Retinal Tears, Holes, and Detachments
What is a Retinal Tear, Hole or Detachment?
Peripheral retinal changes can occur from several possible factors. These can range from systemic diseases, to injuries, and even high myopia. The most common findings are degenerative changes in the peripheral retina from stretching and thinning of the retinal tissue where it attaches to the rest of the eye. These common degenerative changes can progress leading to holes or tears in retina. These must be treated if they are deemed a treat to the rest of the retina as they can allow fluid from the vitreous humor (jelly-like substance in back of the eye) to flow behind the retina and detach it from the rest of the eye. A retinal detachment can be cause by an existing hole or tear, or by traction with the vitreous from other retinal diseases or a direct blow to the eye.
Symptoms of Retinal Tears, Holes, and Detachments
Some symptoms of retinal holes, tears and detachments are a sudden increase in vitreous floaters (dark spots moving in front of the eye), flashes of light (photopsias), shaded or missing parts of your visual field, or even cobweb like shadows in your vision.
Diagnosis/Treatment of Retinal Tears, Holes, and Detachments
Recognizing symptoms of these peripheral retinal changes is extremely important as there are many treatments available to reduce permanent vision loss if they are diagnosed and treated in time. If any symptoms are noted a dilated funduscopic examination is indicated immediately. Retinal laser and cryopexy are treatments that can induce retinal scarring around a hole or tear to reattach retinal tissue and prevent progression to a retinal detachment. Retinal detachments are treated surgically with one or more of the following: sclera buckling, pneumatic retinopexy, and vitrectomy. Each of these techniques allows the detached retina to reattach back with the rest of the eye. Prognosis of visual outcome depends on the extent and duration of the detachment and if the macula (central vision) was detached.
What is Macular Degeneration?
Macular degeneration is the leading cause of blindness in America. It results from changes to the macula, the portion of the retina that is responsible for clear, sharp central vision and is located at the back of the eye.
Most people with macular degeneration have the dry form, for which there is no known treatment. The less common wet form may respond to laser procedures or injections that may reduce progression and loss of vision, if diagnosed and treated early. Some common symptoms are a gradual loss of ability to see objects clearly, distorted vision, a gradual loss of color vision and a dark or empty area appearing in the center of vision.
Recent research indicates certain vitamins and minerals may help prevent or slow the progression of macular degeneration.
Vitreous Detachment and Floaters
What are Vitreous Detachments and Floaters?
The vitreous humor is the jelly-like substance that fills the majority of the back of the eye between the lens and the retina. As we age this substance becomes more fluid and eventually detaches from the retina in several areas. This happens and often produces vitreous floaters, which are thicker portions of the vitreous floating in the more liquid portion. The symptoms of these floaters are shadows or dark spots that move through the visual field and can be seen at all ages. A posterior vitreous detachment or PVD is most common after 40 years of age where the vitreous will separate from the back of the retina near the optic nerve.
Vitreous Detachment Symptoms
When a vitreous detachment occurs, symptoms similar to a retinal detachment may be noted, as traction with the retina is common. These symptoms include increased floaters (especially ring shaped central floaters) and flashes of light (photopsias). It is extremely important to have a dilated funduscopic examination if any of these symptoms are noted as retinal tears are possible during these detachments and must be monitored for up to 3 months after onset of symptoms to rule out this risk of retinal detachment.