Retinal Tear (Retinal Detachment): Symptoms, Causes & Treatment

Retinal tears are a condition where the inner lining of the eye rips, usually as a result of movement from the vitreous in the eye. This is a serious condition that can lead to retinal detachment, which may permanently damage your vision if not addressed. 

With prompt attention, diagnosis and treatment are usually fairly straightforward, with a good chance of a full recovery.

Symptoms of a Retinal Tear

A retinal tear comes in different levels of severity, with some patients not even realizing they’ve had a tear. 

It is a serious condition, and you should contact an eye care professional immediately if you suspect you may have a tear regardless of severity. Delaying treatment could result in your condition worsening and potentially lead to permanent vision loss.

Early symptoms can include the following:

• Black spots in your vision (floaters)
• Unexplained flashing lights
• Blurred vision

More serious symptoms can include retinal detachment (RD) and vitreous hemorrhaging. 

Retinal detachment can produce the effect as if a moving veil is passing over your field of vision. Vitreous hemorrhaging is characterized by various changes to your vision, including floaters, unexplained shadows, and a red hue effect on the vision from the affected eye.

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Causes of a Retinal Tear

Retinal tearing is often caused by the effects of aging. The vitreous of the eye, a gel-like substance that is full of fibers that connect to the retina, shrinks and thins as you get older. This can sometimes cause it to pull on the retina hard enough to cause a tear. 

This tear allows fluid to flow in, which can lift the retina, causing detachment. Retinal detachment is a very serious eye emergency that can result in permanent vision loss.

Risk Factors for Retinal Tears & Detachment

A number of factors can increase your risk of retinal tearing, some of which you will need an eye exam to identify. These include the following:

• A family history of retinal detachment
• Previous retinal tears or retinal detachment
• Nearsightedness
• Serious eye injury
• Certain medications that reduce your pupil size, including glaucoma medications like pilocarpine
• Certain eye surgeries, such as those for cataracts and glaucoma
• Weak areas of your retina
  

Age has a strong link to retinal issues, especially retinal detachment. These problems often manifest after age 40, and people over 80 are most at risk for problems such as macula-off detachment. 

Despite this, young adults, teenagers, and children can also experience retinal tearing. It is just less common. 

Diagnosis of a Retinal Tear

A doctor can diagnose retinal tears through a process called scleral depression, where slight pressure is applied to the eye. They may also use a three-mirror lens to examine the eye. 

Sometimes, an ophthalmic ultrasound (ultrasound of the eye) is used if hemorrhaging has caused the doctor to have a hard time seeing your retina. 

Treatment for Retinal Tears

Doctors can often treat retinal tears with a fairly simple, in-office procedure. They can take a laser or use a freezing procedure called cryotherapy to bind the tear and prevent further damage. While you may experience mild discomfort during the procedure, it is safe and fairly noninvasive, usually only requiring topical or local anesthesia. 

Some retinal tears can heal on their own, although tears should always be inspected by a medical professional to make sure further treatment isn’t necessary. Even if your tear will heal on its own, your doctor will still want to observe the tear and check on the progress of your healing to make sure no complications arise.

Retinal tears can worsen and having one also increases your risk of future tears. Your prognosis for recovery is usually very good if you get the problem addressed as soon as possible and listen to the recommendations of a reputable medical professional.

Prevention of Retinal Tears

There isn’t much you can do to prevent a retinal tear beyond practicing the basics of eye care, such as always wearing the right safety gear to avoid eye injury. Most of the risk factors for retinal tears are outside your control. 

However, you can prevent severe complications by taking any eye health symptoms seriously. If you experience even mild symptoms, such as seeing some floaters or an even slight blurring in your vision, see a doctor. Even if a retinal tear isn’t the cause, these symptoms require an explanation as they can signal a variety of eye health problems. 

Retinal Tear FAQs

How serious is a retinal tear?

Retinal tears are serious, as they can result in further, potentially severe conditions that can damage vision like retinal detachment. If you have any reason to suspect you may have a retinal tear, see a doctor right away. With prompt treatment, permanent damage can usually be avoided. 

Do retinal tears heal on their own?

Retinal tears can heal on their own if the tear is mild enough, but many will not and can worsen. Never assume your retinal tear will heal on your own, especially if you are experiencing symptoms. It is usually only very mild tears (which may cause a person to experience no symptoms at all) that can heal on their own. 

Even if a tear is very mild and may not require treatment, a doctor will still want to observe how it is healing to make sure a patient’s condition doesn’t worsen and that no complications are present.

What causes a tear in the retina? 

Retinal tears can be caused by aging, trauma to the eye, severe myopia, and eye surgery.

What is the most common cause of a retinal tear?

Aging is the most common cause.

What are the symptoms of a retinal tear?

Symptoms of a retinal tear include floaters (black spots in vision), light flashes, loss of peripheral vision, blurriness, and darker vision.

References

1. Retinal Tears. (2016). American Society of Retina Specialists.

2. Retinal Detachment. (April 2012). JAMA.

3. Retinal Detachment Surgery in the Aging Eye. (October 2021). Retina Today.

4. Vitreous Hemorrhage: Diagnosis and Treatment. (March 2007). American Academy of Ophthalmology.

5. Vitreous Hemorrhage. (February 2022). StatPearls

6. What Is a Torn Retina? (November 2021). American Academy of Ophthalmology.

7. Ageing of the Vitreous: From Acute Onset Floaters and Flashes to Retinal Detachment. (May 2015). Ageing Research Reviews.

8. Vitreofoveal Traction Associated With the Use of Pilocarpine to Reverse Mydriasis. (October 2007). Eye.

9. Ocular Ultrasound: Retinal Detachment and Posterior Vitreous Detachment. (May 2014). Academic Life in Emergency Medicine.

10. Investigation of the Effectiveness of a New Portable ‘Cryopen’ Probe for Cryotherapy (CryoTreq®). (April 2021). International Journal of Retina and Vitreous.

11. Will the Myopia Epidemic Lead to a Retinal Detachment Epidemic in the Future? (November 2020). JAMA Ophthalmology.