What is retinal tear or hole?
The retina is a thin, light-sensitive tissue layer that lines the back of the eye like wallpaper. Retinal tears and holes are quite common, present in about 10% of the population. A healthy, intact retina is essential for clear vision. A crack in this thin tissue is called a tear. In most cases, retinal tears occur spontaneously, but other factors such as trauma or previous eye surgery can also cause retinal tears.
Most retinal tears are associated with pulling of the retina by the vitreous gel. The vitreous is a clear, egg-white-like gel that fills the inside of the eye. This gel is attached to the retina at birth, but as we age, it separates from the retina, a condition called posterior vitreous detachment (PVD). Most of the time, this event occurs without any issues. However, in individuals with a naturally “stickier” vitreous, abnormal traction can occur as the vitreous separates from the retina (abnormal vitreoretinal adhesion), and if the adhesion is too tight, it may cause a retinal tear. Although retinal tears can also result from eye trauma, most occur spontaneously due to this process.
The terms retinal tear and retinal hole are sometimes used interchangeably by retina specialists. Retinal tears occur when the vitreous pulls on the retina, whereas retinal holes occur due to progressive thinning of the retina. Retinal holes are typically smaller and carry a lower risk of retinal detachment. However, certain retinal holes still require treatment similar to retinal tears, such as in cases of advanced age, moderate to high myopia, trauma, thinned retinal patches (lattice degeneration), family history of retinal tear and/or detachment, or prior eye surgery.
How is a retinal tear/hole diagnosed?
Retinal tears can be diagnosed through dilated eye exams.
What causes retinal tears/holes?
Vitreous structural changes can lead to retinal tears. The main cause of vitreous changes is aging. In addition, people with myopia are at risk because their retinas are thinner than normal. Finally, retinal tears can occur in less than 1% of patients who have undergone cataract surgery.
What are the symptoms of retinal tears/holes?
Seeing floating objects, sudden flashes of light, reduced vision especially in the peripheral visual field, and a gray curtain across the vision are signs of retinal tears. The most common symptoms are seeing floating objects and sudden light flashes.
Do retinal tears/holes heal on their own? What happens if left untreated?
Retinal tears or holes are serious issues because if untreated, fluid can seep between the retina and the underlying pigment layer. This can lead to retinal detachment, and if the problem progresses, it can result in blindness. Treatment can prevent vision loss and may involve surgical methods or laser therapy.