Retinal Tears

Retinal Tears – Retinal Detachments – Palatka and Jacksonville, FL

A retinal tear occurs when the vitreous gel detaches from the retina. Depending on the severity, this can cause blurred vision and blindness.

What is a Retinal Tear?

The retina is the lining located in the back of the eye that is responsible for light sensitivity. The retina converts light rays so that they interpret the images we see. Attached to the retina is a gel filled section known as the vitreous. When the vitreous moves away from the retinal wall, this is known as a retinal tear or detachment. In many cases, a retinal tear can cause a retinal detachment. Retinal tears are usually not associated with trauma, nor are they caused by a specific activity or event. A tear will result in flashes of light, floaters within the eye, or loss of vision. A retinal detachment is a much worse condition and can potentially lead to permanent vision loss and require emergency eye surgery, which our board-certified eye surgeons are trained to handle. Dr. Shawn Agee and Dr. John Sullivan are trained retina specialists offering advanced treatments for Jacksonville, FL area patients.

Causes and Symptoms

The most common cause of a retinal tear is a posterior vitreous detachment (PVD). The vitreous is the watery gel-like substance that fills the inside of the eye behind the lens and iris. The vitreous and retina are very adherent to each other in certain areas. If the vitreous pulls with enough force on the retina, a tear may develop. As we get older, it is common for the vitreous to change shape, which can cause it to naturally pull away from the retina. If the vitreous pulls some of the retina along with it, this is known as a tear.

Retinal Detachment

A detachment occurs when all of the retina is pulled with the vitreous movement. There are two types of retinal detachments; those which are caused by a hole or tear in the retina, and a second less common type where tissue forms on the surface of the retina and pulls on the retina. This “traction” type of retinal detachment is usually associated with a disease.

The most common type of retinal detachment is a “rhegmatogenous” retinal detachment where a retinal tear or hole allows fluid to get underneath the retina. As more and more fluid accumulates underneath the retina, the retinal detachment enlarges.

If the retina becomes torn it cannot function properly, causing blurry vision. In addition, any area of retinal detachment causes loss of vision. Since most retinal tears or holes occur far away from the optic nerve, in the peripheral retina, loss of peripheral or side vision is usually an initial symptom. As the retinal detachment enlarges, this loss of peripheral vision moves toward the center. If the macula becomes detached, loss of central vision is noted.

Diagnosis

Our team of retinal surgeons can effectively diagnose a retinal tear or a detachment during an eye examination. The eye will be dilated, which widens the pupils so that a better visual for the doctor can be achieved. In some cases, the tear can be seen without an ultrasound, an ultrasound of the eye may also be performed so that further examination and additional detail of the retina can be assessed. During the eye examination, our ophthalmologist will be able to tell whether a retinal tear, early detachment, or a complete retinal detachment is present.

Treatment and Prognosis

Retinal tears may be treated with laser if there has been no progression to retinal detachment. Usually laser treatment around the tear is needed. The laser treatment is applied to encircle the retinal tear or hole. The idea is to cause scarring to the underlying tissue so that the tear is sealed and fluid can NOT get underneath the retina. The goal of successful treatment is to prevent a retinal detachment from developing. Sometimes laser is not possible and cyrotherapy, a type of freezing, is required.

If a retinal detachment has developed along with the retinal tear, surgery may be required. There are several ways to fix a retinal detachment. Very retina doctor uses different criteria and every retinal detachment is different.

Vitrectomy

This is a common way to fix a retinal detachment. Vitrectomy is a method by which we can fix a retinal detachment from the inside of the eye. Essentially, the vitreous and all the fluid underneath the retina (causing the retinal detachment) is removed during the eye surgery. Gas is then infused into the eye to keep the retina, now reattached, in proper position. The gas may require the patient to maintain a specific head position for a number of days or weeks. The location of the retinal tears will dictate the exact head position required.

Scleral buckle

This is an older technique used to fix retinal detachments. It is performed by passing a silicone rubber band around the outside of the eye. Just like a buckle around your waist, this causes the eye to slightly indent, or “buckle.” This indentation changes some of the forces inside the eye to allow the retina to reattach.

Vitrectomy and scleral buckles are often used together to increase the likelihood of success. Once in a while, certain retinal detachments can be fixed in the office by simply injecting gas. This is called “pneumatic retinopexy.”

Call Today for an Evaluation

Retinal tears and retinal detachments can be common among the adult population, and can cause great worry and concern, which is why we invite you to call our skilled team of retinal specialists for a full eye evaluation. Some patients may have a tear, and not even realize it, which can be detected through a routine eye exam. We look forward to meeting you and working with you to solve your vision problems.