Retinal Tear

The retina is a layer of cells at the back of the eye, that detects light and helps to form visual images. Occasionally, the retina can break or tear, which exposes the space underneath the retina.  Therefore, if not treated early, retinal tears can lead to a more serious condition called retinal detachment, which often leads to partial or complete loss of vision.

Retinal tears are painless. Some possible symptoms include seeing an increased number of floaters and flashes, and decreased vision.

Floaters are dots or lines that you may sometimes see moving or floating in your field of vision. A sudden increase in number or size of floaters may suggest a retinal tear.

Flashes are the sensation of flashing lights or lightning streaks in your field of vision that occur when the clear vitreous gel inside your eye pulls on the retina and triggers a bright visual response. Flashes are also a possible sign of a retinal tear.

Retinal tears can progress to a more serious stage when retinal detachments occur. Early detection of retinal tears is essential to prevent the problem from worsening.

Avoidance of eye trauma or excessive eye rubbing can help to reduce the risk of retinal tears.

What causes retinal tears?

When we are young, the clear gel-like vitreous in the eye is attached to the retina. As we age, at some point in our lives, the vitreous will usually degenerate and pull away from the retina, which is called a posterior vitreous detachment (PVD). Sometimes, this may be triggered by eye injuries or excessive eye rubbing. PVD can cause symptoms of floaters and flashes for a few weeks, but in most cases does not cause any major problems. However, in a small proportion of patients, the degenerated vitreous can pull and tear the retina, which carries the risk of visual loss.

What puts me at risk of retinal tears?

If you have a high degree of myopia (short-sightedness), you could have a higher risk of retinal detachment. This is because high myopia causes abnormal thinning of the retina, which may be more fragile and predisposed to developing retinal holes or tears.

Eye injuries, excessive eye rubbing, or recent eye surgery (such as cataract surgery) can also increase risk. A history of retinal tears or detachment in your family members or close relatives is also a risk factor.

Regular eye examinations can pick up problems early. Prompt treatment for a retinal tear can often prevent the development of retinal detachment.

Diagnosis is made by clinical examination. Your ophthalmologist will administer eye drops to enlarge (dilate) the pupils temporarily so that they can examine the retina for tears.

Retinal tears are usually treated with laser treatment, to prevent the retinal tear from developing into a retinal detachment.

Laser treatment does not close the tear, but works by forming a scar around the retinal tear to prevent the retina from detaching.

Occasionally, some retinal tears or holes may not need treatment as they already have some natural scarring around them, or carry a low risk of retinal detachment. However, they may still need to be observed and followed up to ensure that the retina remains stable.

Treatment of retinal tears usually has a success rate of about 95%. Early treatment of retinal tears can preserve normal vision and prevent severe vision loss from retinal detachment.