Retinal tear occurs when the vitreous gel pulls on the retina causing the retinal tissue layer to break or rip, which can cause bleeding into the eye and progress rapidly to a retinal detachment.
Retinal tears can lead to a more serious condition called retinal detachment. The retinal tear is differentiated from a retinal detachment in that the tear is a precursor condition, which left untreated, can progress to a retinal detachment.
Sudden retinal tears occur when the vitreous gel starts to undergo a normal process called syneresis and liquefaction which leads to layers of the gel pulling on parts of the retina. In some individuals, due to hereditary predisposition and structural abnormalities of the retina, when the vitreous gel pulls on the retina, it can tear or cause a break in the retina (think of duct tape pulling away from a wallpaper and causing a tear in the wallpaper).
When the retina is torn, patients experience seeing sudden floaters or flashing lights in the periphery. It is important to have a retinal exam, and if a tear is present, the retina specialist will determine if it requires treatment with laser photocoagulation in order to prevent or reduce the risk of a much more serious condition called retinal detachment. A retinal detachment is similar to a whole area of the wallpaper coming down instead of a small tear of the wallpaper. This leads to loss of vision at first in the periphery and then the central area.
Retinal tears that require treatment are treated with laser photocoagulation (also known as retinopexy), which uses precise laser beams (like welding spots) delivered to encircle the retinal tear, to wall off or barricade the torn retina, thereby reducing the risk of retinal detachment. Another method of treatment is called cryopexy, which uses a probe that reaches subzero freezing temperature to created controlled scarring to the torn retina.
Not all retinal tears require treatment, and special consideration is given to different types of retinal tears, i.e. horseshoe or flap retinal tear vs round, retinal holes, acute vs long standing, presence of symptoms or not, family history of retinal detachment, and other risk factors.
Your retina specialist can determine and discuss with you the best management options.
Laser Photocoagulation (or laser barricade) for retinal tear treatment
Laser photocoagulation uses a special laser to create controlled, precise laser to create burns like welding spots around the torn retina to surround it. This scarring prevents the retina from separating from the wall of the eye (retinal detachment). It is highly effective in reducing the risk of retinal detachment.
Cryopexy for treatment of retinal tear
Cryopexy utilizes a special probe that is placed on the outer wall layer of the eye to create a controlled freeze burn in the area of the torn retina. This creates scarring that helps to reduce the risk of retinal detachment.