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Disease

Retinal Tear

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Retinal Tear

There may be areas where the vitreous is very strongly attached to the retina, usually in the peripheral retina. If the vitreous pulls away from the retina in an area where the retina is weak, the retina may tear. Imagine a piece of adhesive tape attached to tissue paper. If you try to pull the tape off the tissue paper, you will tear the paper. A tear of the retina works very much the same way. If the vitreous is firmly attached, as it pulls, it can tear the retina. If the retina tears across a retinal blood vessel, blood will enter the vitreous. This is called a vitreous hemorrhage.

When there is a little bleed, red blood cells floating and moving in the vitreous create the sensation of walking through a swarm of flies. When a larger vessel is torn, more blood enters the vitreous and it looks like a spider web or a swirling mass of black or red lines. If there is a great deal of bleeding into the vitreous cavity, vision may be reduced significantly, or even become very dark. When a retinal tear occurs, it is a potentially serious problem. If a vitreous hemorrhage also occurs, it is even more serious.

The retina can tear immediately following a posterior vitreous detachment (PVD), or weeks later. If no tear has developed within about eight weeks after a PVD, the retina probably will not tear.

Any patient who experiences sudden or new floaters, or flashing lights of any kind, should have a complete retinal examination immediately. These symptoms may be a warning signal that a retinal tear has occurred. A retinal tear may result in a retinal detachment. Since retinal tears and retinal detachments begin in the peripheral retina, your doctor may suggest that you test your peripheral vision to be sure there are not changes.

Patients with a recent PVD should be re-examined within a few months, because new retinal tears may develop with no, or only few, new symptoms. If any new symptoms do occur, you should call your doctor promptly.

Giant Retinal Tear

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Giant Retinal Tear(torn retinal folded over)

Just as vitreous pulling creates small retinal tears, it can also cause very large retinal tears. If the retinal tear is very great (one quarter of the retina or more), it is called a giant retinal tear. Occasionally, the tear is so large that the retina folds over on itself like a piece of paper folded in half. A giant retinal tear is a very serious problem.

Vitrectomy, scleral buckling, and laser treatment may be used to treat giant retinal tears. The lens of the eye is often removed to make this surgery successful. The goal of the surgery is to unfold the retina, put it back in place, and seal it into its proper position. Silicone oil or fluids that are heavier than water (called perfluorocarbons) may be used to unfold a giant retinal tear and reattach the retina.

Many patients will see well after surgery for a giant retinal tear, but some will not. Most will recover enough vision to get around. Despite modern techniques to reposition the folded retina and hold it into place, many eyes develop scar tissue (PVR) after the surgery and the retina again becomes detached. Your surgeon will discuss with you your chances for regaining some vision with this surgery, as well as the possible complications.