When to treat a retinal tear

Treating a retinal tear can often prevent retinal detachment, but not all tears need treatment. The decision to treat a retinal tear depends on whether the tear is likely to progress to a detachment.

Symptoms are an important factor in deciding whether a retinal tear needs treatment. If a retinal tear does not cause symptoms, such as flashing lights, floaters, or visual defects, it is much less likely to develop into a retinal detachment than if symptoms are present.

The decision to treat a retinal tear sometimes depends on the size, shape, and location of the tear:

  • Large tears and horseshoe-shaped tears with flaps are likely to need treatment, because they often lead to detachments. These types of tears are often the result of posterior vitreous detachment, a condition in which the vitreous gel shrinks and separates from the retina.
  • Tears that are near the macula and are likely to get bigger may also need treatment, because these tears can damage central vision.
  • Small, round holes in the sides of the retina are repaired less often because most do not have any traction on them from the retina or the vitreous gel. Traction occurs when the vitreous gel is so strongly attached to the retina that it pulls on the retina, ripping it. As long as these holes are not causing symptoms, they are less likely to lead to retinal detachment.

If you have other risk factors, this also may help the doctor decide whether you need treatment. A retinal tear poses a higher risk of detachment if you have had a retinal detachment in the other eye, cataract surgery, or lattice degeneration or you are very nearsighted. Treating tears in people with these risk factors may help prevent retinal detachment.

Last Updated: August 26, 2009

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