What are retinal tears, holes and detachments?

• The thin layer of tissue at the back of the eye, called the retina, can develop tears, holes or become separated from its underlying supportive tissue (retinal detachment)
• They are serious eye conditions which need to be assessed by a specialist promptly as they can lead to vision loss

What are the causes?

• As the vitreous humour shrinks or changes over time it can cause tension on the retina which can result in tears, holes or detachments to develop, this is more common in individuals over the age of 40
• Significant short sightedness (myopia) is a risk factor because the eye is longer and the retinal tissue is thinner causing it to be more vulnerable to tears or detachments
• Direct injury or minor trauma to the eye
• Severe diabetic retinopathy with scar tissue formation which causes traction on the retina
• There can be a genetic component, those with a strong family history are more prone to develop tears, holes or detachments
• A history of previous eye surgery, especially vitreous/retinal surgery, as this can weaken the retina

What are the symptoms?

• Sudden appearance of floaters (tiny specks or cobweb-like structures)
• Continuous flashes of light in the affected eye, especially when looking to the side
• A shadow or curtain-like obstruction in your peripheral (side) vision, which can progress towards the centre of your vision

What is the treatment?

• Laser retinopexy
  • It is used for small retinal tears or holes that haven’t progressed to detachment
  • The laser creates small burns around the edges of the tear to seal it and prevent fluid from getting behind the retina
  • It is a quick procedure which can be performed in rooms with local anaesthetic drops
• Retinal Cryopexy
  • Involves the use of extreme cold (freezing) instead of heat to seal the retinal tear
• Scleral Buckle
  • Performed in cases where the retina has partially detached
  • During this surgery, a silicone band or sponge is placed around the outer surface of the eye to push the wall of the eye against the detached retina, allowing it to re-attach
• Vitrectomy
  • In cases of severe retinal detachment, vitrectomy surgery may be necessary
  • During this procedure, the vitreous humour is removed, and any scar tissue or other obstructions are cleared from the eye
  • The surgeon may then replace the vitreous with a gas bubble, silicone oil, or a saline solution to re-attach the retina
  • Postoperative positioning – patients’ may need to maintain a specific head position for a period to ensure the gas bubble or silicone oil effectively pushes the retina back into place