Retinal Tears & Detachment
When a small break occurs in the thin retinal tissue, it is known as a retinal tear. Retinal tears often happen as a result of posterior vitreous detachment (PVD), which occurs in most people as they get older. In PVD, the vitreous fluid that fills the posterior area of the eye diminishes and loses its viscosity, becoming more liquidy as time goes on.
For most people, this doesn’t cause any issues. However, some people have vitreous that is naturally more sticky. When this sticky vitreous becomes attached to the retina, it can pull at the retina as the vitreous shrinks away, causing a tear to form. This tear makes it more likely for a retinal detachment to occur.
When the retina is pulled out of place by the receding vitreous gel, it is known as a retinal detachment. Retinal detachments are considered to be an emergency and require immediate medical attention. If left untreated for too long, retinal detachments can result in permanent vision loss.
Retinal detachment is most often caused by PVD-related tears, but can also be caused by other factors. For example, exudative retinal detachments occur without the presence of retinal tears whatsoever. These types of retinal detachments are instead caused by fluid accumulating in the retina that pushes it away from the back of the eye.
Another type of retinal detachment is tractional retinal detachment, which occurs in patients with diabetes. Tractional retinal detachment happens when high blood sugar levels damage the retinal vascular system, which leads to the formation of scar tissue. As the scar tissue accumulates, it tugs the retina out of position.
Retinal Tear & Detachment Symptoms
The main symptoms associated with retinal tears and detachments are eye flashes and eye floaters. Eye flashes look like spots of light in your field of vision while floaters look like shapes and shadows cast on your vision. Patients also often experience a curtain of darkness over their vision. If you notice a sudden onslaught of eye flashes and floaters, it could be a sign of a retinal tear or detachment and you must seek medical help from a retina specialist right away.
Treatment Options for Retinal Tears & Detachments
Treatment largely depends on whether you have a retinal tear or a full retinal detachment. For retinal tears, the most common treatment options include laser photocoagulation and cryopexy, both of which are used to adhere the retina to the underlying tissue and stabilize its position against the back of the eye.
For retinal detachment, the main course of treatment is to get the retina back to where it belongs. This can be accomplished in a few ways. One of the most common surgical procedures for retinal detachment is the scleral buckle procedure, which utilizes a small piece of sponge and a thin band. The sponge holds the retina in place against the sclera (the white part of the eye) while the band holds it all together.
Another innovative technique for treating a retinal detachment is pneumatic retinopexy, which involves injecting the eye with an expanding gas bubble. The bubble is positioned over the retina so that it gently pushes it back against the back of the eye.
In some cases, retina surgeons perform vitrectomy surgery, which is when the vitreous gel is removed from the eye cavity so that the detached retina is easier to access and repair. Afterward, the vitreous gel may be replaced with a gas bubble, silicone oil, or saline to keep the retina stabilized.