Case Study: Understanding the Impact of a Retinal Tear

Eye careCase Study
Written By Lucinda Howard

The last in our series of 4 video blogs which focuses on common and sometimes severe eye conditions encountered in practice. The aim of these case studies is to highlight ocular issues that need investigating or are discovered at routine examinations.

Retinal Tear Case Study

Mr A - Retinal Tear Case Study

A torn retina is a serious problem that makes your vision blurry. It is when the retina has a tear or hole, like a rip in cloth. A torn retina often leads to a more serious condition called a detached retina. This is where the retina is lifted away from the back of the eye. A torn retina must be treated right away to avoid further vision problems.

How Do You Get a Retina Tear?

As we age, the vitreous in our eyes starts to shrink and become thinner. Usually, the vitreous moves around on the retina without causing problems. But it may stick to the retina and pull hard enough to tear it. When that happens, fluid can pass through the tear and lift (detach) the retina.

When the retina tears, you may suddenly see light flashes or floaters. Sometimes, blood can leak into the vitreous, causing a vitreous haemorrhage, which can cause a large number of floaters.

With a torn retina, fluid may leak through the hole and detach the retina. This serious problem must be treated right away or you could lose vision.

Who Is at Risk for a Torn Retina?

Here are some things that put you at risk of having a torn retina:

  • Needing glasses to see far away (nearsighted)

  • Having had previous cataracts, glaucoma, or other eye surgery

  • Taking medications that make the pupil small (like pilocarpine) that are used to treat glaucoma and can be used for presbyopia (age-related blurry near vision) 

  • Having had a serious eye injury

  • Having a retinal tear or detachment in the other eye

  • Having family members with retinal detachment

  • Having weak areas in the retina (which your ophthalmologist may see during an exam)

Early Signs of a Retinal Tear

A torn retina has to be checked by an ophthalmologist right away. Otherwise, your retina could detach, and you could lose vision in that eye. Call an ophthalmologist immediately if you have any of these signs:

  • You see flashing lights. Some say this is like seeing stars after being hit in the eye.

  • You notice many new floaters.

  • A shadow appears in your peripheral (side) vision.

  • A grey curtain covers part of your field of vision.

How Is a Retinal Tear Diagnosed?

Your ophthalmologist will put drops in your eye to dilate (widen) the pupil. Then, he or she will look through a special lens to see any changes inside the eye. This is the best way to see if you have a retinal tear or early retinal detachment.

retinal tear image

How Are Retinal Tears Treated?

There are two ways your eye surgeon may fix your retinal tear.

Photocoagulation - A laser is used to seal the retina to the wall of the eye. The goal is to keep fluid from going through the tear and detaching the retina.

The treatment usually takes less than 15 minutes. It may be done right in your ophthalmologist’s office. Your ophthalmologist puts a lens on the front of your eye to focus the laser. He or she then makes tiny burns with the laser to form scars. The scars seal the retina to the wall of the eye.

Cryopexy - Extreme cold is used to seal the retina to the wall of the eye. The goal is to keep fluid from going through the tear and detaching the retina.

This treatment usually takes less than 30 minutes. It may be done right in your ophthalmologist’s office. The surgeon uses a special probe that delivers intense cold energy to the retina. This freezes the retina around the tear and creates scar tissue. The scars seal the retina to the eye wall.

Information provided by the NHS.

Thank you Mr. A for sharing your story.

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Lucinda Howard
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