The eye contains a light-sensitive layer of tissue called the retina at its back. This thin layer converts incoming light into electrical signals, which are then transmitted to the brain for interpretation as images. A retinal tear occurs when this delicate tissue develops a break or rip.
Understanding Retinal Tears
A retinal tear occurs when the retina, the inner lining at the back of the eye, develops a small break. This happens when the vitreous, a clear, gel-like substance that fills the eye’s cavity, pulls on the retina with enough force to cause a split. As people age, the vitreous naturally shrinks and can separate from the retina in a process known as posterior vitreous detachment (PVD). While PVD is a common and usually harmless age-related change, it can sometimes lead to a retinal tear if the vitreous remains firmly attached to certain areas of the retina during this separation.
Studies indicate that 8% to 22% of people experiencing symptomatic PVD may also develop retinal tears.
Factors Increasing Risk
Several factors can increase an individual’s likelihood of developing a retinal tear. Age is a primary contributor, as the natural changes in the vitreous gel that occur over time are a cause of these tears.
Nearsightedness, or myopia, especially severe forms, is another factor. In highly myopic eyes, the eyeball is often elongated, causing the retina to stretch and become thinner, which makes it more susceptible to tears. Previous eye surgery, such as cataract surgery, may also elevate risk. Eye trauma, such as a direct impact to the eye, can cause retinal tears, and a family history of retinal tears or detachment suggests a genetic predisposition.
Recognizing the Warning Signs
Identifying the warning signs of a retinal tear is important for timely intervention.
Floaters
One common symptom is the sudden appearance of new floaters. These are small dark spots, specks, or cobweb-like shapes that drift across the field of vision. They are often more noticeable against a plain background like a clear sky or white wall. A sudden increase in their number or size should prompt concern.
Flashes of Light
Another warning sign is the experience of flashes of light, also known as photopsia. These flashes can appear as bright spots, streaks of lightning, or resemble “stars” in the visual field. They occur when the vitreous gel tugs on the retina, stimulating the light-sensing cells. While occasional flashes can be normal, new or persistent flashes warrant immediate attention.
Other Symptoms
Other symptoms that may accompany a retinal tear include a sudden reduction or blurriness in vision. Some individuals might also perceive a dark curtain or shadow that appears to spread across their field of vision, often starting from the periphery. Retinal tears are typically painless, so the absence of pain should not delay seeking professional eye care if these visual symptoms arise.
Tear or Detachment Knowing the Difference
While closely related, a retinal tear and a retinal detachment are distinct conditions. A retinal tear is a break or hole in the retinal tissue itself, creating an opening through which fluid from the vitreous cavity can pass.
A retinal detachment occurs when the retina lifts or pulls away from its normal position at the back of the eye. This separation happens if fluid seeps through a retinal tear and collects underneath the retina, pushing it away from the underlying supportive tissue. An untreated retinal tear can progress to a more serious retinal detachment. Both conditions are medical emergencies and require immediate evaluation by an eye care professional. Prompt attention to symptoms can prevent a retinal tear from advancing to a detachment, which can lead to permanent vision loss if left untreated.