Retinal Tear
A break in the light-sensing layer at the back of the eye
Quick Facts
- Type: Eye (retinal) emergency
- Warning signs: Sudden floaters and flashes
- Main risk: Progression to retinal detachment
- Treatment: Laser or freezing to seal the tear
Overview
The retina is the thin, light-sensing layer of tissue lining the back of the eye that captures images and sends them to the brain. A retinal tear is a break or hole in this delicate layer. Tears often occur when the vitreous gel that fills the eye shrinks and pulls away from the retina, tugging hard enough to create a break.
A retinal tear is important because fluid can pass through the break and lift the retina away from the back of the eye, causing a retinal detachment, which can lead to permanent vision loss. The good news is that a tear caught early can often be sealed with a simple in-office procedure before a detachment develops. Prompt evaluation of warning symptoms is key.
Symptoms
A retinal tear may cause sudden, noticeable symptoms, although some tears cause few warning signs. Watch for:
- A sudden increase in floaters, seen as new spots, threads, or cobwebs
- Flashes of light, often at the edge of the vision
- A shower of many tiny floaters
- Blurred vision
- A shadow or curtain over part of the vision, which suggests the retina may be detaching
These symptoms are an emergency warning sign. Sudden flashes and floaters, or a curtain over the vision, should be evaluated by an eye specialist right away.
Causes
Most retinal tears happen because of changes in the vitreous gel and its attachment to the retina:
- Posterior vitreous detachment: As we age, the vitreous shrinks and separates from the retina; if it pulls too hard, it can tear the retina.
- Eye injury: Trauma to the eye or head.
- Severe nearsightedness: A longer eye shape stretches and thins the retina.
- Eye surgery: Such as previous cataract surgery.
- Other retinal weak spots: Areas of thin retina that are prone to tearing.
Risk Factors
- Older age, when vitreous changes are more common
- Significant nearsightedness (myopia)
- Previous retinal tear or detachment in either eye
- A family history of retinal detachment
- Previous eye surgery
- Eye injury
Diagnosis
A retinal tear is diagnosed by an eye specialist through a careful examination of the retina:
- Dilated eye exam: Eye drops widen the pupil so the doctor can examine the entire retina for tears or breaks.
- Examination of the periphery: Special attention to the edges of the retina, where tears often occur.
- Ultrasound: Used if bleeding or cloudiness blocks a clear view of the retina.
Because symptoms of a tear and a detachment overlap, prompt examination determines which has occurred and how urgently to treat.
Treatment
The goal of treatment is to seal the tear before fluid can detach the retina. When caught early, this is often a quick, in-office procedure.
- Laser treatment (photocoagulation): Laser creates small burns around the tear that form a seal as they heal.
- Freezing treatment (cryopexy): A freezing probe seals the retina around the tear.
- Monitoring: Some small tears may be watched closely if the risk of detachment is low.
- Treating detachment: If the retina has already begun to detach, more extensive surgery may be needed.
After treatment, follow-up exams confirm the seal has formed and check for any new tears.
When to See a Doctor
Seek eye care urgently if you suddenly notice new flashes of light, a shower of new floaters, or a shadow or curtain across your vision. These are warning signs of a retinal tear or detachment. Treat the following as an eye emergency:
- A sudden burst of many new floaters
- Flashes of light, especially repeated ones
- A dark curtain or shadow moving across the vision
- Sudden loss of part of your vision
Early treatment of a tear can prevent a detachment and protect your sight, so do not wait.
Frequently Asked Questions
What are the warning signs of a retinal tear?
The main warning signs are a sudden increase in floaters, flashes of light, and a shower of new spots. A shadow or curtain over part of the vision suggests the retina may be detaching. Any of these warrant urgent eye evaluation.
Is a retinal tear an emergency?
Yes. A retinal tear can let fluid lift the retina off the back of the eye, causing a retinal detachment and possible permanent vision loss. Prompt evaluation lets the tear be sealed before a detachment develops.
How is a retinal tear treated?
Most tears are sealed in the office with laser treatment or freezing (cryopexy), which creates a barrier around the tear as it heals. This is usually quick and effective when the tear is caught early, before the retina detaches.
What causes retinal tears?
Most occur when the vitreous gel shrinks with age and pulls on the retina hard enough to tear it. Risk is higher with significant nearsightedness, eye injury, previous eye surgery, or a personal or family history of retinal tears or detachment.
Can a retinal tear heal on its own?
A retinal tear generally does not heal on its own and usually needs treatment to seal it. Some very small, low-risk tears may be monitored closely, but this decision should be made by an eye specialist who has examined the retina.
References
- National Eye Institute (NEI). Retinal Detachment.
- American Academy of Ophthalmology. Retinal Tear.
- MedlinePlus, U.S. National Library of Medicine. Retinal detachment.
- Mayo Clinic. Retinal detachment.