Retinal Tear

The retina lines the back wall inside the eye and it is a delicate layer of nerve cells critical for our eye sight. A tear or hole in the retina can occur due to a number of factors including ageing changes of the eye, as a result of eye injury or surgery, or in highly short-sighted eyes. As we get older, the vitreous jelly that fills the middle of our eyes and is immediately adjacent to and supports the retina, starts to shrink and lose its protective firmness. As the vitreous jelly degenerates and shrinks, in healthy ageing, it normally separates away from the retina without causing any problems except for some floaters. However, in some instances, the vitreous jelly maybe more “sticky” to the retina and instead of separating away cleanly, it can pull hard enough away from it to tear it. When that happens, fluid (liquified vitreous) can pass through the tear and lift or detach the retina, leading to vision loss. A detached retina can no longer function normally, resulting in vision loss and blindness.

People are at most risk of developing a torn retina around the ages of 40-50 years when their vitreous jelly undergoes age-related degenerative changes as just described above. However, the age at when this occurs is highly variable and retinal tear can occur at younger and older age groups. Some of the individual risk factors that can put you at higher chance of developing a torn retina include:

• Being short-sighted (or needing highly myopic prescription glasses to see far away).
• Having a retinal tear or detachment in the other eye.
• Having family members who have had retinal detachment.
• Having weak or fragile areas in the retina (which your optometrist or eye specialist may find during a dilated retinal examination).
• Having had previous cataract, glaucoma or other eye surgery.
• Having had significant eye injury or trauma.

A torn retina has to be urgently detected and treated by an ophthalmologist right away. Otherwise your retina could detach and you could lose vision in that eye. Urgently contact your eye specialist if you have any of the following symptoms:

• You become acutely aware of many new floaters (shaped like moving small dots, hairs, flies or cobwebs).
• You see flashing lights. These are often very brief flashes of light (like a camera flash) and are most noticeable in the dark or dim illumination.
• A shadow or gray curtain appears in your peripheral (side) vision.

Only a thorough and detailed dilated retinal examination by an experienced retinal specialist can detect small or very peripheral retinal tears or holes. Your ophthalmologist will put drops in your eye to dilate (widen) the pupil. He will then look into the back of your eye through special optical lenses and use a diagnostic microscope to examine all the areas of your retina in 3D. Standard 2D imaging or retinal scans can easily miss a peripheral retina tear or hole. Also, a 2D wide field digital retinal imaging can also result in a false positive result, where a retinal tear or hole is incorrectly diagnosed when in fact, there is no such problem. Either way, it is vital to have the definitive diagnosis confirmed by your ophthalmologist, giving you the reassurance and confidence in the most appropriate treatment and/or monitoring plan being instituted.