Retinal tear: causes, symptoms and treatment

What is a retinal tear?

A retinal tear happens when the vitreous gel inside the eye pulls away abnormally from the retina, the light-sensitive tissue at the back of the eye. This pulling can cause a piece of the retina to tear, particularly if there is strong adhesion between the retina and the vitreous. A retinal tear can develop into a sight-threatening retinal detachment, so it is crucial to have your eye examined by a specialist if you notice symptoms.

Is a retinal tear an emergency?

Yes, a retinal tear can lead to a retinal detachment, which usually requires urgent treatment to prevent loss of sight. Once a retinal tear occurs, fluid can flow through the tear and separate the retina from the wall of the eye, a condition known as rhegmatogenous retinal detachment. Since a retinal tear is easier to repair than a retinal detachment, it is recommended to have your eye examined within 24 hours of noticing any sudden vision changes.

What causes a retinal tear?

• Posterior Vitreous Detachment (PVD): The most common cause of a retinal tear is PVD. As the vitreous gel shrinks and becomes more liquid with age, it pulls away from the retina. If this pulling is too strong, it can tear the retina.
• Eye trauma: Severe blunt trauma to the eye can also cause a retinal tear or retinal detachment.

What are the symptoms of a retinal tear?

Symptoms of retinal tears are similar to those of retinal detachment and include:

• Sudden increase in floaters (spots that appear to float across your vision)
• Appearance of a shadow in the peripheral vision, which can rapidly increase in size and lead to loss of central vision
• Onset of flashing lights in the vision

If you experience these symptoms, see an eye specialist immediately to prevent the retinal tear from leading to retinal detachment.

Treatment options

Retinopexy: The primary treatment for a retinal tear is retinopexy, which involves using laser or cryotherapy to seal the tear. This process is similar to spot-welding around the tear, reducing the chance of the surrounding retina detaching from the eye wall. The treatment is performed under local anaesthesia and takes between 10 and 30 minutes.

What to expect after treatment

After treatment, your vision will be blurred for a few hours but should clear by the next day. You may be prescribed eye drops for a week or more, and your eye may be red and feel gritty or dry during this period.

Several weeks after the procedure, your retina specialist will confirm if the treatment was successful. If you develop new symptoms such as floaters or shadows in your peripheral vision, seek immediate attention to ensure no new retinal tears or detachment have developed.

In the months following a retinal tear, there is a small chance of developing an epiretinal membrane at the central retina, which can blur fine vision. Extensive retinopexy may slightly increase this risk.

Learn more about epiretinal membrane treatment here.