A retinal tear is a tear in the retinal lining. It occurs when the vitreous jelly traction on the retina causes a rip, such as a tear in wallpaper. This requires urgent treatment as the tear may enlarge in size and the retinal lining may detach. This is caused by the fluid from the vitreous jelly leaking under the retina, causing it to lift off. This is like wallpaper falling off a wall due to inadequate adhesion. This may be associated with some haemorrhage into the vitreous jelly.
Treatment for a retinal tear usually involves laser treatment. This is usually done in the consulting rooms. The laser beam causes a seal around the retinal tear, in a similar way to welding. During the treatment, It is important to look where directed and not look directly at the laser beam as this powerful beam of light can burn the central vision if you look directly at the laser beam. It is important to stop any medication (such as Aspirin or Warfarin) that may thin the blood, as this may cause further bleeding around the retinal tear. It is important to check with your doctor before stopping these medications.
Cryotherapy may be performed in conjunction with laser if the tear is too large for the laser treatment alone. This is usually performed in an operating theatre and is often done as a day procedure. The cryotherapy probe allows more powerful treatment to cause a reaction around the retinal tear to seal it.
The laser treatment has a success rate of approximately 90 to 95%. Most retinal tears are effectively treated and usually do not require re-treatment. There are some patients in whom the retinal tear may enlarge despite treatment and these may require further laser or cryotherapy. If a retinal detachment develops, then surgery will be required.
The patient should rest for approximately three days after the treatment, avoiding any heavy lifting or anything that may increase the blood pressure. If you suffer from hypertension, then it is important to get this checked by your General Practitioner.
Following the laser treatment, your vision will be blurry and the eye may ache. This usually settles over a few hours. You may take analgesics such as Panadol or Panadeine, but it is important to avoid aspirin.
You may still see flashes of light and floaters after the laser treatment. This should settle with time, but may take some weeks to months. In some cases, an occasional flash of light of floater may persist, which usually does not cause any problem.
You should watch out for any sudden onset of new flashes or floaters. It is also important to watch out for loss of vision or the impression that a curtain is coming down or going up in your line of vision. These symptoms may mean progression of the retinal tear, or the development of a retinal detachment. If you have any of these symptoms, please contact City Eye Centre on 3831 6888 as soon as possible.
Most patients take one to three days off work. If your work involves heavy lifting and straining, then a longer period of up to a week may be required.
A follow up appointment a week after the treatment is required. If there is an associated vitreous haemorrhage with a retinal tear, you may require closer monitoring. Once the retinal tear is treated, the vitreous haemorrhage should clear, though it may still take up to several weeks to some months to fully clear. The blood in the vitreous jelly usually gravitates to the bottom of the eye and is reabsorbed. If you shake your head, the vitreous haemorrhage may circulate again into the centre of the visual axis and you may notice a floater again. Any increase in the floaters should be reported as this may mean that there is further bleeding from the retinal tear.