Fundus photo of a highly myopic patient with lattice retinal degeneration showing associated superior retinal tears.

A Retinal Tear is a rip in the thin, light-sensitive tissue that lines the back of the eye. Retinal tears can lead to a more serious condition called Retinal Detachment. This is where the retina is lifted away from the back of the eye. A retinal tear must be treated right away to avoid further vision loss from a subsequent retinal detachment.

Retinal tears are caused by pulling of the vitreous gel away from the retina. This can happen with the development of a posterior vitreous detachment or (PVD). Once the retina is torn, fluid can pass through the tear and lift or detach the retina.

What are the Risk Factors for Retinal Tear and Retinal Detachment?

  • Degree of myopia (nearsightedness)
  • Previous eye surgery
  • Medications that make the pupil small (ex. pilocarpine) used to treat glaucoma or used for presbyopia  
  • Previous eye injury
  • History of retinal tear or detachment in the other eye
  • Family history of retinal tear or detachment
  • Lattice retinal degeneration or other peripheral retinal abnormalities

What are the Signs and Symptoms of Retinal Tear and Retinal Detachment?

A torn retina must be evaluated right away. Otherwise, it can progress to a retinal detachment and lead to vision loss. Call immediately if you experience any of the following:

  • Photopsia or flashing lights, like seeing stars after being hit in the eye
  • New floaters
  • Blurred vision – sometimes caused by vitreous hemorrhage
  • If the retinal tear leads to a retinal detachment, you may also see:
  • A shadow as if curtains are closing in from the peripheral vision
  • A gray curtain covering part of your field of vision

However, it is important to note that in some cases, a retinal tear may not manifest any noticeable symptoms at all.

How is a Retinal Tear or Retinal Detachment Diagnosed?

A thorough and timely examination by a retina specialist using scleral depression (applying slight pressure to the eye) is the most important step in diagnosing a retinal tear or retinal detachment.

How is a Retinal Tear or Retinal Detachment Treated?

If a retinal tear is diagnosed promptly before it progresses to retinal detachment, the prognosis is extremely good. Retinal tears are best treated with laser photocoagulation. This treatment, called laser retinopexy, is performed in the office and is very effective and quite safe. It is performed by placing tiny burns with the laser to form scars around the tear. The scars seal the retina to the wall of the eye. The goal is to keep fluid from going through the tear and detaching the retina.

After a tear has been treated, there remains a future risk of developing additional, separate retinal tears; therefore, continued monitoring is important.

If you have a retinal detachment, depending on how much of the retina is detached, where the detachment is located, and what type of retinal detachment you have, you may be recommended to be treated with laser surgery, cryotherapy (freezing treatment), pneumatic retinopexy or another type of surgery called vitrectomy. Smaller and more localized retinal detachments can often be treated with laser photocoagulation in the office. More advanced and complicated retinal detachments, however, may require surgeries such as vitrectomy or scleral buckle procedures which are done in the operating room to re-attach the retina.

Fundus photo of the superior retinal tears after laser retinopexy.

Source: American Academy of Ophthalmology