From the Guidelines
Retinal tears are primarily caused by posterior vitreous detachment (PVD), a process where the vitreous gel inside the eye shrinks and pulls away from the retina, leading to traction that can tear the retina, particularly in areas where the vitreous is strongly adhered. This is supported by the study published in Ophthalmology in 2020 1, which highlights the relationship between PVD, retinal breaks, and lattice degeneration. The study notes that PVD typically occurs between the ages of 45 and 65 in the general population, with earlier onset in men, and may lead to vitreomacular traction, potentially causing mechanical distortion of the macula or retinal tears.
Risk Factors and Symptoms
Risk factors for retinal tears include:
- Aging (most common in people over 50)
- High myopia (severe nearsightedness)
- Previous eye surgery or trauma
- Family history of retinal detachment
- Certain eye conditions like lattice degeneration
- Inflammatory eye diseases and diabetic retinopathy Symptoms of retinal tears may include sudden flashes of light, new floaters, or a shadow in peripheral vision. Another study published in Ophthalmology in 2020 1 emphasizes the importance of early diagnosis and treatment of retinal tears to prevent progression to retinal detachment, which could lead to permanent vision loss.
Treatment and Prevention
Prompt treatment with laser photocoagulation or cryotherapy is essential for any suspected retinal tear, as it can prevent progression to retinal detachment and reduce the risk of retinal detachment to less than 5% 1. The treatment creates a controlled scar around the tear, effectively "welding" the retina to the underlying tissue and preventing fluid from entering through the tear. Immediate ophthalmological evaluation is crucial for any suspected retinal tear, and patients should be encouraged to have follow-up evaluations to monitor for any changes or progression of the condition.