You don’t have to be an ophthalmologist to know that the term “torn retina” can mean bad news. In fact, for many patients the term may be downright terrifying — partly because of the phraseology and partly because they may not fully understand what it means.
Any eye doctor knows just how complex the eye is, and explaining the implications of an eye injury or anything that might lead to dreaded vision loss can be one of the more challenging parts of the job.
So, to help both doctors and patients, we’re here with a brief overview of retinal tears: what they mean for both doctor and patient, what should be done about them, and what other complications they can lead to.
How Serious Is a Torn Retina?
First, let’s make sure we’re clear on terminology. The retina is the thin, light-sensitive tissue on the back of the eye near the optic nerve. It collects the light the lens focuses and sends it the information to the brain. So, simply put: no retina, no vision.
A torn retina can be potentially very serious, though it isn’t always. A retinal tear can allow fluid to enter between the retina and the vitreous gel that makes up most of the eye. In a worst-case scenario, this can lead to retinal detachment — which, in turn, can lead to vision loss. Retinal detachment is indeed a medical emergency that requires immediate ophthalmic intervention, even if symptoms may seem minor at first. Any delay in treating a detached retina increases the risk of vision impairment and loss. This risk grows more serious the longer the delay is.
A retinal tear doesn’t always lead to retinal detachment, but once detected it should be carefully monitored. But how would someone know if they were suffering a retinal tear?
Retinal Tear Symptoms
The most common symptoms of a torn retina are:
- A sudden onset of flashing lights
- A significant and rapid increase in the number of new floaters
- Blurred vision
- Reduced peripheral vision, or a gray shadow, especially in the case of vitreous hemorrhage
Do note that a torn retina doesn’t necessarily manifest any symptoms. But if you or anyone you know starts to experience the above symptoms, get to an ophthalmologist right away.
Torn Retina Treatments
As one might expect, a torn retina requires treatment — usually in the form of surgery.
Two of the most common treatments are laser therapy and cryotherapy. Essentially, both seal the edges of the hole so that it can’t grow anymore, preventing a possible posterior vitreous detachment. Both laser treatment (photocoagulation) and cryotherapy (cryopexy) can be performed in a clinic rather than in a hospital and usually cause minimum discomfort.
Photocoagulation
Photocoagulation relies on a laser to burn the edges of the retinal hole, creating scar tissue. This laser surgery will hold the hole in place so it doesn’t grow anymore. You’ll get local anesthesia put in your eye and the doctor will shine a laser through your pupil to seal the hole.
Cryopexy
Similar to photocoagulation, cryopexy relies on keeping the hole in place — except it uses a freezing probe rather than a laser. The doctor will touch a freezing probe to the sclera (the white part of the eye) nearest the hole. The intense cold will create scar tissue around the edge of the hole so it won’t move anymore. Because your eye will be treated with local anesthesia, you won’t feel much.
Macular Hole Treatments
There are specific and interesting new treatments for a hole in the macula — the central part of the retina. The most common treatment has been pars plana vitrectomy followed by the insertion of a gas bubble, called pneumatic retinopexy, that allows the hole to heal. However, other possibilities do exist. For example, some studies indicate using eye drops to dehydrate the macula allows holes to heal without any surgical intervention. Further studies have shown that stem cells, including amniotic stem cells and mesenchymal stem cells isolated from umbilical cords, can be valuable for treating macular holes. Check out our article linked above for more on those treatments.
Who Is at Risk of a Torn Retina?
Generally, retinal tears and detachments affect the elderly more than anyone else. As you age, the vitreous pulls away from the retina, which happens often and normally without incident. However, not all vitreous is made the same, and in some people it’s more sticky — which leads to an increased risk of tearing when it fails to peacefully release from the retina.
There are some other risk factors in addition to age that can lead to a higher risk of retinal tears. These can include:
- Previous eye surgery
- Eye trauma, i.e. injuries
- A family history of retinal detachment
- Previous eye diseases, like lattice degeneration
- Extreme nearsightedness
Preventing Retinal Tears
Patients who are over 60 or have any of the above symptoms should have regular checkups with their ophthalmologist. It’s far better to catch a retinal tear before any symptoms manifest or it worsens into a retinal detachment, after all.
An ophthalmologist can detect a retinal tear before it progresses, most commonly via scleral depression — applying slight pressure to the eye — or via a 3-mirror lens. In some cases, ultrasound might be necessary.
In any case, preventing retinal holes can be as simple as having a regular comprehensive eye exam — which we guarantee is much more fun than retinal detachment surgery.
