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Retinal Tear and Retinal Detachment

Background

The retina, which lines the inside of the eye like wallpaper, is responsible for all vision. For the retina to function properly, it must be attached to the next layer inside the eye called the retinal pigment epithelium (RPE).

The attachments of the vitreous gel are separating from the retina and optic nerve. Note the firm adhesion point that can lead to a retinal tear (arrow).

The attachments of the vitreous gel are separating from the retina and optic nerve. Note the firm adhesion point that can lead to a retinal tear (arrow).

As we get older, the vitreous gel, which fills the eye, separates from its attachments on the retina (posterior vitreous detachment). When this happens, patients often notice floaters that look like cobwebs or pepper spots in their vision. If the vitreous gel pulls hard enough, it can create a retinal tear. A retinal tear acts as an opening that liquid vitreous can enter.

If your retinal specialist identifies a retinal tear in your eye, he or she will discuss options with you. Some tears can be followed without treatment; however, certain tears are considered high risk and have a significant chance of causing a retinal detachment. These tears can often be “walled off” with a simple laser procedure performed in office, significantly reducing the risk of future vision loss.

Large retinal tear causing a retinal detachment that involves the macula.

Large retinal tear causing a retinal detachment that involves the macula.

If a portion of the vitreous gel travels through the tear, creating a blister under the retina, this will cause a retinal detachment.

Most retinal detachments need to be repaired surgically to prevent the loss of vision. Your retinal specialist will discuss which procedure is best for your specific situation and which options will maximize your visual outcome. The most common techniques used to repair retinal detachments are:

Retinal tears can also result from trauma, infections involving the eye, advanced diabetes, lattice degeneration, sickle cell disease, and other rare eye conditions. Any tear in the retina can lead to a retinal detachment.

Most common symptoms

  • Flashing lights in the peripheral vision
  • Floaters (cobwebs, pepper spots)
  • Shadows or curtains that originate in the peripheral vision and do not resolve

Potential complications

  • Vision loss

What to do if you develop these symptoms

Call your retinal specialist or eye doctor immediately. Most complications arise with the onset of new symptoms and should be addressed promptly.