Retinal Detachments & Tears

What is a retinal tear?

A retinal tear is a tear or hole in the retina. Retinal tears often occur with aging, as the vitreous (the jelly-like substance that fills the middle of the eye and keeps it round) gets thinner. As it thins, the vitreous may start sticking to the retina and pulling on it. Pulling hard enough can tear the retina.

When the retina tears, you may see a sudden increase in flashes or floaters. Left untreated, a retinal tear may lead to a retinal detachment.

Signs of a retinal tear

• Flashing lights, like seeing stars
• A sudden, rapid increase in floaters
• A shadow in your peripheral vision
• A gray curtain covering part of your field of vision

If you recognize these signs, contact your ophthalmologist immediately. Being seen as soon as possible is essential to avoid permanent vision loss or a retinal detachment.

What is a retinal detachment?

A retinal detachment is a serious condition in which the retina pulls away and lifts from the back of the eye. It causes permanent vision loss if not treated promptly. Many patients experience a retinal tear before the retina detaches. You are at higher risk if:

• You have had previous eye injuries
• You have a family history of retinal detachment
• You have had surgery on your eyes
• You have significant nearsightedness or certain other eye conditions
• You have a history of retinal tears

If you know you are at increased risk, talk to your eye doctor about the best schedule for comprehensive eye exams and how to protect your eyes.

How is a retinal detachment treated?

Treatment depends on severity. You and your ophthalmologist will discuss the best options, which may include a combination of the following:

Laser (thermal) therapy or cryopexy

If a tear is found before it becomes a detachment, it can be sealed with a laser or a freezing probe. Both create scarring that helps hold the retina in place.

Pneumatic retinopexy

A small gas bubble is injected into the vitreous. The bubble presses against the retina to close the tear, and the fluid under the retina is absorbed by the body. This is often recommended for less extensive detachments, and is usually combined with laser or cryopexy.

Scleral buckle

A silicone band (the buckle) is placed around the eye to support the retina while it heals. Laser or cryopexy is then used to seal the tear.

Vitrectomy

The vitreous is removed and replaced with air, gas or oil to put the retina back in place.

Videos: understanding your condition and treatment

Patient-education videos from the American Academy of Ophthalmology. Captions are available with the CC button.