The mechanics of sight are incredible: When light enters the eye, it passes through the iris to the retina, where images are focused and converted to electrical impulses that are carried by the optic nerve to the brain. The retina, a thin layer of tissue that lines the back of the eye, is kind of like the projector screen for our eyeballs. As we age, the retina can tear, creating a risk of retinal detachment and severe loss of vision. However, if caught quickly, a retinal tear can be repaired relatively easily, so it’s a good idea to know how to recognize them.

What is a Retinal Tear?

Labeled anatomical diagram of a human eyeballThink of an eyeball like a grape; the retina could be compared to the skin, and the gel-like inner substance is called the vitreous. At birth the vitreous is attached to the retina, but as we age, the gel separates from the retina creating a posterior vitreous detachment, or PVD. This is a natural change that accompanies aging, and most of the time, this happens without any issues or noticeable symptoms. Sometimes, however, the vitreous is “sticky,” and as it pulls away from the retina it can take bits with it, causing a tear. 

Some specialists refer to retinal tears and retinal holes interchangeably, although they’re not quite the same thing. Retinal tears develop when the vitreous pulls on the retina, while holes usually develop due to progressive thinning of the retina and are typically smaller and less worrisome than tears.

What Are Retinal Tear Symptoms?

A field of poppies, with shadows overlying them
Example of how floaters can appear

When you get a retinal tear, you might experience the sudden onset of black spots or “floaters” in the affected eye. A floater is a mobile, blurry shadow, like the inverse of what happens when you look directly into the flash on a camera. Sometimes there are multiple floaters, so it can look like someone shaking pepper in your vision or even a swarm of insects. You could also experience Photopsia or spontaneous flashes of light.

Occasionally a retinal tear is accompanied by vitreous hemorrhage (bleeding into the clear cavity), or retinal detachment. This would cause blurred vision or a shadow that seems as if curtains are closing in from the peripheral vision.

Common Risk Factors

Retinal tears can happen to anyone, but the American Society of Retina Specialists lists a few commonalities that make getting one a bit more likely:

    • Advanced age
    • Nearsightedness
    • Associated lattice degeneration (or thin patches in the retina)
    • Trauma to the eye
    • Family history of retinal tears or detachment
    • Prior eye surgery

Treatment and Prognosis

An eye doctor gives eyedrops to an older woman who is seatedMost retinal tears can be easily diagnosed by an eye doctor using scleral depression (applying slight pressure to the eye) and/or a 3-mirror lens technique. If discovered quickly — before it can progress to retinal detachment — a retinal tear has an overwhelmingly positive prognosis.

The procedure to repair a retinal tear is relatively simple: topical or local anesthesia is applied, and a laser is used to “spot-weld” (for lack of a better term) around the edges of the tear, eliminating the chances of it progressing to retinal detachment. While some tears can repair themselves, it is always important to have an optometrist closely monitor and observe any changes.

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