A Retinal Tear Doesn’t Always Feel Like an Emergency
When most people imagine a serious eye problem, they expect pain, redness, or an obvious loss of vision. A retinal tear may not cause any of those things.
Some retinal tears produce noticeable warning signs such as flashes of light or a sudden increase in floaters. Other symptoms may be subtle, and occasionally a tear may be discovered during a dilated eye examination before a patient realizes anything is wrong. That can make retinal tears particularly concerning. Left untreated, some tears can allow fluid to travel underneath the retina and lead to a retinal detachment, a potentially vision-threatening emergency.
Understanding the warning signs and your individual risk can help you know when it is time to seek care.
What Is a Retinal Tear?
The retina is a thin layer of light-sensitive tissue lining the back of the eye. It converts light into signals that travel to the brain, allowing you to see.
The center of the eye is filled with a clear, gel-like substance called the vitreous. As we age, the vitreous naturally becomes more liquid and begins to shrink. Eventually, it may separate from the retina in a process known as a posterior vitreous detachment, or PVD. This is a common age-related change and frequently occurs without serious complications.
However, if the vitreous is firmly attached to an area of the retina, it can pull hard enough during separation to create a tear.
What Does a Retinal Tear Feel Like?
One of the surprising things about a retinal tear is that it usually does not hurt. The retina does not respond to injury with pain in the way that the surface of the eye might. Instead, patients are more likely to notice changes in what they see. Common symptoms can include:
- Sudden flashes of light
- A noticeable increase in floaters
- A shower of small spots appearing in the vision
- New cobweb-like shapes
- Blurred or hazy vision
Some people describe flashes as brief streaks, sparks, or lightning in the peripheral vision. These symptoms do not automatically mean you have a retinal tear. Changes in the vitreous can also produce flashes and floaters without damaging the retina.
The problem is that you cannot reliably tell the difference based on symptoms alone.
Can You Have a Retinal Tear Without Symptoms?
Yes. Although many retinal tears produce symptoms, some can be asymptomatic. A tear may occasionally be identified during a routine dilated examination or while a retina specialist is evaluating the eye for another reason.
Symptoms can also be mild enough that a person dismisses them. A few new floaters may not seem important, particularly for someone who has experienced floaters for years. This is why the word new matters.
A sudden change in the number or appearance of your floaters, particularly when accompanied by flashes of light, deserves prompt attention.
Who Is More Likely to Develop a Retinal Tear?
Retinal tears can occur in anyone, but certain factors can increase the likelihood. Risk may be higher in people who:
- Are significantly nearsighted
- Have experienced a posterior vitreous detachment
- Have previously had a retinal tear or retinal detachment
- Have a family history of retinal detachment
- Have undergone certain eye surgeries, including cataract surgery
- Have experienced significant eye trauma
- Have areas where the peripheral retina is thinner or more vulnerable
Age also matters because changes in the vitreous become increasingly common over time. Your ophthalmologist or retina specialist can help you understand whether your individual eye history places you at greater risk.
What Is the Difference Between a Retinal Tear and a Retinal Detachment?
These terms are sometimes used interchangeably by patients, but they describe different problems. A retinal tear is a break or opening in the retina.
A retinal detachment occurs when the retina separates from the tissue beneath it.
A tear can create an opening that allows fluid to move underneath the retina. As more fluid accumulates, the retina may begin to detach.
Not every retinal tear progresses to a retinal detachment, but identifying certain tears early can provide an opportunity for treatment before a detachment develops.
What Happens if the Retina Begins to Detach?
As a retinal detachment progresses, symptoms may become more dramatic. A patient may notice a shadow, curtain, or dark area moving across the field of vision. Peripheral vision may begin to disappear, and central vision can eventually become affected depending on the location and extent of the detachment.
A retinal detachment requires urgent medical attention. Waiting to see whether these symptoms improve on their own can allow the detachment to progress and may affect the chances of preserving vision.
How Does a Retina Specialist Find a Retinal Tear?
A comprehensive dilated retinal examination allows the physician to carefully examine the peripheral retina, where many tears occur. Because these areas are far from the center of the retina, a retinal tear may not be visible during a basic vision test or by simply looking at the front of the eye.
Your physician may use specialized lenses and examination techniques to evaluate the retina. Additional imaging or ultrasound may sometimes be used depending on the circumstances, particularly if blood or another condition makes it difficult to see the retina clearly.
How Are Retinal Tears Treated?
Treatment depends on the type, location, symptoms, and characteristics of the tear. When treatment is recommended, laser photocoagulation or cryotherapy may be used to create a barrier around the retinal tear. The resulting adhesion helps reduce the likelihood that fluid will travel through the tear and cause the retina to detach.
These treatments do not simply “erase” the tear. Instead, they are designed to secure the retina around the affected area.
Some retinal findings may be monitored rather than treated immediately. Your retina specialist will determine the appropriate approach based on your individual examination.
Does Treatment Mean the Risk Is Completely Gone?
Treatment can substantially reduce the risk associated with a retinal tear, but continued monitoring may still be important. A person who develops one retinal tear can sometimes develop another tear in a different area. The vitreous may also continue changing after the initial symptoms or treatment.
Follow-up examinations allow your physician to make sure the treated area remains stable and check for additional retinal changes.
Patients should also continue paying attention to new symptoms, even after treatment.
Know the Symptoms That Require Prompt Attention
Contact an eye care professional promptly if you develop:
- A sudden increase in floaters
- New flashes of light
- A shower of spots in your vision
- New blurred or hazy vision
- A shadow or curtain across your field of vision
- Sudden loss of peripheral vision
- Sudden or significant vision loss
If you have already been evaluated for flashes or floaters but your symptoms suddenly worsen, contact your eye care provider again. Changes can occur after an initial examination, and new symptoms may warrant another look at the retina.
Early Detection Can Help Protect Your Sight
A retinal tear may be small, painless, and difficult to recognize on your own. What makes it important is what can happen next.
Identifying and treating an appropriate retinal tear before it progresses to retinal detachment can make a significant difference in protecting vision.
At Mississippi Retina Associates, our physicians specialize in diseases and conditions affecting the retina and vitreous. If you experience sudden flashes, new floaters, a curtain or shadow in your vision, or another sudden visual change, prompt evaluation can help determine what is happening inside the eye and whether treatment is needed.
