Retinal Tears

Retinal tears occur when the protective vitreous gel pulls away from the retina, typically following a case of PVD that went untreated or misdiagnosed. Severe trauma to the eye or complications following eye surgery can sometimes also lead to a retinal tear. At Comprehensive Retina Consultants in Ocala, FL, board-certified retina specialist Dr. Shalesh Kaushal works with patients who have retinal tears, which can lead to serious vision problems if left untreated. While a retinal detachment or PVD can cause floaters, flashes of light, or blurry vision, a tear can cause severe vision loss that may need emergency eye surgery. Dr. Kaushal is a seasoned retina surgeon offering advanced, minimally invasive treatments to help area patients.

PVD, also known as a posterior vitreous detachment, is the most common cause of a retinal tear. If untreated or if the vitreous pulls with enough force on the retina, a tear may form that can lead to severe vision problems. As we age, it is common for the vitreous to change shape, which can cause it to naturally pull away from the retina. Treatment and reducing its movement can help prevent a full tear. If the retina becomes torn, it cannot function properly and can lead to extensive vision loss. In many cases, this vision loss begins with the peripheral or side vision. It is often the first telling sign that a tear has occurred since most retinal tears occur far away from the optic nerve, in the peripheral retina. As the retinal detachment enlarges, this loss of side vision moves toward the center. If the central vision becomes affected, then this indicates that the macula has become detached.

Dr. Kaushal is able to detect a retinal tear upon an eye examination by dilating the eyes. In some cases, he may also order an ultrasound as this will help assess tears that are still tiny in nature. By performing these tests, an accurate diagnosis can be given as to whether the retina has experienced a tear, an early detachment, or a complete retinal detachment. In any event, surgical intervention is usually recommended.

There are numerous strategies to help repair a retinal tear. For tears that have not progressed, laser surgery is often effective for repairing or stopping the progression. During this treatment, the laser causes scarring to the underlying tissue so the tear can be sealed. This means fluid cannot make its way under the retina, which could lead to further movement. Cryotherapy offers a similar result, which is performed to “freeze” the area preventing further damage. This is often performed if laser treatment is not an option. Surgery may be necessary if a retinal detachment has developed along with the retinal tear.

One of the most common methods is via a vitrectomy, which removes the fluid under the retina. Then a gas solution is applied to help maintain the correct position of the retinal head. Although this is an older technique, it is still useful and successful to help treat tears. A scleral buckle is performed by passing a silicone rubber band around the outside of the eye, which causes the eye to slightly indent, or “buckle.” This changes some of the forces inside the eye to allow the retina to reattach. Depending on the nature, the location, and the severity of the tear, Dr. Kaushal sometimes incorporates a joint surgery using both the vitrectomy and scleral buckle technique. This often increases the likelihood of success.

While retinal tears generally do not cause long-term vision loss and can be effectively repaired through minimally invasive techniques or laser treatment, it is important that the condition is caught early. If not, a retinal detachment may occur which almost always causes vision loss or blindness. At Comprehensive Retina Consultants in Ocala, FL, Dr. Kaushal will evaluate each case promptly, offering a fast and effective diagnosis so treatment can be applied before further damage occurs.