Retinal tears may develop without any noticeable symptoms. In other cases, the vitreous gel pulling away from the retina may cause the person to see flashes of light.
Floaters, which appear as black spots or lines in the field of vision, may result from bleeding of torn retinal vessels or the formation of small clumps of vitreous matter.
Once retinal detachment occurs, the person may notice a wavy or watery quality in their vision. If detachment occurs in the peripheral retina, a curtain or shadow may appear across the field of vision. If the area of detachment is in the macula, central vision will be distorted or reduced.
Retinal Tears and Detachments
Most serious retinal problems that require surgery are caused by problems with the vitreous. The vitreous, fills the central cavity of the eye and is attached to the retina. It is most strongly attached to the retina at the sides of the eye, but is also attached to the optic nerve, the macula, and the large retinal blood vessels.
Posterior Vitreous Detachment (PVD): As a person ages, small pockets of fluid form within the vitreous gel. As the eyeball moves, the liquefied vitreous moves around inside the vitreous cavity and pulls on the retina. Over time, the vitreous can pull free and separate from the retina and optic nerve. This kind of detachment happens eventually in most people and only sometimes causes a problem.
When a parson develops a posterior vitreous detachment, flashes of light or large spots in the vision may occur. The flashes of light are caused by the tugging of the vitreous where it is attached to the retina. The spots (or “floaters”) are caused by the vitreous becoming somewhat condensed and stringy.
Retinal Tear and Viterous Hemorrhage: If the vitreous pulls away from the retina in an area where the retina is weak, the retina may tear. If the retina tears across a retinal blood vessel, there will be bleeding into the vitreous. This is called a vitreous hemorrhage.
Retinal Detachment: When a retinal tear occurs, the liquid in the vitreous cavity may pass through the tear and get under the retina, collecting there and lifting the retina up off the back of the eye until it separates. Vision is lost wherever the retina becomes detached.
Treating Retinal Tears and Retinal Detachments
In Office Procedures
Laser treatment or cryotherapy, or both, may be used to seal a retinal tear and prevent a retinal detachment from happening. The laser is a beam of light that turns to heat when it hits the retina. The laser light is directed through a special contact lens. Cryotherapy is a means of freezing the part of the retina that needs to be treated, by placing a cryoprobe on the outside of the eye. Both laser treatment and cryotherapy seal the retina to the back wall of the eye.
Both laser surgery and cryotherapy are done on an outpatient basis. Patients may return to full activity in a short period of time.
If the detachment is too large for laser treatment or cryotherapy alone, surgery is necessary to reattach the retina and avoid total loss of vision. There are two types of surgery for retina detachment: scleral buckling and pneumatic retinopexy.
Scleral Buckling Surgery is the traditional surgery for retinal detachment. The surgeon first treats the retinal tear with cryotherapy. A piece of silicone plastic or sponge is then sewn onto the outside wall of the eye (sclera) over the site of the retinal tear. This pushes the sclera in toward the retinal tear and holds the retina against the sclera until the tear is sealed.
Pneumatic Retinopexy is another type of surgery that can be done for retinal detachments. Instead of placing a cleral buckle on the outside of the eye, the surgeon uses a needle to inject a gas bubble inside the vitreous cavity of the eye. The gas bubble then pushes the detached retina against the back wall of the eye to seal the retinal tear.
Vitrectomy is used when a retinal detachment is so complicated and severe that it cannot be treated with either standard sclera buckling surgery or pneumatic retinopexy. During the procedure, the vitreous is removed (thus the name “vitrectomy”) and replaced with clear fluid or with air that completely fills the eye. Over time, this fluid or air is absorbed and the eye replaces the vitreous with its own fluid.
Macular holes are retinal holes in the center of the macula, caused by vitreous traction. The vitreous overlying the macula may contract and pull up the center of the macula, developing a tiny hole. With time, this hole may become larger. When a macular hole occurs, central or detail vision is lost.
Once a macular hole develops, vitrectomy surgery may help. Our doctors will discuss the likelihood of it helping in your specific case.
Learn More Today
We invite you to call and learn more about our procedures for treating retinal detachment, retinal tears and macular holes. Click here or Call 1 (800) 321-EYES (3937) now to schedule your consultation with one of our surgeons and learn about your treatment options.