If you’ve ever been diagnosed with a retinal detachment, you’ll know that your eye surgeon considers this a medical emergency. The management of retinal tears, on the other hand, can vary depending on several factors but also should always be assessed by an optometrist or eye doctor. If you’ve been recommended surgery for a retinal tear or a retinal detachment, keep reading to find out what to expect.
What is a Retinal Tear?
As the name suggests, a retinal tear is a break in the retina. The retina is the delicate light-sensitive tissue at the back of the eye. A similar entity is a retinal hole; sometimes, an eye doctor will use these terms interchangeably.
What Causes Retinal Tears
Most retinal tears are a complication of an age-related change to the eye called a posterior vitreous detachment. The vitreous gel fills up the back space of the eyeball and is attached to certain points around the retina. As we get older, this gel-like substance liquefies and can put tension on these areas of attachment. This tugging on the retina can result in a retinal tear. In some cases, it can cause a retinal detachment.
Another cause of a retinal tear is eye trauma.
Risk factors for retinal tears include:
- Older age
- Short-sightedness (myopia)
- Retinal thinning
- A previous retinal tear
Symptoms of a Retinal Tear
Symptoms of a retinal tear can include:
- Floating specks in the vision
- Intermittent flashing lights
- Blurred vision due to blood leaking from broken blood vessels present
However, many cases of retinal tears don’t present with any noticeable symptoms and are only detected as an incidental finding in the far peripheral retina during a routine eye exam.
What is a Retinal Detachment?
A retinal detachment is much more serious compared to a retinal tear as it can lead to vision changes, such as an area of permanent vision loss.
A retinal detachment occurs when the retina separates entirely from the underlying tissues at the back of the eye. A detachment can involve the macula (which is responsible for your central vision) or remain confined to the peripheral retina.
Retinal Detachment Causes
Similar to those for retinal tears, causes for a retinal detachment can include eye injuries or age-related changes to the vitreous gel. A retinal detachment may also occur spontaneously without an identifiable reason, though there are some known associated risk factors, such as:
- Previous cataract surgery
- Previous retinal detachment
- Areas of retinal thinning
- Family history of retinal detachment
Retinal Detachment Symptoms
Symptoms of retinal detachments are similar to that of a tear. You may see the following:
- Intermittent flashing lights, often with rapid eye movement
- Floating specks, squiggles, or cobwebs
- A dark shadow coming across your peripheral vision
- Other vision changes, such as a blurry patch
An acute retinal detachment tends to be more noticeable compared to a retinal tear. However, there have still been cases when a patient has been unaware they were experiencing a retinal detachment.
What is Involved in Retinal Tear Treatment and Recovery?
Not all retinal tears require treatment. If the tear is deemed low risk by your eye surgeon, you may elect just to be monitored over time as opposed to having retinal surgery. However, if the retinal tear has the potential to develop into a detachment, it would be wiser to have it preventatively treated.
Laser surgery for retinal tears is known as laser photocoagulation. During this procedure, a laser beam is used to create tiny burns around the retinal tear. This induces scar tissue, which helps to adhere the retina back to the eye.
There is typically no eye pain associated with this laser treatment, though some patients report a prickly sensation.
After your laser surgery, you can expect some blurred vision and will need someone to drive you home. Ensure you get some rest over the following days, and attend your follow-up appointment as scheduled several weeks later. You won’t require eye drops after this procedure.
This is known as cryopexy and is similar to laser treatment. The eye surgeon uses a freezing probe to form scar tissue around the edges of the torn retina, helping the retina anchor to the eye.
The retina heals within a couple of weeks after cryopexy surgery. Expect your vision to be blurry for several days, your eye may be slightly red, and you may experience some mild swelling. This can be managed with off-the-shelf painkillers and a cold pack. You can return to most of your normal activities as soon as you’re feeling well enough but avoid exercise or strenuous activities for a few weeks.
What is involved in Retinal Detachment Surgery and Recovery?
This medical emergency requires surgery with modern surgical techniques in a timely manner in order to minimise the impact of permanent vision changes.
Pneumatic retinopexy is a form of retinal surgery involving the injection of a gas bubble into the eye. The bubble expands and pushes the area of detachment against the back of the eye. The eye surgeon can then use a freezing probe to seal the retina in place.
After your retinal surgery, you may have a protective covering such as an eye patch placed over the eye for the next couple of days and also be given eye drops to prevent infection. Your eye surgeon will advise you whether you need to keep your head in a certain position to hold the gas bubble in the right area. You should also avoid quick head movements and heavy lifting.
Scleral Buckle Surgery
Scleral buckle surgery is often performed under general anaesthesia. If, for some reason, this isn’t feasible, you will have local anesthesia. A silicone band is sewn around the outside of the eyeball (sclera), which gently indents the walls of the eye towards the detached retina. The eye surgeon can then use laser surgery or cryopexy to seal around the torn retina.
The healing process involves using eye drops to prevent eye infections. You’ll also need a protective covering and may require a cold pack to manage swelling for a few weeks. Painkillers can be helpful for eye pain, which should subside in a few days.
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Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.