Could I Have a Retinal Tear?

 

Are retinal tears common?

Retinal tears occur most commonly over age 40, although can happen anytime. Often, a retinal tear is brought about by a posterior vitreal detachment, or PVD. PVD’s happen to everyone, and most people have no symptoms.

But what exactly is a PVD? The vitreous, or jelly part of the eye, is what helps your eye hold its shape. It sits in front of the retina but behind the lens. It’s sort of the “gooey center” of the eyeball. It starts out the consistency of jello, but as we age, it liquefies. Eventually these changes cause the vitreous to detach from the back of the eye, the retina. Not a big deal, unless the attachment between the vitreous and the retina is tight. If they don’t break apart easily, then you will experience flashes of light, a shower of new floaters, and in 1 of 7 people, a retinal tear.

The PVD itself isn’t a bad thing—it’s actually a good thing! Once the vitreous has detached from the retina you are much less likely to have a retinal tear or detachment. That tight adhesion and pressure on the retina is gone. Also, if cataract surgery is in your future, it’s much easier with a nice, loose vitreous.

Let’s say you have flashes of light (we used to say they looked like a flash bulb, but since no one knows what that is anymore, we now use lightening or fireworks to describe it) and shower of tiny back floaters. Does that mean that you have a retinal tear?

NO. Those who are more nearsighted, have had an eye injury, or have a family history of retinal detachment are at higher risk. Still, there really is no way to know if you’ve had a retinal tear unless you have your eyes examined. That’s where we come in.

If you call our office with flashing lights and new floaters as symptoms we will see you the same day if possible. We will dilate your eyes with drops and take a good look. Statistically, only about 10% of the time will there be a retinal tear, but it’s best to find it early.

Retinal tears are usually treated easily as an in-office laser procedure (the retinal specialists make it look easy). We refer to the VRS office here in Duluth (yes, the same group that fixed  tear), or to Essentia retinal specialty. Usually, the vision returns to normal once the vitreous floaters clear.

It is not supposed to hurt to have a retinal tear repaired, although I’ve had some patients tell me they can feel it. The retina doesn’t have any pain receptors, just light. That’s why when it’s being yanked around by the vitreous in a PVD it doesn’t hurt, it just causes flashes of light. So theoretically using a laser on the retina shouldn’t hurt, but I guess I wouldn’t have it done if I didn’t need it!

What happens if you don’t come in and it is, in fact, a retinal tear? The retina will continue to tear. It acts like super thin plastic wrap. I’m pretty sure everyone has become frustrated with clumped up plastic wrap at some point and can relate. After the retina is torn, fluid can build up behind it, leading to a detachment. The retina can still be repaired, but the procedure is much more involved and success rates are much lower.

It’s too bad Mike had to have a retinal tear, but it brought attention to an important health event. Call if you have any of the symptoms above, and we will be happy to see you. Of course, regular eye care is a must. There’s something to be said for having an eye doctor BEFORE there is an eye emergency!

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