Retinal Tear and Detachment

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Figure 1A

Figure 1B

Figure 1C
Figure 2A
Figure 2B
As previously described in the “How the Human Eye Works” section of this website, the vitreous is the clear gel that fills the inside cavity of the eye behind the lens of the eye. The vitreous is a firm semi-solid gel matrix that is 98% water and has a solid outside surface called the hyaloid. This hyaloid surface attaches everywhere to the retina.

As we grow older, the vitreous gel matrix breaks down with the solid parts of the gel separating from the fluid parts and the outside hyaloid surface separating from the retina. This process is what leads to the common symptoms of “flashes and floaters”. The flashes result from the hyaloid pulling on the retina; it is this tractional stimulation of the retina that produces the sensation of flashes of light. The floaters are the patient’s perception of the solid parts of the vitreous get floating around inside the liquid parts. It is normal for people to experience “flashes and floaters” as they get older and these symptoms usually subside over time.

However, a small percentage of eyes develop Retinal Tears because the hyaloidal traction on the retina is strong enough to actually tear it (Figure 1A). If the fluid part of the vitreous gel goes through the retinal tear, this can lead to Retinal Detachment. (Figure 2A). Therefore, any patient who notices new flashes and floaters should promptly have a thorough retinal examination to rule out these potentially vision threatening problems.

Both Retinal Tear and Retinal Detachment are treatable conditions. Furthermore, in the majority of cases the treatments can be safely and quickly performed in the office (Figures 1 B and C; Figure 2 B). However, surgery in the operating room may be necessary in many cases. Fortunately, the success rate is very high and vision is usually preserved following these interventions.

 

 
 
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