Treatment for Retinal Tear and Retinal Detachment 

A retinal tear or detachment can be a vision-threatening condition resulting in permanent vision loss. Though retinal tears are not the same as retinal detachment, the two conditions are closely related. Keep reading to find out what you should know about retinal detachment and retinal tears. 

The Retina 

The retina is the light-sensing tissue at the back of the eye. It detects incoming light, converts that light energy into neural impulses, and then sends this information off to the brain to process vision. Though there are other parts of the eye also crucial for vision (such as the cornea and lens), if there is disease or damage to the retina, it is likely to cause some degree of vision loss. 

What is a Retinal Tear?

A retinal tear is a tear or break in the retina tissue. Many retinal tears occur spontaneously after an age-related change to the eye called a posterior vitreous detachment.

The vitreous is a gel-like substance filling the back space of the eyeball (the vitreous cavity).

As we age, this gel liquefies, which can cause it to pull on areas of the retina as it shrinks and collapses.

If the vitreous gel is unable to separate from this point of attachment to the retina, it can result in a retinal tear or, worse, a retinal detachment. 

Other cases of a retinal tear may be a result of an eye injury, such as a hit to the eye. 

Although not the same as retinal detachment, a retinal tear may progress to a detached retina.

Symptoms of Retinal Tear 

Not all retinal tears have symptoms. In fact, many findings of a retinal tear happen incidentally during a regular eye test with your eye doctor or optometrist. Most retinal tears occur in the periphery of the retina rather than towards the centre. 

In some cases, you may notice the symptoms of a retinal tear, which can include seeing flashes of light or floating spots or lines in your vision (floaters). Vision loss or blurred vision are not symptoms of a retinal tear. 

What is a Retinal Detachment?

A retinal detachment is a much more serious condition compared to a retinal tear and can result in permanent vision loss if early treatment is not administered. 

During a retinal detachment, the retina detaches from the underlying tissue, such as the choroid. These tissues provide critical support for the retina; if the retina separates from these layers, it will not be able to function. 

A retinal detachment can affect any size of the area of the retina. Quite often, it occurs in the peripheral retina, but a large detachment can involve the macula, resulting in central vision loss. A retinal detachment is a medical emergency. 

Symptoms of Retinal Detachment

The symptoms of a retinal detachment can be similar to that of a retinal tear. They include:

• Seeing flashing lights 
• Seeing floaters due to blood leaking from broken blood vessels
• Seeing a dark shadow across your sight 

Treatment for Retinal Detachment and Retinal Tears

A true retinal detachment requires urgent retinal surgery. However, if you’re found to have retinal holes or a retinal tear, depending on several factors, it may be more appropriate to monitor the tear over time rather than undergoing retinal surgery. Your eye doctor will advise you on the best treatment options after performing a thorough retina examination. 

Laser Surgery (Laser Photocoagulation)

A higher-risk retinal tear can be treated in the eye doctor’s office with a laser treatment. Using a highly precise laser beam, your eye doctor essentially spot welds the retina securely to the underlying tissues by deliberately inducing small burns that turn into scarring. 

A higher-risk retinal tear is one with the potential to progress into a detached retina. 

Freeze Treatment (Cryopexy)

Your eye doctor may choose to use a freezing probe to create scarring around the edges of the retinal tear to prevent retinal detachment. Similar to laser photocoagulation, the subsequent scarring helps reattach the retina to the back of your eye. 

Pneumatic Retinopexy

This is a form of eye surgery used to treat retinal detachment. A gas bubble is injected into the eye, which helps to push the area of detachment back against the wall of the eyeball. From here, the eye surgeon may use laser surgery or a freezing probe to seal the retina into place.

After this type of eye surgery, some surgeons will recommend you keep your head in a certain position for a few days so that the bubble remains pushed against the right part of the retina. This can depend on where your detachment occurred. 

Scleral Buckle

This is another way of treating a retinal detachment. A silicone band is surgically attached to the outside of your eyeball to gently press it inwards. This allows your retina to come back into contact with the eye wall. Insertion of a scleral buckle is performed in an operating theatre under general anaesthetic. 

Recovery After Retinal Surgery 

Depending on which type of treatment you had and whether you were being managed for a retinal tear or a retinal detachment, your recovery can last from a few days to a few weeks. It is likely you will need to take some time off work. 

In most cases, your recovery from retinal surgery will involve the following:

• Using prescription eye drops in the affected eye
• Protecting yourself from eye injury 
• Making sure you get enough rest and avoid strenuous activity
• Attending follow-up appointments with your eye doctor 

Immediately after your retinal surgery, it can be normal to have some swelling, pain, and blurry vision. If anything feels not quite right, such as your pain is increasing over time, or there is discharge from the eye, contact your eye doctor immediately. 

Treatment for a retinal detachment using pneumatic retinopexy can often result in inducing a cataract. If this happens, your surgeon will discuss cataract surgery to improve your vision. 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. 

References

Laser Surgery and Freeze Treatment for Retinal Tears.
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinal-detachment/laser-surgery-and-freeze-treatment-retinal-tears

Surgery for Retinal Detachment.
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinal-detachment/surgery-retinal-detachment