As we age, the vitreous slowly shrinks, and as it does so, its fine fibers pull on the retinal surface to pull away from it. Usually the fibers break, allowing the vitreous to separate – an event called a posterior vitreous detachment (PVD). This is a common process that usually doesn't threaten vision. However, in about one in six people, a PVD causes the retina to tear. Subsequently, fluid from inside the eye can seep through the retinal tear and detach the retina from the tissues that nourish it. Retinal detachment can lead to permanent vision loss.
Retinal tears and detachments are painless. Key warning signs include:
New onset of floaters and flashesGradual shading of vision like a curtain being drawnSignificant and rapid decline in sharp, central vision
If you experience any of these warning signs, call us for a thorough retinal evaluation as soon as possible.
While early detection is the key, finding a retinal break may be difficult and requires a very thorough examination. Your ophthalmologist will dilate your pupil specifically for this exam and, using a light source and a hand-held lens, will examine the eye as slight pressure is put on the eyeball with a stick-like instrument called a scleral depressor. This exam will bring any retinal breaks into view and show their exact size and location.
If a retinal tear is detected early, treatment can prevent the retina from detaching. Retinal tears can best be treated with laser photocoagulation treatment in the office to fuse the retina to the back wall of the eye and prevent retinal detachment and vision loss. However, if a retinal tear is not treated with laser, a retinal detachment is likely and further surgical intervention will be necessary.