment or vitrectomy surgery to cure the detachment
- The most common surgery is vitrectomy surgery.
- This involves key-hole surgery through the white part of the eye (sclera).
- The vitreous jelly is removed and the fluid drained from under the retina to reattach it.
- Laser is then applied to permanently seal the retina.
- The eye is then filled with a substance to keep the retina in place whilst it heals.
Options include gas, silicone oil or heavy liquid. After the operation you may be asked to position your head in a certain direction for a few days. If a gas bubble has been placed in your eye you will not be allowed to fly on an aeroplane or go to high altitudes until this has dissolved. How much sight you will get back depends on how severe the retinal detachment is.
Another operation performed for retinal detachment is a scleral buckle. This is a plastic band that wraps around the eye, supporting the wall of the eye against the retina. The buckle is meant to stay in place around your eye for the rest of your life (it will not usually be visible).