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Retinal Tear / Retinal Detachment

The retina is the membrane at the back of the eye. It is where the image that falls through the pupil is sent through the optic nerve to the visual areas of the brain, where it can be properly seen.

The space between the retina and the lens is filled by a gel called the vitreous humor. As time goes on, this gel starts to shrink, and as it does, fibers tug on the surface of the retina that cause the vitreous to pull away from it. Eventually, these fibers snap, and the vitreous separates in a process called posterior vitreous detachment. This usually doesn’t result in blindness, but in uncommon instances, the retina itself tears. When this happens, the fluid can infiltrate the tear and detach the retina completely. This can lead to permanent blindness.

The unfortunate thing about retinal tears and retinal detachments is that they’re painless. Signs that one might be developing are swarms of floaters and flashes in the field of vision, a sensation like a curtain being pulled down over the field of vision and a sudden and noticeable deterioration in the person’s central vision. A person who is experiencing these signs should call Campus Eye Group as soon as possible. Treating these symptoms quickly is a way to correct retinal tear / retinal detachment and prevent blindness.

Though it is important that a retinal tear or retinal detachment be found early, finding it is challenging and requires a careful examination. To this end, the ophthalmologist dilates the patient’s pupil and examines the back of the eye with a lens and a scleral depressor. This helps the ophthalmologist find the damage to the retina and evaluate its exact location and size.

If a tear is located, it can be treated with a procedure called laser photocoagulation. This treatment reattaches the retina to the back of the eyeball and lowers the risk of a detachment and its attendant blindness. During laser photocoagulation, the ophthalmologist numbs the eye then uses a precise laser to burn the place around the tear. This creates scar tissue and helps to seal the tear and prevent fluid from the vitreous humor from seeping beneath the retina. Laser photocoagulation can even be used to repair a retinal detachment.

After the treatment, the ophthalmologist gives the patient a topical steroid to keep down swelling. The patient will need to rest in bed for a few days, probably sleep with their head elevated for a time and avoid strenuous exercise while their eye heals.

Retinal tear / retinal detachment can also be treated through cryotherapy. In this treatment, cold, not lasers, is used to create the scar issue. Again, the eye is anesthetized, and the ophthalmologist puts a freezing probe over the area to be treated. They may need to do this several times. Again, the ophthalmologist gives the patient a topical steroid after the treatment, and the patient will need to rest for a few days.

If the tear isn’t treated, the patient is at risk for a detachment and may need more invasive surgery. These interventions include vitrectomy, which removes the vitreous humor and replaces it with a synthetic gel. Another treatment is the scleral buckle, which secures the retina against the back of the eye by causing the white of the eye, or sclera to buckle. Pneumatic retinopexy is another eye surgery where gas is introduced into the eyeball in order to push the detached or torn retina against the posterior wall of the eye.