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Retinal Tear and Detachment

Overview

A retinal tear commonly occurs when there is traction on the retina by the vitreous gel inside the eye. As a person ages, the vitreous gradually becomes thinner, more liquid and gradually separates from the retina. This is known as a posterior vitreous detachment (PVD). They are typically harmless and cause floaters in the eye. In some cases the traction on the retina may create a tear. Retinal tears frequently lead to detachments as fluids seep underneath the retina, causing it to separate and detach.

Retinal detachments are often associated with a tear or hole in the retina through which the internal fluids of the eye may leak, causing separation of the retina from the underlying tissues.

During a detachment bleeding from small retinal blood vessels may cloud the interior of the eye, which is normally filled with vitreous fluid. Central vision becomes severely affected if the macula becomes detached.

Symptoms

	Bright flashes of light, especially in peripheral vision
	Floaters
	Blurred Vision
	Shadow or blindness in part of the visual field of one eye

Small holes and tears and very limited retinal detachments are usually treated with laser photocoagulation or cryopexy. These procedures are usually administered in the physician's office. Laser photocoagulation is a procedure whereby pinpoints of laser light are used to create tiny burns around a small hole to "weld" the retina back to the wall of the eye. Cryopexy is a similar procedure which, instead of using heat, freezes the area around a hole back into place.

Extensive detachments are treated surgically with a procedure called scleral buckling. In scleral buckling, a tiny synthetic band is implanted on the outside of the eyeball to gently push the wall of the eye against the detached retina. If necessary, a vitrectomy may also be performed to treat more severe cases. During a vitrectomy, the diseased vitreous is surgically removed and an artificial substance is inserted to push the retina back against the eye wall.

If treated early, sight is usually improved in 80% of the patients with the first treatment. In other cases, more treatments are necessary to remedy the damage.