Tears & Detachment

Tears and Detachment Care in Chattanooga, Knoxville, and the Tri-Cities Region

Despite its integral role in enabling the sense of sight, the retina is a very delicate structure, vulnerable to many disorders and issues. One of the more serious conditions of the retina is retinal tears, which are when holes or breaks form in the retinal tissue. This can progress to an even more serious condition known as retinal detachment, which occurs when the retina is peeled off the back wall of the eye and out of position. Both retinal tears and retinal detachments cause the retina to stop functioning properly, contributing to vision problems and potentially permanent blindness. Retinal tears and detachment are emergencies, requiring immediate treatment.

At Southeastern Retina Associates, our retina specialists and surgeons have an accumulated experience of over 237 years providing advanced retinal care to patients throughout Tennessee and the entire Tri-Cities region. If you have a retinal tear or detachment, we have the equipment and expertise necessary to diagnose and treat it, giving you the best chance of preserving your vision.

DISCLAIMER:  Please note that the following information is for educational purposes only and is not a substitute for professional medical advice.

Retinal Tear Causes and Risk Factors

Retinal tears usually develop as a result of normal aging, specifically from a condition called posterior vitreous detachment (PVD). This targets your vitreous (also called vitreous gel or humor), a clear, sticky, gel-like substance that fills the eye. PVD happens naturally as we age, causing the vitreous to shrink, become more liquid, and lose its thickness.

Many people never experience any complications related to PVD, but for some, particularly if their vitreous is particularly sticky, it can get stuck on the retina and pull on it as it retracts, causing a spontaneous tear. Once tears are present, vitreal fluid can leak behind the retina; if not repaired, this can result in either partial or full retinal detachment.

Other causes and risk factors for retinal tears include:

  • Trauma
  • Eye surgery
  • Severe nearsightedness
  • Genetic predisposition
  • Peripheral retinal degeneration, such as lattice degeneration
  • Diabetic retinopathy-related complications
  • Ocular inflammation or infection
  • Certain medications

Types of Retinal Detachment

There are three types of retinal detachment based on specific causes.

Rhegmatogenous Retinal Detachment

The most common type, rhegmatogenous retinal detachment stems from minuscule retinal tears or breaks in your retina. While the leading cause is PVD, rhegmatogenous detachments may also form because of myopia (nearsightedness), eye injuries, or having had eye surgery.

Tractional Retinal Detachment

Tractional retinal detachments are caused by scar tissue developing on the retina. This type of detachment is often associated with diabetic retinopathy, which can cause scar tissue to form and tug on the retina, disconnecting it from the back of the eye. This is another reason why people with diabetes must have comprehensive dilated eye exams, regularly and practice proper diabetes management.

Exudative Retinal Detachment

Exudative retinal detachment occurs when fluid accumulates behind your retina without causing tears or breaks, and forces the retina out of place. This type usually occurs when blood vessels leak or swell in the back of the eye. It is caused by a wide range of factors, including trauma, eye tumors, intraocular inflammation, age-related macular degeneration (AMD), and Coats disease.

Retinal Tear and Detachment Signs and Symptoms

Both retinal tears and detachments are painless. In some cases, small retinal tears may have no noticeable symptoms at first, however, as the tear gets bigger, symptoms will be more likely. These symptoms will suddenly get more intense right before the retina completely detaches, so if you experience a sudden proliferation of the following, it could be a sign of an impending retinal detachment. These symptoms include:

  • New eye floaters
  • Flashing lights in your field of vision
  • Shadows or blurriness in your peripheral vision
  • A gray curtain obscuring a portion of your field of vision

If you experience any of these symptoms, connect with a retina specialist immediately.

Treatment for Retinal Tears and Detachment

In some cases, retinal tears may be small or stable enough to only require monitoring as treatment. In other cases, the typical treatment options are laser surgery or cryotherapy (freezing), both performed at the retinal clinic. These procedures are performed to seal tears, secure the retina in place, and help prevent full detachments.

For retinal detachments, surgery is necessary. Typical procedures include:

  • Scleral buckle, in which a flexible piece of material is implanted into the eye with the intent of pushing the sclera (the eye’s white part) against the retina, securing the retina in place. During this procedure, any vitreal liquid that seeped under the retina is removed.
  • Vitrectomy is a procedure involving the removal of the vitreous, partial or complete, from the eye. This allows your surgeon to repair the detached retina or remove the force that’s moved it out of place. The vitreous is typically replaced with a gas bubble.
  • Pneumatic retinopexy, often performed along with laser therapy or cryotherapy, involves a gas bubble being injected into the vitreous cavity. This pushes and closes the torn retina, allowing new fluid to fill the eye as you heal.

Retinal Tears and Detachment FAQ

  • Anyone at any age can suffer a retinal tear or detachment. A common condition, retinal tears affects about 10% of people. It’s been shown that usually, within two months of retinal tear symptoms appearing, 10% of affected eyes go on to develop subsequent retinal tears. With a new retinal tear, the risk of retinal detachment is about 7%.

  • If caught and addressed early, retinal tears and detachments can often be treated successfully. However, be aware that any progress can take time. If the retina has suffered excessive damage, your vision may not return at all. Additionally, no matter how early the care is provided, blindness can occur, particularly among those with extensive scar tissue.

  • A retinal redetachment is when a previously repaired retinal detachment reoccurs. This can happen despite successful initial treatment and may require further intervention. Retinal redetachment can occur due to various reasons, such as the development of new tears in the retina, incomplete sealing of existing tears during the initial surgery, or the progression of underlying eye conditions.

  • Determining the appropriate surgical technique for retinal detachment involves considering various factors, including age, overall health, the number and location of tears, the size of the detachment, and the degree of nearsightedness. Factors such as the presence of a vitreous hemorrhage, lattice degeneration, the status of your natural lens, or whether you have undergone cataract surgery can also impact the choice of procedure.