What are the symptoms of a retinal tear?
The retina is a thin, light-sensitive inner lining at the back of the eye. A healthy and intact retina is essential to provide good vision. When there is a crack on the retina, it is known as a tear. A retinal tear occurs when the vitreous humour (a clear-gel that fills up the vitreous chamber) pulls on the retina causing a crack. This condition requires prompt retinal tear treatment for to preserve the vision.
The eye is filled with vitreous humour, which provides support to the retina and eye. The vitreous humour liquifies as we age, and during this process, posterior vitreous detachment takes place, whereby the vitreous separates from the retina. Most people have no issue when this happens, but in some whose retina is thin or the vitreous is naturally ‘sticky’, it may lead to a retinal tear.
Risk factors that can cause a retinal tear include:
- Eye injury.
- High myopia.
- Lattice degeneration.
- Family history of retinal detachment, tear or retinal detachment in the other eye.
- Usage of certain medications.
- Contact sports that pose a high risk to head injury.
- Previous eye surgery.
- Certain health conditions like diabetes, sickle cell disease, inflammatory disorders, autoimmune disease, can also increase the risk of a retinal tear.
A retinal tear is not akin to a retinal detachment but it can develop into a retinal detachment if no treatment is done to seal the tear, as the vitreous humour can leak behind the tear, causing the retina to be separated from the wall of the eyeball. This causes the retina to lose its oxygen and nourishment supply. A retinal detachment is a serious eye condition which can cause permanent loss of vision if left untreated.
Common symptoms of a retinal tear include:
- Seeing sudden flashes that can look like flashing lights, lightning streaks or stars in your vision field. Flashes are optical illusion caused by the vitreous pulling on the retina.
- Sudden onset or sharp increase in floaters, which are small dark shapes that float across your vision. They can look like small moving specks of clouds, small dots, threads, strands or cobwebs.
Flashes and floaters are the most common symptoms associated with a retinal tear, but a sudden decrease in vision, shadow-like in the peripheral vision or curtain vision (i.e. darkening across your vision field) are also possible indications of a retinal tear or more severe a retinal detachment.
Retinal Tear Treatment Singapore
A retinal tear does not always require treatment, but treating it minimises the risk of a retinal detachment which can be sight-threatening.
The types of retinal tear laser treatment include photocoagulation and cryopexy.
Photocoagulation uses a laser to create small burns to seal the retina. This procedure usually takes less than 15 minutes. The eye specialist places a lens on the front of the eye to focus the laser, and will thereafter make tiny burns with a laser to form scars.
Cryopexy uses extreme cold to seal the retina. This procedure usually takes less than 30 minutes and the eye specialist uses a special probe that delivers intense cold energy to the retina thereby freezing the retina around the tear to create scar tissues.
Both procedures create scars to seal the retina to prevent fluid from going through the tear and under the retina. Recovery is quick and normal life resumes immediately post-procedure.
Retinal Detachment Surgery Singapore
Retinal detachment is a much more serious eye condition than retinal tears that needs to be quickly treated. Otherwise, when more of the retina detaches, it will increase the risk of irreversible vision loss or even blindness. It may occur as a result of injury to the eye or by structural changes in the eye. Most retinas can be reattached if the condition is diagnosed early. The 2 main treatments to reattach the retina are vitrectomy and scleral buckle.
A vitrectomy is performed under local or general anaesthesia in an operating theatre. Three small openings are made in the sclera (white of the eye) and microsurgical instruments are used to remove the vitreous gel. There is no need to refill the vitreous gel as it is not required for the eye to function normally.
Depending on your condition, various surgeries including membrane peeling, laser therapy and freezing (cryotherapy) may be performed as part of the treatment. Finally, the eye surgeon may inject synthetic air or silicone oil into the eye to hold the retina in place.
Scleral buckle surgery performed in an operating theatre to treat a detached retina. The eye surgeon will sew a silicone sponge or band onto the sclera below the eye muscles. The sponge or band is tied in a way to ensure the retina stays in place as it pushes in the sclera creating a mark that releases the abnormal internal pressure on the retina. Some fluid may be removed from underneath the retina. The detached retina will then be able to reattach itself with the eyewall.