Torn Retina - Causes, Diagnosis, and Treatment

Introduction

The eyes are a complex organ responsible for vision and capable of changing environments and situations accordingly. The eyes are supplied by an ophthalmic artery which divides into branches to supply different eye parts.

The main components of the eye are the cornea, pupil, iris, lens, retina, and optic nerve. Each component plays a significant role in creating an image for vision. The light enters the eye through the cornea and passes through the iris and lens, from where the light will be directed towards the retina, and this retinal layer will send the information to the brain to form an image for vision. All these components are prone to infections and injuries. Infections can denote an underlying medical condition also.

Between the lens and the retinal layer, a vitreous body is present, responsible for giving shape to the eye and maintaining a space for letting the light pass through it to reach the retina. As a person ages, this vitreous layer will become thin and shrink. In some cases, the layer will be stuck to the retina, and thus it pulls away, causing retinal tears. Apart from this, a few medical conditions are also believed to cause retinal tears. Retinal tears can cause issues with vision, and it needs immediate attention. A torn retina will present with a collection of blood and fluid and has to be treated with utmost precision. If left untreated, a torn retina will become a retinal detachment capable of causing permanent blindness. This article will discuss the causes, risk factors, diagnosis, and management of retinal tears.

What Are the Causes of Torn Retina?

One of the most common causes of a retinal tear is.

• The retina and lens have an in-between content called a vitreous body which generally contains gel. The vitreous gel is also called vitreous humor and is responsible for giving a shape to the eye, acts as a shock absorber, and lets the light focus on the retina by offering a clear space. It is a transparent gel.

As a person ages or after having an injury to the eye, this gel will become fluid; thus, the layer will become thin and it shrinks. This layer will sometimes be attached to the retinal layer, and when it tries to pull away from the back of the eye, the retinal layer will tear.

Sometimes, an underlying medical condition can also be associated with retinal tears, and they are,

• Diabetes - High sugar levels.

• Nearsightedness - It is also known as myopia. It is a condition in which the objects placed nearby can be seen clearly, whereas farther objects become blurry.

• Sickle Cell Disease - It is an inherited disorder in which an inherited gene will affect the red blood cells and give them a sickle shape. Normal red blood cells have a round shape. In the case of this disease, the cells will become hard and form a sickle shape. These sickle cells are found to die early, and thus there will be a shortage of cells. Also, when these cells tend to pass through the blood vessels, they will get stuck and obstruct the flow, causing stroke and other diseases.

• Retinal Degeneration - The cells of the retinal layer will die, causing degeneration of the retina. This could become permanent damage if not treated at the right time. It is a genetic disorder but can be triggered by smoking, high blood sugar and pressure, light eye, and skin color, taking a lot of saturated fats, etc.

• Retinopathy - This includes diseases of the retinal layer that includes the blood vessels supplying the layer. The main causative factors are uncontrolled blood sugar and pressure levels.

• A history of eye injury.

• A history of a torn retina or detached retina.

• Cancer.

• Inflammatory conditions.

What Are the Symptoms of a Torn Retina?

Generally, a torn retina will present as a collection of blood and fluid. The symptoms include,

• The first sign of a retinal detachment (untreated retinal tear results in retinal detachment) would be the sudden light flashes.

• Floaters (gray or black strings seen moving) will increase in number and size.

• The patient can see a moving black or gray curtain across the eyes.

• Blurred vision and will have trouble focusing on things.

• Headache.

• A shadow appears in the peripheral part of the vision field.

What Are the Risk Factors For Having a Torn Retina?

• People on medications like pilocarpine for treating glaucoma are at a higher risk of having a torn retina.

• Familial history of retinal tear or detachment.

• History of an eye injury or eye surgery.

• People wearing glasses to correct nearsightedness.

How to Diagnose a Torn Retina?

An ophthalmologist will examine the eyes by placing a few drops of dilating solution to dilate the pupil. After widening the pupil, the doctor will study the changes in the structure using a special instrument. In case of bleeding, an ultrasound will be done to assess the changes in the retinal layer.

How to Treat a Torn Retina?

Two standard management techniques to correct a torn retina are photocoagulation and cryopexy.

• Photocoagulation - Photocoagulation is laser treatment. It is done to seal the torn retinal layer to prevent fluid and blood leakage. It is basically done to avoid retinal detachment, as this condition is capable of causing vision loss. The doctor will start the procedure by numbing the site and dilating the pupil. A lens will be placed in front of the eyes to focus the laser precisely. The doctor will make a few scar sites on the retinal layer, which will seal the layer and prevent fluid and blood leakage through the layer. Post-treatment, the patient might feel mild pain for two to three days, and it will subside on its own.

• Cryopexy - This treatment involves the use of extreme cold to seal the retina. A cold will be applied to the torn retinal layer to freeze with a probe-like instrument, forming scar tissue. This scar tissue will seal the retinal layer.

What Are the Post-treatment Side-Effects?

Occasionally, these procedures can cause a few complications.

• Pressure increases in the eye resulting in glaucoma.

• Bleeding can be seen at times in the eye.

• Rarely will the tear not seal.

• Infection of the eye.

Conclusion

All the retinal tears do not require treatment. Mild cases showing no symptoms can be left as such because most cases will heal independently by forming adherence. In case of serious symptoms, consult an ophthalmologist to treat the condition and prevent complications.